Bera Alak Kumar, Das Samiran, Bhattacharyya Jayanta, Majumdar Sayan, Ghosh Saumitra, Goel Preeti
Department of Prosthodontics and Crown and Bridge, Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India.
J Indian Prosthodont Soc. 2018 Oct-Dec;18(4):343-355. doi: 10.4103/jips.jips_80_17.
Altered orofacial morphology and poor dental status affects the dietary intake of cleft patient, making susceptible to nutritional imbalance. Oral health care planning for this population is impossible without the evaluation of stomatognathic functional status as well as prosthetic and nutritional status and need.
The aim of this study was to evaluate prosthetic status and prosthetic treatment need, bite force and nutritional status, in adult cleft patients and to compare them with the adult noncleft population of similar definition.
Cleft ( = 250) and noncleft ( = 250) individuals of either sex, aged 18 years or above, excluding severe medically compromised and differently abled, were examined and individual biteforce was measured after obtaining written consent and ethical clearance from the two institutions in Kolkata.
A "raw data sheet" was prepared according to the parameters of the "Oral Health Surveys: Basic methods," World Health Organization (1997) for evaluation of prosthetic status and need, dentition status and Mini-Nutritional Assessment, Nestlé (1994) for the evaluation nutritional status. A Gnathodynamometer was used to record bite force.
Statistical analysis was performed using SPSS 20.0.1, Graph Pad Prism version 5, Student's -test, and Chi-square test.
The mean bite force of frontal area in cleft group (3.4356 ± 0.9457 kgf) was found to be significantly lower ( < 0.0001) than in noncleft (22.8749 ± 5.3644 kgf) group. The difference of mean bite force in the right side (2.4576 ± 0.6131 kgf) and left side (1.2708 ± 0.1036 kgf) in cleft group was found to be statistically significant ( < 0.0001). Prosthetic need in maxillary arch was found to be significantly (χ: 490.0000; < 0.0001) higher in cleft than in noncleft group. Nutritional status was observed to be significantly (χ: 179.4049; < 0.0001) higher "at risk" in cleft than in noncleft group.
Lack of adequate Government concern leading to significantly higher prosthetic need and lower prosthetic status, hence lower bite force resulting lower nutritional status in adult cleft patients in Kolkata.
口面部形态改变和牙齿状况不佳会影响唇腭裂患者的饮食摄入，使其易出现营养失衡。如果不评估口颌系统功能状态以及修复和营养状况与需求，就无法为该人群制定口腔保健计划。
本研究的目的是评估成年唇腭裂患者的修复状况和修复治疗需求、咬合力和营养状况，并将其与定义相似的成年非唇腭裂人群进行比较。
对年龄在18岁及以上、排除严重医疗并发症和残疾的250名唇腭裂患者和250名非唇腭裂患者（男女不限）进行检查，并在获得加尔各答两家机构的书面同意和伦理批准后测量个体咬合力。
根据世界卫生组织（1997年）《口腔健康调查：基本方法》的参数编制一份“原始数据表”，用于评估修复状况和需求、牙列状况；根据雀巢公司（1994年）的《微型营养评定》评估营养状况。使用咬力计记录咬合力。
使用SPSS 20.0.1、Graph Pad Prism 5版、学生t检验和卡方检验进行统计分析。
唇腭裂组额部平均咬合力（3.4356±0.9457千克力）显著低于非唇腭裂组（22.8749±5.3644千克力）（P<0.0001）。唇腭裂组右侧（2.4576±0.6131千克力）和左侧（1.2708±0.1036千克力）的平均咬合力差异具有统计学意义（P<0.0001）。发现唇腭裂组上颌弓的修复需求显著高于非唇腭裂组（χ²：490.0000；P<0.0001）。观察到唇腭裂组“有风险”的营养状况显著高于非唇腭裂组（χ²：179.4049；P<0.0001）。
政府缺乏足够关注导致加尔各答成年唇腭裂患者的修复需求显著更高、修复状况更低，因此咬力更低，营养状况也更低。
