Feine J S, Maskawi K, de Grandmont P, Donohue W B, Tanguay R, Lund J P
Faculté de médecine dentaire, Université de Montréal, Québec, Canada.
J Dent Res. 1994 Oct;73(10):1646-56. doi: 10.1177/00220345940730101001.
In the past, fixed prostheses were believed to be more efficient implant-supported devices than removable types for edentulous patients. However, this hypothesis was never properly tested. Therefore, a within-subject crossover clinical trial was designed in which 145 completely edentulous subjects were tested wearing implant-supported mandibular fixed prostheses and long-bar overdentures. Eight subjects received the fixed appliance first and seven the removable type. The patients' perceptions of various characteristics of the implant-supported prostheses were measured after a minimum of two months' adaptation. Mandibular movements and jaw muscle electromyographic activity were recorded while the patients chewed five standard-sized test foods: bread, apple, hard cheese, sausage, and raw carrot. The prostheses were then changed, worn for the same period of adaptation, and the procedures repeated. There were three test sessions per prosthesis, and each included five trials per food. The measurements were repeated three times at one-week intervals. Mastication time was found to be shorter for three foods (bread, cheese, and sausage) when subjects wore the long-bar overdenture. The vertical amplitude of the masticatory strokes was significantly less with the overdenture for all foods except carrot. Cycle duration was significantly longer with the overdenture for sausage and carrot. Contrary to what might be expected, the long-bar overdenture appears to be no less efficient than the fixed prosthesis. Furthermore, these data suggest that patients are capable of adapting their masticatory movements to the characteristics of the two prostheses.
过去，对于无牙患者，固定义齿被认为是比可摘义齿更有效的种植体支持装置。然而，这一假设从未得到恰当验证。因此，设计了一项受试者自身交叉临床试验，145名全口无牙受试者分别佩戴种植体支持的下颌固定义齿和长杆覆盖义齿进行测试。8名受试者先佩戴固定矫治器，7名先佩戴可摘型。在至少两个月的适应期后，测量患者对种植体支持义齿各种特性的感知。在患者咀嚼五种标准尺寸的测试食物（面包、苹果、硬奶酪、香肠和生胡萝卜）时，记录下颌运动和颌面部肌肉的肌电活动。然后更换义齿，佩戴相同的适应期，并重复上述过程。每种义齿有三个测试阶段，每个阶段每种食物包括五次试验。测量在一周的间隔内重复三次。发现受试者佩戴长杆覆盖义齿时，三种食物（面包、奶酪和香肠）的咀嚼时间较短。除胡萝卜外，所有食物使用覆盖义齿时咀嚼冲程的垂直幅度明显较小。使用覆盖义齿咀嚼香肠和胡萝卜时，周期持续时间明显更长。与预期相反，长杆覆盖义齿似乎并不比固定义齿效率低。此外，这些数据表明患者能够根据两种义齿的特性调整咀嚼运动。
