›› 2019, Vol. 39 ›› Issue (9): 811-814.

• 临床研究 • 上一篇    下一篇

骨转换标志物对于牙槽嵴重度吸收患者咀嚼效能与两种改良牙合型全口义齿戴用的影响

申林1,兰小琴2,汪婷婷3,张红4   

  1. 1. 北京市第一中西医结合医院
    2. 北京市第一中西医结合医院检验科
    3. 北京市第一中西医结合医院口腔科
    4. 南京大学医学院附属口腔医院
  • 收稿日期:2018-06-12 修回日期:2018-07-17 出版日期:2019-09-28 发布日期:2019-09-17
  • 通讯作者: 申林 E-mail:shjwzx1@163.com
  • 基金资助:
    2012年度南京市医学科技发展项目(医药卫生科研课题)

  • Received:2018-06-12 Revised:2018-07-17 Online:2019-09-28 Published:2019-09-17

摘要: 目的 对骨转换标志物正常和升高的牙槽嵴重度吸收的无牙颌患者,分析两种改良牙合型(长正中牙合型、舌向集中牙合型)全口义齿的戴用与咀嚼效能的关系,以期为临床全口义齿修复中牙合型的选择提供参考。 方法 选取85例(男45例,女40例)牙槽嵴重度吸收的无牙颌患者,采用随机数字表法随机选用两种改良牙合型全口义齿(长正中牙合型全口义齿、舌向集中牙合型全口义齿)治疗方案。电化学发光免疫法测量血清中骨转换标志物——Ⅰ型前胶原N端前肽(P1NP)和Ⅰ型胶原交联C末端肽(CTX)的水平,分为骨转换标志物正常组及升高组。义齿戴用3个月后,吸光度法测定咀嚼效能,多因素方差分析不同骨转换标志物测量值的患者不同类型改良牙合型全口义齿的戴用与咀嚼效能的关系。 结果 骨转换标志物(P1NP和CTX)正常组的患者,不同类型改良牙合型(长正中牙合型、舌向集中牙合型)全口义齿的戴用与其咀嚼效能的关系无统计学差异。而骨转换标志物(P1NP和CTX)升高组患者,不同类型改良牙合型全口义齿的戴用与其咀嚼效能的差异有统计学意义(P<0.01),与戴用舌向集中牙合型全口义齿的患者相比,戴用长正中牙合型全口义齿的患者具有更高的咀嚼效能。 结论 骨转换标志物较高的患者,选用长正中牙合型全口义齿会得到相对更高的咀嚼效能。骨转换标志物有望成为牙槽嵴重度吸收的无牙颌患者选择戴用不同改良牙合型全口义齿时的参考指标。

关键词: 长正中牙合, 舌向集中牙合, 骨转换标志物, 咀嚼效能, 全口义齿, 无牙颌, 牙槽骨吸收

Abstract: Objective To analyze the relationship between the masticatory efficiency and the two modified dentures (long centric occlusal denture and lingualized occlusal denture) of the patients with normal and high amount of biochemical markers of bone turnover, and to provide the reference for how to choose the complete dentures during clinical practice. Methods 85 elderly edentulous patients (45 males and 40 females) with severe residual alveolar ridge resorption were randomly divided to be repaired by long centric occlusal denture or lingualized occlusal denture. The serum amount of biochemical markers of bone turnover (P1NP and CTX) was detected by electrochemiluminescence immunoassay and the patients were divided into the normal group and the higher group. Three months after the complete dentures wearing, masticatory efficiency was determinated by spectrophotometry. Then multifactor analysis of variance was used to analyze the relationship between the masticatory efficiency and the two modified dentitions of the patients with normal and high amount of biochemical markers of bone turnover. Results In the normal group, there was no significant difference in masticatory efficiency between two kinds of dentures(P >0.05). In contrast, in the higher group, there was significant difference:compared with patients with lingualized occlusal dentures, patients with long centric occlusal dentures had relatively higher masticatory efficiency. Conclusion For patients with high amount of biochemical markers of bone turnover, long centric occlusal dentures are helpful to them to achieve higher masticatory efficiency. Biochemical markers of bone turnover are reasonable to be expected as an index to assess the denture options for edentulous patients with severe residual alveolar ridge resorption.

Key words: long centric occlusal denture, lingualized occlusal denture, biochemical markers of bone turnover, masticatory efficiency, complete dentures, edentulous, alveolar ridge resorption

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