Dentures

假牙
  • DOI:
    文章类型: Journal Article
    目的:探讨义齿咬合板联合综合理疗治疗不复位颞下颌关节盘移位(ADDwoR)的疗效。
    方法:选择2019年1月至2020年12月衡水市人民医院正畸与修复科就诊的ADDwoR及牙列缺损或牙齿严重磨损患者60例,根据治疗方法随机分为义齿咬合板组(A组)和义齿咬合板+综合理疗组(B组)。在治疗前和治疗三个月期间每三周记录所有患者的最大张口(MMO)和视觉模拟疼痛评分(VAS)。分别于治疗前及治疗后3个月进行锥形束CT(CBCT)检查。分析两组患者治疗前后临床疗效指标变化及CBCT资料。采用SPSS26.0软件包进行统计学分析。
    结果:治疗前至治疗后3周,A组和B组的VAS评分差异有统计学意义(P<0.05)。B组减少更多。从治疗后3周,B组治疗前MMO及VAS评分比较,差异均有统计学意义(P<0.05).治疗后9周,A组治疗前MMO差异有统计学意义(P<0.05),A组和B组的MMO和VAS评分差异无统计学意义(P>0.05).CBCT显示前关节间隙狭窄,后关节间隙加宽,扩大的上关节空间,髁突水平角减小,关节结节斜度增大(P<0.05)。关节深度之间的差异,髁的前后直径,内径和外径差异无统计学意义(P>0.05)。前路有显著差异,上级,和后关节间隙,髁水平角度,B组与A组比较,关节结节的斜率及差异有统计学意义(P<0.05)。
    结论:义齿咬合板可有效改善ADDwoR症状,和义齿咬合板结合综合理疗可以迅速改善张口,减轻关节区疼痛。
    OBJECTIVE: To explore the efficacy of denture occlusal plate combined with comprehensive physical therapy for temporomandibular joint disc displacement without reduction(ADDwoR).
    METHODS: Sixty patients of ADDwoR and dentition defect or severely worn teeth who visited the Department of Orthodontics and Prosthodontics of Hengshui People\'s Hospital from January 2019 to December 2020 were selected and randomly divided into denture occlusal plate group (group A) and denture occlusal plate + comprehensive physical therapy group (group B) according to the treatment methods. Maximum mouth opening (MMO) and visual analog pain score(VAS) among all patients were recorded before treatment and every three weeks during three months of treatment. Cone-beam CT(CBCT) was taken before and 3 months after treatment. The changes in clinical efficacy indicators before and after treatment and CBCT data between the two groups were analyzed. Statistical analysis was performed with SPSS 26.0 software package.
    RESULTS: The differences of VAS of group A and B were statistically significant from before treatment to three weeks after treatment(P<0.05), and group B decreases more. From 3 weeks after treatment, there was a significant difference of group B for MMO and VAS before treatment (P<0.05). From 9 weeks after treatment, there was a significant difference of group A for MMO before treatment (P<0.05), but there was no significant difference in MMO and VAS between group A and B(P>0.05). CBCT showed narrowed anterior joint space, widened posterior joint space, enlarged superior joint space, decreased horizontal angle of the condyle and increased slope of joint nodules (P<0.05). The difference between joint depth, anteroposterior diameter of the condyle, internal and external diameter was not significant (P>0.05). There was significant differences in anterior, superior, and posterior joint space, condylar level angle, and slope of joint nodules of group B compared with group A(P<0.05).
    CONCLUSIONS: Denture occlusal plate can effectively improve symptoms of ADDwoR, and denture occlusal plate combined with comprehensive physical therapy can quickly improve mouth opening and reduce pain in the joint area.
