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上颌骨四种植体支持式覆盖义齿治疗。第二部分:上颌骨种植体支持式覆盖义齿患者与言语和口腔健康相关的生活质量——一项为期3年的前瞻性随访研究。

Four-implant-supported overdenture treatment in the maxilla. Part II: Speech- and oral health-related quality of life in patients with implant-supported overdentures in the maxilla-A prospective 3-year follow-up.

作者信息

Fonteyne Ester, Burms Eline, Matthys Carine, Van Lierde Kristiane, De Bruyn Hugo

机构信息

Periodontology and Oral Implantology, Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

Department of Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

出版信息

Clin Implant Dent Relat Res. 2021 Oct;23(5):680-691. doi: 10.1111/cid.13034. Epub 2021 Aug 11.

Abstract

BACKGROUND

Implant-supported overdentures (IOD) are becoming a more commonly used treatment in the dental practice and it risks causing speech problems.

PURPOSE

The aim of this study was investigating the changes in speech, satisfaction with speech, and overall oral health-related quality of life (OHRQoL) in edentulous patients during and after treatment with maxillary IODs.

MATERIALS AND METHODS

Twenty-one patients receiving an IOD participated in speech assessment. They were examined preoperatively with their conventional denture (CD) with full palatal coverage, after connection of the implant-bar connected denture, without palatal coverage, and 3 years thereafter. The examination included assessment of articulation in speech, OHRQoL based on total OHIP-14, and satisfaction with overall oral health and speech (visual analogue scale).

RESULTS

There was a reduction in mean number of articulation disorders from 1.00 at baseline to 0.55 at connection, although statistically insignificant (p = 0.059). Especially the /s/ sound is vulnerable. At 3 years follow-up, still 6/16 (37.5%) of the patients suffered from this speech problem. Overall satisfaction improved from 64.05/100 at baseline to 82.95/100 at connection (p = 0.008) and remained unchanged with 81.69/100 after 3 years follow-up. Patients' satisfaction with speech increased from 70.62/100 with CD to 82.63/100, 3 years follow-up (p = 0.009). Total OHIP-14 decreased from 21.45/56 with CD to 8.00/56 (p < 0.001) with IOD and 6.13/56 3 years after connection (p = 0.001). Significant improvement of all seven domains in OHRQoL was observed with IOD compared to CD.

CONCLUSIONS

Patients treated with maxillary IODs show improved OHRQoL 3 years after connection of the IOD compared to the CD. Even though patients reported improvement of satisfaction and OHRQoL, articulation disorders were still present, suggesting that patients should be informed about possible speech issues.

摘要

背景

种植体支持的覆盖义齿(IOD)在牙科实践中越来越常用,但有导致言语问题的风险。

目的

本研究的目的是调查无牙患者在上颌IOD治疗期间及治疗后的言语变化、对言语的满意度以及与口腔健康相关的总体生活质量(OHRQoL)。

材料与方法

21名接受IOD的患者参与了言语评估。术前用全腭覆盖的传统义齿(CD)对他们进行检查,在连接种植体杆连接义齿后(无腭覆盖)以及此后3年进行检查。检查包括言语清晰度评估、基于OHIP-14总分的OHRQoL评估以及对总体口腔健康和言语的满意度(视觉模拟量表)。

结果

言语清晰度障碍的平均数量从基线时的1.00降至连接时的0.55,尽管无统计学意义(p = 0.059)。特别是/s/音较为脆弱。在3年随访时,仍有6/16(37.5%)的患者存在这种言语问题。总体满意度从基线时的64.05/100提高到连接时的82.95/100(p = 0.008),3年随访后保持不变,为81.69/100。患者对言语的满意度从使用CD时的70.62/100提高到3年随访时的82.63/100(p = 0.009)。OHIP-14总分从使用CD时均值21.45/56降至使用IOD时的8.00/56(p < 0.001),连接后3年为6.13/56(p = 0.001)。与CD相比,使用IOD观察到OHRQoL的所有七个领域均有显著改善。

结论

与CD相比,接受上颌IOD治疗的患者在连接IOD 3年后OHRQoL有所改善。尽管患者报告满意度和OHRQoL有所提高,但言语清晰度障碍仍然存在,这表明应告知患者可能存在的言语问题。

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