Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Removable Prosthodontic Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
Professor, Oral and Maxillofacial Prosthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Removable Prosthodontic Department, Faculty of Oral and Dental Medicine, Minia University, Minia, Egypt.
J Prosthet Dent. 2021 Apr;125(4):636-644. doi: 10.1016/j.prosdent.2020.07.006. Epub 2020 Sep 4.
Studies on the impact of incorporating attachments in removable prostheses on patient-based outcomes are scarce.
The purpose of this clinical study was to investigate oral health-related quality of life (OHRQoL) and patient satisfaction in partially edentulous participants before and after rehabilitation with mandibular attachment-retained removable prostheses as compared with conventional removable prostheses.
This crossover study included 74 participants (aged 36 to 57). Initially, 56 received conventional clasp-retained removable dental prostheses (RDPs), and 18 received conventional overdentures (ODs) based on their mandibular partially edentulous state. Two months later, of the 56 RDP participants, 24 had received extracoronal attachment-retained RDPs, 17 received telescope-retained RDPs, and 15 received bar-attachment retained RDPs. The 18 OD participants received ball attachment-retained ODs. Assessments included Oral Health Impact Profile-short version-14 for OHRQoL and a visual analog scale (VAS) for patient satisfaction. Assessments were done before treatment and 2 months after wearing each prosthesis with a 1-month washout period. Statistical analysis included the Friedman then the Wilcoxon signed rank test for Oral Health Impact Profile-short version-14 scores and repeated measures ANOVA then the Bonferroni or paired t test for VAS scores (α=.05).
There were no dropouts. Rehabilitation, irrespective of prosthesis type, significantly improved OHRQoL in all domains and significantly increased overall patient satisfaction (P<.05). When compared with the conventional prostheses, attachment-retained prostheses significantly improved functional limitation, psychological discomfort, and physical limitation domains in all groups (P<.05), as well as the physical pain domain in the OD group (P=.041). General satisfaction, stability, comfort, ability to speak, and ability to masticate significantly increased (P<.05) with attachment-retained prostheses. Conventional prostheses were significantly easier to clean (P<.05) in all groups, except for the telescope-attachment group.
Both conventional and attachment-retained prostheses significantly increased patient satisfaction and improved OHRQoL in all domains as compared with before treatment. However, incorporation of attachments further improved functional limitation, psychological discomfort, and physical limitation domains in all groups, as well as the physical pain domain in the OD group. Participants were more satisfied with their attachment-retained prostheses in most aspects.
关于在可摘义齿中加入附件对患者结果的影响的研究很少。
本临床研究的目的是调查下颌附着体可摘义齿修复与传统可摘义齿修复后,部分缺牙患者的口腔健康相关生活质量(OHRQoL)和患者满意度。
本交叉研究纳入了 74 名参与者(年龄 36-57 岁)。最初,56 名参与者接受了传统卡环固位的可摘义齿(RDP)修复,18 名参与者根据下颌部分缺牙状态接受了常规覆盖义齿(OD)修复。两个月后,在 56 名 RDP 参与者中,24 名接受了外冠附着体固位的 RDP,17 名接受了伸缩式附着体固位的 RDP,15 名接受了杆附着体固位的 RDP。18 名 OD 参与者接受了球附着体固位的 OD。评估包括口腔健康影响简表-14 用于 OHRQoL 和视觉模拟量表(VAS)用于患者满意度。在佩戴每种义齿前和佩戴 2 个月后进行评估,每个阶段之间有 1 个月的洗脱期。统计分析包括 Friedman 检验然后 Wilcoxon 符号秩检验用于口腔健康影响简表-14 评分和重复测量方差分析然后 Bonferroni 或配对 t 检验用于 VAS 评分(α=.05)。
没有脱落。无论义齿类型如何,修复后所有领域的 OHRQoL 均显著改善,总体患者满意度显著提高(P<.05)。与传统义齿相比,附着体义齿在所有组中显著改善了功能受限、心理不适和身体受限领域(P<.05),以及 OD 组的身体疼痛领域(P=.041)。附着体义齿显著增加了总体满意度、稳定性、舒适度、言语能力和咀嚼能力(P<.05)。除了伸缩式附着体组外,所有组的传统义齿都更容易清洁(P<.05)。
与治疗前相比,传统义齿和附着体义齿均显著提高了患者满意度和所有领域的 OHRQoL。然而,在所有组中,附着体的加入进一步改善了功能受限、心理不适和身体受限领域,以及 OD 组的身体疼痛领域。在大多数方面,参与者对附着体义齿的满意度更高。