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  • 文章类型: Journal Article
    背景技术我们使用14项口腔健康影响概况-14(OHIP-14)问卷评估了来自也门一个中心的241名可移动部分或完整义齿佩戴者的社会人口统计学变量与口腔健康相关生活质量之间的关系。材料与方法从牙科学院口腔修复学系共招募了241个局部义齿(PD)和全口义齿(CD)佩戴者,萨那大学,和科技大学。在开始佩戴义齿之前和使用义齿3-6个月后收集数据。问卷包括社会人口统计信息和义齿类型,另一个是OHIP评估口腔健康相关生活质量(OHRQoL),口腔健康影响量表包括7个分量表,每个评估口腔健康和功能的不同方面。对参与者进行描述性统计。进行独立t检验以比较不同的患者组,专注于PD和CD佩戴者。配对样本t检验用于检查使用可摘义齿前后患者组内的变化。结果在所有参与者中,67.6%为男性,CD的佩戴者是74.6%的男性,PD为58.3%,CD(71.0%)和PD(72.8%)佩戴者一致。佩戴假体对PD和CD患者的OHRQoL有显著影响(P<0.01)。在CD佩戴者中,这些分量表(3-6)中有4个具有统计学意义,但是障碍分量表显示,PD穿着者治疗后的身体疼痛明显减轻。结论佩戴假牙对患者的OHRQoL有积极影响,影响他们健康的各个方面,包括功能,物理,心理,和社会福祉。
    BACKGROUND We used the 14-item Oral Health Impact Profile-14 (OHIP-14) questionnaire to evaluate the association between sociodemographic variables and oral health-related quality of life in 241 wearers of removable partial or complete dentures attending a single center in Yemen. MATERIAL AND METHODS A total of 241 partial dentures (PD) and complete dentures (CD) wearers were enrolled from the Department of Prosthodontics at the Faculty of Dentistry, Sana\'a University, and the University of Science and Technology. Data were collected before the commencement of denture wearing and after 3-6 months of denture use. The questionnaire consisted of sociodemographic information and denture type, and another for the OHIP to assess oral health-related quality of life (OHRQoL), oral health impact profile scale comprises 7 subscales, each evaluating different aspects of oral health and functionality. Descriptive statistics were calculated for participants. Independent t tests were performed to compare different patient groups, focusing on PD and CD wearers. Paired-sample t tests were used to examine changes within patient groups before and after removable denture use. RESULTS Among all participants, 67.6% were male, wearers of CDs were 74.6% male, PDs were 58.3%, and was consistent for CD (71.0%) and PD (72.8%) wearers. The wearing prostheses significantly impacted the OHRQoL of patients using both PDs and CDs (P<0.01). Among CD wearers, 4 of these subscales (3-6) were statistically significant, but the handicaps subscale showed evident reductions in physical pain after treatment among PD wearers. CONCLUSIONS Wearing dentures positively affects the OHRQoL of patients, influencing various aspects of their health, including functional, physical, psychological, and social well-being.
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  • 文章类型: Journal Article
    背景:表观遗传年龄加速(EAA)代表了实际年龄和表观遗传年龄之间的差异,反映了加速的生物衰老。观察性研究表明,口腔疾病可能会影响DNA甲基化模式和衰老,但它们的因果关系在很大程度上仍未被探索。这项研究旨在调查牙齿特征和EAA之间的潜在因果关系,以及确定可能的调解人。
    方法:使用主要是欧洲血统的全基因组关联研究的汇总统计,我们进行了单变量和多变量孟德尔随机化(MR)来估计十个牙齿特征的总体和独立影响(假牙,牙龈出血,牙龈疼痛,牙齿松动,牙痛,溃疡,牙周炎,齿数,和两种龋齿测量)对四种EAA亚型(GrimAge加速度[GrimAA],PhenoAge加速度[PhenoAA],HannumAge加速度[HannumAA]和固有EAA[IEAA]),并使用两步孟德尔随机化来评估12个潜在的关联介质。使用综合敏感性分析来验证稳健性,异质性,和多功能性。
    结果:单变量逆方差加权MR分析揭示了假牙对较大GrimAA的因果影响(β:2.47,95%CI:0.93-4.01,p=0.002),PhenoAA(β:3.00,95%CI:1.15-4.85,p=0.001),和HannuAA(β:1.96,95%CI:0.58-3.33,p=0.005)。在多变量MR中,在调整牙周炎后,这种关联仍然很重要,龋齿,牙齿数量和牙龈出血。12个衰老危险因素中的3个被确定为假牙和EAA之间关联的介体,包括体重指数,身体脂肪百分比,和腰围。未检测到反向因果关系和多效性的证据(p>0.05)。
    结论:我们的研究结果支持假牙佩戴的遗传责任对表观遗传老化的因果影响,通过肥胖的部分调解。应更加重视肥胖的监测和管理,以减缓义齿佩戴者的EAA。
    BACKGROUND: The epigenetic-age acceleration (EAA) represents the difference between chronological age and epigenetic age, reflecting accelerated biological aging. Observational studies suggested that oral disorders may impact DNA methylation patterns and aging, but their causal relationship remains largely unexplored. This study aimed to investigate potential causal associations between dental traits and EAA, as well as to identify possible mediators.
