Associate Professor, Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas (UFPel), Pelotas, Brazil.
Doctoral student, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas (UFPel), Pelotas, Brazil.
J Prosthet Dent. 2019 Nov;122(5):450-458. doi: 10.1016/j.prosdent.2019.01.021. Epub 2019 Apr 1.
Although implant-retained mandibular overdentures (IMOs) provide functional benefits, the influence of the vertical facial pattern (FP) and the anteroposterior skeletal discrepancy (ASD) on the masticatory function and patient-centered outcomes during the transition to IMOs is still uncertain.
The purpose of this interventional clinical study was to evaluate the influence of the FP and ASD on the masticatory function, oral health-related quality of life (OHRQoL), and satisfaction of completely edentulous patients before and after transition to IMOs.
Cephalometric analysis was performed on 42 participants before treatment. Ricketts analysis was used to classify the FP, and the maxillomandibular relationship to the base of the skull determined the ASD. Masticatory performance (MP) and swallowing threshold (ST) test results were evaluated by the multiple sieve method by using artificial test food (Optocal cubes) to determine the median particle size (×50), homogenization index (B), and masticatory efficiency based on sieves 5.6 (ME: 5.6) and 2.8 (ME: 2.8). OHRQoL and satisfaction were evaluated by using the Dental Impact on Daily Living questionnaire. The data were analyzed using mixed-effects linear regression models to estimate the effect of time, FP, ASD, age, and sex on MP, ST, and OHRQoL.
The MP, ST, OHRQoL, and satisfaction improved significantly after IMO loading, irrespective of FP and ASD. However, MP outcomes were most negatively affected mainly among dolichofacial (B and ME: 2.8), class II, and class III (×50, B, and ME: 2.8) participants. The ST test showed that class II participants still showed inferior ×50 values and performed a lower number of cycles than class I and class III participants. Women presented reduced masticatory function for all MP and ST outcomes and reported lower coefficients for appearance and general performance domains than men.
The MP test detected more subtle improvements than the ST test, especially in class III participants. The class II participants benefited the least from the IMO installation according to the ST test. The IMO treatment improved the OHRQoL and satisfaction of edentulous patients, irrespective of the FP or ASD.
尽管种植体支持的下颌覆盖义齿（IMOs）提供了功能益处，但垂直面型（FP）和前后向骨骼差异（ASD）对咀嚼功能以及向 IMO 过渡期间患者为中心的结果的影响仍不确定。
本介入性临床研究的目的是评估 FP 和 ASD 对面部无牙患者向 IMO 过渡前后咀嚼功能、口腔健康相关生活质量（OHRQoL）和满意度的影响。
42 名参与者在治疗前进行了头颅侧位片分析。Ricketts 分析用于分类 FP，上下颌骨与颅底的关系确定 ASD。通过使用人工测试食品（Optocal 立方体）进行多次筛检法评估咀嚼性能（MP）和吞咽阈值（ST）测试结果，以确定中值粒径（×50）、均化指数（B）和基于筛网 5.6（ME：5.6）和 2.8（ME：2.8）的咀嚼效率。使用 Dental Impact on Daily Living 问卷评估 OHRQoL 和满意度。使用混合效应线性回归模型分析数据，以估计时间、FP、ASD、年龄和性别对 MP、ST 和 OHRQoL 的影响。
无论 FP 和 ASD 如何，IMO 加载后 MP、ST、OHRQoL 和满意度均显著改善。然而，主要是在长面型（B 和 ME：2.8）、II 类和 III 类（×50、B 和 ME：2.8）参与者中，MP 结果受到的负面影响最大。ST 测试显示，II 类参与者的×50 值仍较低，并且比 I 类和 III 类参与者完成的循环次数更少。女性的所有 MP 和 ST 结果的咀嚼功能都较差，并且在外观和一般表现领域的评分系数都低于男性。
MP 测试比 ST 测试检测到更细微的改善，尤其是在 III 类参与者中。根据 ST 测试，II 类参与者从 IMO 安装中获益最小。IMO 治疗改善了无牙患者的 OHRQoL 和满意度，与 FP 或 ASD 无关。
