School of Dentistry, Federal University of Pelotas, RS, Brazil.
Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, RS, Brazil.
J Prosthodont. 2019 Jul;28(6):634-642. doi: 10.1111/jopr.13070. Epub 2019 May 22.
To investigate the influence of impaired masticatory function on the oral health-related quality of life of conventional complete denture wearers before and after the transition to implant-retained mandibular overdentures.
Masticatory function and oral health-related quality of life were evaluated in 40 edentulous patients after 3 months of adaptation to complete dentures and after transition to implant-retained mandibular overdentures. Masticatory function was evaluated through the swallowing threshold test with a standardized portion of an artificial test food (Optocal) to determine median particle size (×50) and homogenization index (B). After the test, the masticatory function outcomes were used to categorize patients in 2 groups according to chewing performance: (i) satisfactory or (ii) unsatisfactory. The cutoff value for ×50 was based on a preestablished value of 3.68 mm, whereas for the B index, median values were adopted for categorization. The oral health-related quality of life was analyzed via the Oral Health Impact Profile for Edentulous Adults (OHIP-EDENT) questionnaire. The Mann-Whitney test was used to compare masticatory function outcomes and OHIP-EDENT scores, and associations were checked using the Spearman correlation test and multiple linear regression.
Masticatory function was significantly correlated with functional limitation (p = 0.02) and physical disability (p = 0.04) for complete denture wearers with unsatisfactory masticatory function. After the transition to implant-retained mandibular overdentures, only the psychological discomfort domain (p = 0.02) was influenced by the masticatory function category. Multiple linear regression analysis revealed that only the functional limitation domain (p < 0.001) of the complete denture wearers was associated with masticatory function outcomes.
Implant-retained mandibular overdentures eliminate the problems that lead to functional limitations, consequently improving masticatory function and oral health-related quality of life of these individuals; however, patients with unsatisfactory masticatory function after transition to implant-retained mandibular overdentures still experience more psychological discomfort.
研究咀嚼功能障碍对常规全口义齿佩戴者在过渡到种植体支持下颌覆盖义齿前后的口腔健康相关生活质量的影响。
40 名无牙颌患者在适应全口义齿 3 个月后和过渡到种植体支持下颌覆盖义齿后,评估咀嚼功能和口腔健康相关生活质量。通过吞咽阈值试验,用标准化的人工测试食物(Optocal)来评估咀嚼功能,以确定中值粒径(×50)和均化指数(B)。试验后,根据咀嚼性能将患者分为 2 组:(i)满意或(ii)不满意。×50 的截止值基于预先确定的 3.68mm 值,而 B 指数则采用中位数进行分类。口腔健康相关生活质量通过成人无牙颌口腔健康影响量表(OHIP-EDENT)问卷进行分析。采用 Mann-Whitney 检验比较咀嚼功能和 OHIP-EDENT 评分,采用 Spearman 相关检验和多元线性回归检查相关性。
咀嚼功能与不满意咀嚼功能的全口义齿佩戴者的功能障碍(p=0.02)和身体残疾(p=0.04)显著相关。过渡到种植体支持下颌覆盖义齿后,只有心理不适域(p=0.02)受咀嚼功能类别的影响。多元线性回归分析显示,只有全口义齿佩戴者的功能障碍域(p<0.001)与咀嚼功能结果相关。
种植体支持下颌覆盖义齿消除了导致功能障碍的问题,从而改善了这些患者的咀嚼功能和口腔健康相关生活质量;然而,过渡到种植体支持下颌覆盖义齿后咀嚼功能不满意的患者仍经历更多的心理不适。