    METHODS: Using summary statistics of genome-wide association studies of predominantly European ancestry, we conducted univariable and multivariable Mendelian randomization (MR) to estimate the overall and independent effects of ten dental traits (dentures, bleeding gums, painful gums, loose teeth, toothache, ulcers, periodontitis, number of teeth, and two measures of caries) on four EAA subtypes (GrimAge acceleration [GrimAA], PhenoAge acceleration [PhenoAA], HannumAge acceleration [HannumAA] and intrinsic EAA [IEAA]), and used two-step Mendelian randomization to evaluate twelve potential mediators of the associations. Comprehensive sensitivity analyses were used to verity the robustness, heterogeneity, and pleiotropy.
    RESULTS: Univariable inverse variance weighted MR analyses revealed a causal effect of dentures on greater GrimAA (β: 2.47, 95% CI: 0.93-4.01, p = 0.002), PhenoAA (β: 3.00, 95% CI: 1.15-4.85, p = 0.001), and HannumAA (β: 1.96, 95% CI: 0.58-3.33, p = 0.005). In multivariable MR, the associations remained significant after adjusting for periodontitis, caries, number of teeth and bleeding gums. Three out of 12 aging risk factors were identified as mediators of the association between dentures and EAA, including body mass index, body fat percentage, and waist circumference. No evidence for reverse causality and pleiotropy were detected (p > 0.05).
    CONCLUSIONS: Our findings supported the causal effects of genetic liability for denture wearing on epigenetic aging, with partial mediation by obesity. More attention should be paid to the obesity-monitoring and management for slowing EAA among denture wearers.
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  • 文章类型: Journal Article
    背景:牙齿脱落是影响全球许多人的常见问题。探索知识,态度,患者中的实践(KAP)可以在遵循推荐的实践中识别障碍和挑战,为牙科保健提供者提供有价值的见解,政策制定者,和研究人员。本研究旨在探讨牙弓缺陷患者牙齿缺失和假牙的KAP。
    方法:基于Web的,采用自行设计的问卷对牙弓缺陷患者进行横断面研究.
    结果:纳入有效问卷3166份。参与者平均KAP得分为6.84±2.27(可能范围:0~12),39.4±3.72(可能范围:9~45),27.7±4.36(可能范围:8~40),分别。多因素Logistic回归分析显示,知识(OR=1.383),受雇(OR=1.805),家族史(OR=2.158),和治疗(OR=1.683)与态度独立相关。此外,知识(OR=1.239),姿态(OR=1.250),女性(OR=0.619),年龄(OR=0.967),大学/学士(OR=0.373),硕士及以上学历(OR=0.418),受雇(OR=0.554)或学生(OR=0.434),每月家庭收入10,001-20,000元(OR=0.492),已结婚(OR=0.609),吸烟(OR=0.595),饮酒(OR=0.397),病程(OR=0.972),有家族史(OR=1.676),与治疗(OR=3.492)独立相关(均P<0.05)。
    结论:牙弓缺陷患者知识不足,积极的态度,以及对牙齿脱落和假牙的适度练习,这可能会受到多种人口因素的影响。
    BACKGROUND: Tooth loss is a common problem that affects many people worldwide. Exploring knowledge, attitude, and practice (KAP) among patients can identify barriers and challenges in following recommended practices, providing valuable insights for dental healthcare providers, policymakers, and researchers. This study aimed to explore the KAP of patients with dental arch deficiencies regarding tooth loss and dentures.
    METHODS: This web-based, cross-sectional study was conducted among patients with dental arch deficiencies using a self-designed questionnaire.
    RESULTS: 3166 valid questionnaires were included. Participants\' mean KAP scores were 6.84 ± 2.27 (possible range: 0 ~ 12), 39.4 ± 3.72 (possible range: 9 ~ 45), and 27.7 ± 4.36 (possible range: 8 ~ 40), respectively. Multivariable logistic regression analysis showed that knowledge (OR = 1.383), employed (OR = 1.805), family history (OR = 2.158), and treatment (OR = 1.683) were independently associated with attitude. Moreover, knowledge (OR = 1.239), attitude (OR = 1.250), female (OR = 0.619), age (OR = 0.967), college/bachelor (OR = 0.373), and master and above degree (OR = 0.418), employed (OR = 0.554) or student (OR = 0.434), with 10,001-20,000 Yuan household income per month (OR = 0.492), have been married (OR = 0.609), smoking (OR = 0.595), drinking (OR = 0.397), disease duration (OR = 0.972), with family history (OR = 1.676), and with treatment (OR = 3.492) were independently associated with practice (all P < 0.05).
