两种𬌗型全口义齿修复后患者咀嚼效率及咬合力的比较研究

doi:10.13591/j.cnki.kqyx.2024.11.010

摘要/Abstract

摘要：

目的评价解剖式𬌗与舌向集中𬌗全口义齿修复后患者的咀嚼效率、咬合功能指标及患者满意度。方法选取2021年4月—12月南京市口腔医院修复科无牙颌患者20例,随机分为两组,分别为两组患者制作解剖式𬌗全口义齿与舌向集中𬌗全口义齿,在义齿使用1个月时通过吸光度法对两种𬌗型全口义齿咀嚼效率进行测定,使用TeeTester咬合分析系统测定两组患者相关咬合功能指标同期进行全口义齿满意度调查表。采用SPSS 20.0对数据进行统计学分析。结果舌向集中𬌗组咀嚼效率、咬合功能指标低于解剖式𬌗组,患者满意度中大部分项目亦低于解剖式𬌗组,在语音恢复方面上高于解剖式𬌗组,其中COF-y差异具有统计学意义(P<0.05)。结论舌向集中𬌗型式全口义齿与解剖式𬌗型式全口义齿在咀嚼效率、咬合功能及患者满意度方面差异并无统计学意义;舌向集中𬌗型全口义齿在患者的掌握、适应及日常使用上具有较好表现。

关键词: 全口义齿, 解剖式𬌗, 舌向集中𬌗, 咀嚼效率, 满意度

Abstract:

Objective In this study, we compared the masticatory efficiency, occlusal functional indexes, and satisfaction of lingualized occlusion(LO) vs. anatomic occlusion(AO) and discussed the difference between these occlusions. Methods Twenty edentulous patients were included in this clinical trial during 2021 April to December. They were divided into 2 groups according to their denture occlusion. Masticatory efficiency was tested by chewing the same amount of peanuts (by weight) and then the absorption of the solution was compared under a spectrophotometer after wearing dentures for 1 month. The TeeTester occlusion analysis system was used to test masticatory function, and satisfaction research was conducted for the edentulous patients at this time point as well. Finally, statistical analyses were conducted to compare the difference in masticatory efficiency between AO and LO by SPSS 20.0. Results The indexes of LO were worse than AO in masticatory efficiency, masticatory function and most of satisfaction research, while LO was better than AO in speech recovery. The difference was only statistically significant in COF-y of masticatory function (P<0.05). Conclusion LO is similar with AO in terms of masticatory efficiency, satisfaction and denture stability; LO has good performance in denture’s fit and use for patients.

Key words: complete denture, anatomic occlusion, lingualized occlusion, masticatory efficiency, satisfaction

中图分类号:

R783.4

王佩露, 魏煦, 杨晓静, 聂蓉蓉, 孟翔峰. 两种𬌗型全口义齿修复后患者咀嚼效率及咬合力的比较研究[J]. 口腔医学, 2024, 44(11): 851-855.

WANG Peilu, WEI Xu, YANG Xiaojing, NIE Rongrong, MENG Xiangfeng. Clinical research on masticatory efficiency and force in the two types of complete denture[J]. Stomatology, 2024, 44(11): 851-855.

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参考文献 22

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分组	病例数	性别		年龄				Atwood^[3]牙槽嵴分类
分组	病例数	男	女	50~59岁	60~69岁	70~79岁	80~89岁	Ⅱ	Ⅲ	Ⅳ
舌向集中??组	10	6	4	0	6	4	0	4	3	3
解剖式??组	10	3	7	1	4	4	1	2	5	3
合计	20	9	11	1	10	8	1	6	8	6

项目	评分	评价标准
美观	8~10分	丰满度正常,颜色形态与面部协调
	4~7分	丰满度较好,颜色形态较满意
	1~3分	丰满度差,颜色形态不满意
舒适^*	8~10分	无异物感,肌肉运动不受影响,无疼痛
	4~7分	轻微异物感,佩戴时间较长时有不适感
	1~3分	异物感明显,佩戴时可出现疼痛
语音	8~10分	日常发音不受影响
	4~7分	一般发音正常,部分音节发音受影响
	1~3分	语音含糊不清
咀嚼	8~10分	日常进食正常
	4~7分	能咀嚼一般食物,部分食物咀嚼受影响
	1~3分	仅能咀嚼较脆的食物
固位^*	8~10分	进食讲话不脱位
	4~7分	仅食用较黏的食物时脱位
	1~3分	进食讲话易脱位

组别	最大咬合力/N	咬合接触时间/s	COF-x	COF-y	咀嚼效率
舌向集中??LO	52.48±10.16	0.92±0.72	27.84±21.48	55.19±17.63	0.27±0.17
解剖式??AO	58.29±27.72	0.49±0.36	17.19±7.14	36.10±12.76	0.25±0.13
统计量	t=-0.561	z=-1.600	z=-0.889	t=2.667	t=0.263
P	0.583	0.117	0.395	0.017	0.796

组别	美观	舒适(上颌)	舒适(下颌)	语音	咀嚼	固位(上颌)	固位(下颌)
舌向集中??LO	9.13±0.99	8.75±1.16	8.00±1.51	9.25±1.04	7.13±1.81	8.63±2.5	7.00±2.44
解剖式??AO	9.50±0.71	9.30±1.06	8.20±1.14	8.90±1.10	8.40±1.07	9.00±1.33	7.50±1.27
统计量	z=-0.790	z=-1.054	t=-0.551	z=-0.728	z=-1.495	z=-0.245	t=-0.561
P	0.435	0.349	0.594	0.527	0.128	0.856	0.583