口腔修复治疗部分牙列缺失患者的口腔健康相关生活质量：系统评价和荟萃分析。

Oral health-related quality of life after prosthodontic treatment for patients with partial edentulism: A systematic review and meta-analysis.

机构信息

Specialty registrar, Department of Restorative Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, and Doctoral student, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom.

Professor of Psychology as applied to Dentistry, School of Clinical Dentistry, The University of Sheffield, Sheffield, United Kingdom.

出版信息

J Prosthet Dent. 2019 Jan;121(1):59-68.e3. doi: 10.1016/j.prosdent.2018.03.003. Epub 2018 Jul 10.

DOI:10.1016/j.prosdent.2018.03.003

PMID:30006220

Abstract

STATEMENT OF PROBLEM

Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated.

PURPOSE

The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments.

MATERIAL AND METHODS

Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implant-supported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardized mean change, 95% confidence intervals).

RESULTS

Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled standardized mean change OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases.

CONCLUSIONS

TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP.

摘要

问题陈述

目前，临床医生无法量化修复治疗对牙齿缺失的社会心理、功能和美观影响。了解治疗对牙齿缺失的口腔健康相关生活质量（OHRQoL）的影响对于知情同意至关重要。因此，需要对使用修复体替代牙齿的 OHRQoL 改善的证据进行系统评价，并对不同治疗方式的结果进行比较。

目的

本系统评价的目的是检查不同牙列缺损修复治疗后患者的 OHRQoL。

材料与方法

通过电子数据库和手工检索，确定了报告接受种植体支持冠（ISC）、种植体支持固定义齿（IFDP）、种植体支持可摘局部义齿（IRDP）、牙支持固定义齿（TFDP）和可摘局部义齿（RPD）的个体 OHRQoL 的队列研究和临床试验。两位评审员独立进行文章选择、数据提取和质量评估。使用随机效应模型比较 OHRQoL 变化评分（标准化均数差，95%置信区间）。

结果

在 2147 项已识别的研究中，有 2 项随机对照试验和 21 项队列研究符合纳入标准。总体而言，研究的偏倚风险较低或中度。TFDP 的 OHRQoL 变化的平均合并值≤9 个月为 15.3，RPD 为 11.9，IFDP 为 14.9。TFDP 和 IFDP 的 OHRQoL 变化>9 个月的合并标准化均数变化分别为 13.2 和 15.8。在 9 个月内，TFDP 与 IFDP 之间以及 RPD 与 IFDP 之间的直接比较均明显有利于 IFDP。