    CONCLUSIONS: Patients with dental arch deficiencies have insufficient knowledge, positive attitudes, and moderate practice toward tooth loss and dentures, which might be affected by multiple demographic factors.
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  • 文章类型: Journal Article
    背景:在老年人群中,使用不同类型的假体对完全无牙颌的口腔健康相关生活质量(OHRQoL)的改善是这些脆弱患者临床决策的关键因素。这篇综述旨在评估老年人无牙人群中使用不同类型的全足弓假体治疗后OHRQoL的变化,以确定导致OHRQoL改善最大的假体。材料和方法:在PubMed中搜索了不同类型的全足弓假体的临床研究,这些假体测量了60岁或以上的无牙患者的OHRQoL,Embase和Scopus电子数据库,通过额外的手工搜索来总结所选研究的结果。结果:在302项确定的研究中,选择了10项研究。共有504名患者佩戴133个全口义齿,在选定的研究中评估了372个种植体覆盖义齿和39个固定假体。总体OHIP和GOHAI评分在基线和第3,6th,用各自的假体治疗的第12个月和第18个月。从治疗后第3个月到1年,与常规假牙相关的OHIP总评分提高了9.21-12.5%,而与种植体覆盖义齿和全弓固定假体相关的患者在1年时为9-25.26%,在第18个月随访时为18.53-26.79,分别。常规假牙的GOHAI总体得分提高了21.3-25.43%,从第3个月到第6个月随访,种植体覆盖义齿为36.82-41.32%,全弓固定假体为39.48-42.83%。结论:总的来说,种植覆盖义齿修复后OHRQoL的改善在一年内下降,全足弓固定假体在第18个月的随访中下降;同时,与传统假牙相关的OHRQoL稳定改善长达一年,但是,与传统假牙相比,植入物支持的假牙在OHRQoL方面的改善明显更大。然而,随访时间较长的研究仍需评估长期临床疗效.
    Background: The improvement of oral-health-related quality of life (OHRQoL) with different types of prosthesis for completely edentulous jaws in the elderly population is a critical factor in clinical decision making for these vulnerable patients. This review aims to evaluate the changes in OHRQoL after treatment with different types of full-arch prostheses in the elderly edentulous population to determine the prostheses that result in the greatest improvement in OHRQoL. Materials and Methods: Clinical studies of different types of full-arch prostheses that measured the OHRQoL in edentulous patients 60 years or older were searched for in the PubMed, Embase and Scopus electronic databases, with additional hand searching to summarize the outcomes of the selected studies. Result: Among the 302 identified studies, 10 studies were selected. A total of 504 patients wearing 133 complete dentures, 372 implant overdentures and 39 fixed prostheses were assessed among the selected studies. The overall OHIP and GOHAI scores were evaluated at baseline and in the 3rd, 6th, 12th and 18th months of treatment with the respective prostheses. The improved OHRQoL with overall OHIP scores associated with conventional dentures were 9.21-12.5% from the 3rd month to 1 year after treatment, whereas those associated with implant overdentures and full-arch fixed prosthesis were 9-25.26% at 1 year and 18.53-26.79 at the 18th-month follow-up, respectively. The increased overall GOHAI scores were 21.3-25.43% for conventional dentures, 36.82-41.32% for implant overdentures and 39.48-42.83% for full-arch fixed prosthesis from the 3rd month to the 6th-month follow-up. Conclusion: In general, the improvement in OHRQoL after rehabilitation with implant overdentures declined at one year, and that with full-arch fixed prosthesis declined at the 18th-month follow-up; meanwhile, the OHRQoL associated with conventional dentures improved stably up to one year, but the implant-supported prostheses resulted in an obviously greater improvement in the OHRQoL than that obtained with conventional dentures. However, studies with longer follow-up periods are still required to evaluate the long-term clinical effectiveness.
