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覆盖义齿治疗能多快改善萎缩性无牙颌患者的咀嚼功能和 OHRQoL?一项为期 1 年的纵向临床研究。

How fast can treatment with overdentures improve the masticatory function and OHRQoL of atrophic edentulous patients? A 1-year longitudinal clinical study.

机构信息

Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil.

Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.

出版信息

Clin Oral Implants Res. 2018 Feb;29(2):215-226. doi: 10.1111/clr.13101. Epub 2017 Dec 7.

Abstract

OBJECTIVES

The aim of this prospective clinical study was to evaluate the masticatory function (MF) and subjective perception of patients with poor denture-bearing tissue in relation to change and the time required to identify an improvement in these parameters after rehabilitation with mandibular overdentures (MO) by two narrow-diameter two-piece implants.

MATERIAL AND METHODS

Twenty-three edentulous patients were selected for MO installation. The masticatory function (MF) was evaluated with the masticatory performance (MP) and swallowing threshold (ST) tests. In the MP test, each volunteer was instructed to masticate a portion of Optocal (standardized artificial test food) for 40 masticatory cycles. During the swallowing threshold test, the patients were instructed to chew a new portion of Optocal cubes until they felt the desire to swallow. The MF tests were performed while complete denture (CD) wearers (baseline) and 1, 3, 6, and 12 months after MO loading. In addition, the subjective perception was assessed through the questionnaires Dental Impact on Daily Living (DIDL), Geriatric Oral Health Assessment Index (GOHAI), and Oral Health Impact Profile in Edentulous (OHIP- EDENT) at the baseline and 3, 6, and 12 months after MO loading.

RESULTS

A significant improvement in masticatory function (p < .05) was observed already in the first month of loading. Three months after MO loading, a significant improvement (p < .05) was found in the subjective perception of patients. The effect size indicates that the MO had the greatest impact on the domains related to function and comfort of all questionnaires and in relation to psychosocial domain of the GOHAI. The level of patient satisfaction increased significantly after the MO loading and reached >90% satisfied patients at 12 months.

CONCLUSION

The MO improved both the MF of the patient and their oral health-related quality of life and satisfaction regarding the prosthesis in a short time period.

摘要

目的

本前瞻性临床研究旨在评估在使用 2 个窄径两段式种植体行下颌覆盖义齿修复后,咀嚼功能(MF)和主观感知发生的变化,并评估患者戴用下颌覆盖义齿后这些参数改善所需的时间,这些患者的牙槽嵴组织条件较差,无法支持传统全口义齿。

材料与方法

选择 23 名无牙颌患者安装下颌覆盖义齿。咀嚼功能(MF)通过咀嚼效能(MP)和吞咽阈(ST)测试进行评估。在 MP 测试中,每位志愿者被要求咀嚼 Optocal(标准化人工测试食物)40 次。在吞咽阈测试中,患者被要求咀嚼新的 Optocal 方块,直到他们有吞咽的欲望。MF 测试在患者戴用全口义齿时(基线)以及下颌覆盖义齿戴用 1、3、6 和 12 个月时进行。此外,还通过戴用下颌覆盖义齿前和戴用后 3、6 和 12 个月的日常生活影响牙科量表(DIDL)、老年人口腔健康评估指数(GOHAI)和无牙颌口腔健康影响量表(OHIP-EDENT)评估主观感知。

结果

在加载后的第一个月,MF 就有了显著的改善(p <.05)。在下颌覆盖义齿戴用 3 个月后,患者的主观感知有了显著的改善(p <.05)。效应量表明,下颌覆盖义齿对所有问卷中与功能和舒适度相关的领域以及 GOHAI 的心理社会领域的影响最大。患者满意度在戴用下颌覆盖义齿后显著提高,在 12 个月时达到>90%的患者满意。

结论

在短时间内,下颌覆盖义齿不仅改善了患者的 MF,还提高了他们的口腔健康相关生活质量和对义齿的满意度。

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