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揭示义齿引起的口腔病变:分类与疼痛评估的综合研究。

Unveiling denture-induced oral lesions: A comprehensive study on classification and pain assessment.

机构信息

Oral Medicine Unit, Sheba Medical Center, Tel HaShomer, Israel.

In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.

出版信息

J Oral Rehabil. 2024 Jun;51(6):931-937. doi: 10.1111/joor.13664. Epub 2024 Feb 14.

Abstract

BACKGROUND

Denture-induced oral Lesions (DIOLs) often manifests shortly after the placement or adjustment of new or realigned dentures, frequently resulting in severe pain and discomfort.

OBJECTIVES

This study aimed to classify DIOLs placing a particular emphasis on assessing the associated pain.

METHODS

A prospective case study was conducted involving 126 patients who were fitted with a total of 193 dentures of various types at the Hadassah School of Dental Medicine. All patients underwent comprehensive intra-oral examinations within 1-8 weeks following denture delivery, completed symptom questionnaires and had their medical records reviewed. Key variables documented included age, gender, overall health status, denture type, and a detailed description of the DIOLs. The description encompassed factors such as lesion location, shape, colour, size, border characteristics, ulcerative appearance, membrane coverage, 3D morphology (elevated, immersed and flat) and patient-reported Verbal Pain Score (VPS) when touching the DIOLs, when wearing the denture, and when not wearing the denture.

RESULTS

Notably, 25.4% of denture wearers required no adjustments, while 14.4% necessitated more than three revisions. A majority (71.8%) of DIOLs cases were associated with mandibular complete dentures, primarily situated on the alveolar ridge. The mean VPS indicated a pain intensity of 7 ± 2.1, with temporary dentures in both jaws causing the most discomfort. Implant-supported overdentures were particularly painful when placed in the mandible. Additionally, VPS scores were higher among older individuals and those with prior prosthetic experiences. A significant correlation was observed between pain intensity and presence of chronic health condition (0.036).

CONCLUSIONS

This study revealed distinct characteristics of DIOLs and highlighted the multifactorial nature of pain experienced following the development of DIOLs. Insights into the influence of patient and denture characteristics on DIOLs and pain intensity can guide healthcare professionals in optimising patient comfort and satisfaction.

摘要

背景

义齿引起的口腔病变(DIOL)通常在新义齿或重新排列的义齿放置或调整后不久出现,常导致严重的疼痛和不适。

目的

本研究旨在对 DIOL 进行分类,特别强调评估相关疼痛。

方法

对 126 名在 Hadassah 牙科医学院佩戴 193 副不同类型义齿的患者进行前瞻性病例研究。所有患者在义齿交付后 1-8 周内接受全面的口腔内检查,完成症状问卷并查阅病历。记录的关键变量包括年龄、性别、整体健康状况、义齿类型以及 DIOL 的详细描述。描述包括病变位置、形状、颜色、大小、边界特征、溃疡性外观、膜覆盖、3D 形态(凸起、浸入和平坦)以及患者报告的触摸 DIOL 时、佩戴义齿时和不佩戴义齿时的口述疼痛评分(VPS)。

结果

值得注意的是,25.4%的义齿佩戴者无需调整,而 14.4%需要进行三次以上的修改。大多数(71.8%)的 DIOL 病例与下颌全口义齿有关,主要位于牙槽嵴上。平均 VPS 表明疼痛强度为 7±2.1,上下颌临时义齿引起的不适最严重。下颌植入物支持的覆盖义齿尤其疼痛。此外,年龄较大和有过修复体经验的患者 VPS 评分较高。疼痛强度与慢性健康状况之间存在显著相关性(0.036)。

结论

本研究揭示了 DIOL 的独特特征,并强调了 DIOL 发展后疼痛的多因素性质。了解患者和义齿特征对 DIOL 和疼痛强度的影响,可以指导医疗保健专业人员优化患者的舒适度和满意度。

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