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  • 文章类型: Journal Article
    这项研究的目的是基于生物心理社会模型研究抑郁症状和社会参与在功能性牙齿和认知功能之间的连锁中介作用。对2018年中国健康与退休纵向研究的数据进行了分析。研究结果揭示了缺乏无动症和认知功能之间的良好联系,即使在考虑义齿使用的中介因素时也要坚持,抑郁症状,和社会参与。此外,该研究确定了这种关系中的六种间接途径。本研究证实了无性症与认知功能之间的相关性,从而提出了针对义齿使用的干预措施,抑郁症状,和社会参与有可能作为预防老年痴呆症患者认知功能下降的预防措施。这强调了解决这些因素以缓解认知能力下降的重要性。
    The objective of this study was to investigate the chain mediating effects of depressive symptoms and social participation between functional teeth and cognitive function based on the biopsychosocial model. Data from the 2018 China Health and Retirement Longitudinal Study were analyzed. The findings revealed a favorable connection between the lack of edentulism and cognitive function, persisting even when accounting for the mediating factors of denture usage, depressive symptoms, and social participation. Furthermore, the study identified six indirect pathways in this relationship. The present study has substantiated the correlation between edentulism and cognitive function, thereby proposing that interventions aimed at denture usage, depressive symptoms, and social participation could potentially serve as preventive measures against cognitive decline in elderly individuals afflicted with edentulism. This underscores the significance of addressing these factors to alleviate cognitive decline.
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  • 文章类型: Journal Article
    饮食是健康人口老龄化的一个可改变的因素。此外,口腔健康和饮食是影响抑郁症状的重要因素。评估饮食多样性(DD)在老年人口腔健康和抑郁症状的中介作用,我们从2018年中国纵向健康长寿调查(CLHLS)中选择了8442名年龄≥65岁的参与者进行横断面研究.根据10项流行病学研究中心抑郁量表(CESD-10)的评分确定抑郁症状。根据食物组的摄入频率建立饮食多样性评分(DDS)。通过义齿使用和刷牙频率来测量口腔健康。使用逐步多元线性回归和PROCESS宏进行介导效应分析和测试。样本对抑郁症状的阳性检出率为44.1%,40.8%用于义齿使用,每天一次刷牙占41.9%。义齿使用(ρ=-0.077,p<0.01)和刷牙频率(ρ=-0.115,p<0.01)是老年人抑郁症状的负预测因子。DD显著介导义齿使用之间的关联(间接效应-0.047;95CI:-0.068-0.028;p<0.001),刷牙频率(间接效应-0.041;95CI:-0.054-0.030;p<0.001),和抑郁症状。义齿使用和刷牙频率不仅直接降低老年人抑郁症状的风险,但也通过DD间接影响抑郁症状。
    Diet is a modifiable factor in healthy population aging. Additionally, oral health and diet are important factors affecting depressive symptoms. To assess the mediating role of dietary diversity (DD) in oral health and depressive symptoms in older adults, we selected 8442 participants aged ≥ 65 years from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS) for a cross-sectional study. Depressive symptoms were determined based on scores on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Dietary diversity scores (DDS) were established based on the frequency of intake of food groups. Oral health was measured by denture use and toothbrushing frequency. Stepwise multiple linear regression and PROCESS macros were used for mediated effects analysis and testing. The sample had a positive detection rate of 44.1% for depressive symptoms, 40.8% for denture use, and 41.9% for once-a-day toothbrushing. Denture use (ρ = -0.077, p < 0.01) and toothbrushing frequency (ρ = -0.115, p < 0.01) were negative predictors of depressive symptoms in older adults. DD significantly mediated the association between denture use (indirect effect -0.047; 95%CI: -0.068-0.028; p < 0.001), toothbrushing frequency (indirect effect -0.041; 95%CI: -0.054-0.030; p < 0.001), and depressive symptoms. Denture use and toothbrushing frequency not only directly reduce the risk of depressive symptoms in older adults, but also indirectly affect depressive symptoms through DD.
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  • 文章类型: Journal Article
    目的:近年来,人们对研究健康衰老的决定因素越来越感兴趣。这项研究的主要目的是调查口腔状态,根据牙齿脱落和义齿使用的定义,以及中国老年人在四年内的健康老龄化。
    方法:数据来自2014年和2018年中国纵向健康长寿调查的浪潮。采用描述性统计和多变量逻辑回归分析进行统计分析。
    结果:结果表明,与天然牙齿少于20颗的老年人相比,天然牙齿≥20颗的老年人经历健康衰老的可能性更高。在完全调整的模型中,只有≥20颗天然牙齿的老年人比那些有0颗天然牙齿的老年人表现出更高的健康衰老率,OR(95%CI):2.09(1.54-2.84)。
    结论:这些结果强调了保持≥20颗牙齿对于促进中国老年人健康衰老的重要性。此外,戴假牙可以,在不同程度上,减轻牙齿脱落对健康衰老的不利影响。康复干预措施,例如假牙的使用和其他临床策略,在提高老年人口腔健康状况方面发挥着关键作用。
    OBJECTIVE: In recent years, there has been a growing academic interest in investigating the determinants of healthy aging. The main objective of this study was to investigate the association between oral status, as defined by tooth loss and denture use, and healthy aging among Chinese older adults over a four-year duration.
