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种植牙与营养对老年无牙颌受试者的影响:析因随机临床试验方案

Effects of Dental Implants and Nutrition on Elderly Edentulous Subjects: Protocol for a Factorial Randomized Clinical Trial.

作者信息

Qian Shu-Jiao, Liu Beilei, Shi Junyu, Zhang Xiao, Deng Ke, Shen Jie, Tao Yang, Qiao Shichong, Lai Hong-Chang, Yuan Changzheng, Tonetti Maurizio S

机构信息

Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, College of Medicine, Shanghai Jiao Tong University, Shanghai, China.

School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Nutr. 2022 Jun 27;9:930023. doi: 10.3389/fnut.2022.930023. eCollection 2022.

Abstract

BACKGROUND

Loss of masticatory function consequent to tooth loss has been associated with changes in food choices and insufficient nutritional intake. To date, interventions based on dental prostheses alone did not significantly improve nutrient intake. Pilot studies have shown positive impacts of interventions combining implant-supported fixed dental prosthesis with brief dietary advice. The relative contribution and the potential synergy of the components of such interventions need to be determined as it has major public health implications for the community-dwelling aging population that continues to disproportionately suffer from tooth loss and its consequences.

OBJECTIVE

To assess the effect of rehabilitation of masticatory function with fixed implant supported dentures and nutrition education in older subjects with terminal dentition (stage IV periodontitis) or full edentulism.

METHODS

A 2 × 2 factorial randomized controlled trial with 16-month follow-up of eligible adults (≥60 years) with loss of masticatory function consequent to full arch edentulism or terminal dentition ( = 120) will be conducted to test whether the rehabilitation of masticatory function with fixed implant supported dentures, nutrition education and/or their combination improves intake of fresh fruits and vegetables for aging subjects. The study has been designed to detect changes in fresh fruits and fresh vegetables intake at 4 months using the 24-h dietary recall method. Changes in protein as percentage of total energy, nutritional biomarkers, plasma metabolomics, oral and gut microbiome, quality of life and masticatory function will also be assessed.

DISCUSSION

We hypothesize that receiving rehabilitation of masticatory function with fixed implant dentures together with nutrition education is the most effective intervention for improving nutrient intake in aging community-dwelling subjects with extensive tooth loss. The results of this study will assist in designing better treatment regimens, guide medical care for individual subjects, and inform public health and policy.

CLINICAL TRIALS REGISTRATION

NCT05334407.

摘要

背景

牙齿缺失导致的咀嚼功能丧失与食物选择的改变和营养摄入不足有关。迄今为止,仅基于假牙的干预措施并未显著改善营养摄入。试点研究表明,将种植体支持的固定假牙与简短的饮食建议相结合的干预措施具有积极影响。由于社区居住的老年人群体持续不成比例地遭受牙齿缺失及其后果的影响,此类干预措施各组成部分的相对贡献和潜在协同作用需要确定,这对公共卫生具有重大影响。

目的

评估采用固定种植体支持假牙恢复咀嚼功能及营养教育对患有晚期牙列(IV期牙周炎)或全口无牙的老年受试者的效果。

方法

将进行一项2×2析因随机对照试验,对因全牙弓无牙或晚期牙列导致咀嚼功能丧失的符合条件的成年人(≥60岁,n = 120)进行16个月的随访,以测试采用固定种植体支持假牙恢复咀嚼功能、营养教育和/或它们的组合是否能改善老年受试者的新鲜水果和蔬菜摄入量。该研究旨在使用24小时饮食回顾法检测4个月时新鲜水果和新鲜蔬菜摄入量的变化。还将评估蛋白质占总能量的百分比、营养生物标志物、血浆代谢组学、口腔和肠道微生物群、生活质量和咀嚼功能的变化。

讨论

我们假设,对于社区居住的牙齿大量缺失的老年受试者,采用固定种植假牙恢复咀嚼功能并结合营养教育是改善营养摄入的最有效干预措施。本研究的结果将有助于设计更好的治疗方案,指导个体受试者的医疗护理,并为公共卫生和政策提供信息。

临床试验注册

NCT05334407。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6b6/9272417/f37329d25bc4/fnut-09-930023-g0001.jpg

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