    METHODS: The data were derived from the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. Descriptive statistics and multivariate logistic regression analysis were employed for statistical analysis.
    RESULTS: The results suggest that older adults with ≥20 natural teeth have a higher likelihood of experiencing healthy aging compared to those with fewer than 20 natural teeth. In the fully adjusted model, only older adults with ≥20 natural teeth demonstrated a higher rate of healthy aging compared to those with 0 natural teeth, with an OR (95% CI): 2.09 (1.54-2.84).
    CONCLUSIONS: These results highlight the importance of maintaining ≥20 teeth for promoting healthy aging among Chinese older adults. Furthermore, wearing dentures can, to varying degrees, mitigate the adverse effects of tooth loss on healthy aging. Rehabilitative interventions, such as the utilization of dentures and other clinical strategies, play a pivotal role in enhancing the oral health status of older individuals.
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  • 文章类型: Journal Article
    背景:本研究旨在利用T-SCANⅢ分析磨牙全冠固定修复前后咬合力分布的纵向变化规律,为咬合调整和长期维持提供参考。
    方法:我们共招募了20名接受磨牙常规修复治疗的患者。封堵检查分3个阶段进行(放置前,放置后立即,和放置后3个月)使用T-SCANIII(Tekscan南波士顿,MA,美国,10.0)以检查和测量全牙列的咬合接触面积。
    结果:结果表明,固定修复前后患者磨牙区的咬合力分布发生变化,但磨牙牙弓的咬合力百分比在修复前后没有显着差异(P>0.05)。修复后三个月,侧牙修复牙弓的咬合力百分比显着增加(P<0.05)。
    结论:这项研究的结果表明,患者的咬合力随着牙齿的移动和适应而变化,这主要体现在咬合力的增加。采用T-SCANⅢ型咬合分析仪定量咬合力分析可提供更客观、准确的数据,有效指导临床咬合调整。
    BACKGROUND: This study aims to analyze the longitudinal variation of occlusal force distribution prior to and after fixed restoration for molar full-crowns with T-SCAN III which provide reference for occlusal adjustment and long-term maintenance.
    METHODS: We enrolled a total of 20 patients who received conventional restorative treatment for molars. The occlusion examination was conducted in 3 stages (before placement, immediately after placement, and 3 months after placement) using T-SCAN III (Tekscan South Boston, MA, USA, 10.0) to examine and measure the occlusal contact areas of the full dentition.
    RESULTS: The results indicated that the occlusal force distribution in the molar region of the patients changed before and after the fixed restoration, but the percentages of occlusal force in the dental arch of the molar did not differ significantly before and after the restoration (P > 0.05). Three months after the fixed restoration, the percentage of occlusal force in the restored dental arches of lateral teeth increased significantly (P < 0.05).
    CONCLUSIONS: The results of this study indicated that the occlusal forces of the patients changed with tooth movement and adaptation, which is mainly reflected in the increasing occlusal force. Quantitative occlusal force analysis using T-SCAN III occlusal analyzer can provide more objective and accurate data to effectively guide clinical occlusion adjustments.
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    文章类型: English Abstract
    目的:评价血管化腓骨游离皮瓣修复下颌骨缺损患者术后义齿修复及义齿功能。
    方法:在研究中,154例接受下颌骨段切除术并使用血管化游离腓骨皮瓣修复由于炎症引起的下颌骨缺损的患者,收集2015年1月至2020年12月的创伤和肿瘤.这些患者有共同的纳入标准,即术前稳定咬合关系,下颌骨及邻近部位病变引起的下颌骨节段性缺损(如口底、舌头,cheek),游离腓骨皮瓣用于修复,术后存活。回顾了相关数据,并随访了义齿修复情况。已为完成义齿康复的人提出了与义齿功能评估有关的问卷。由专家权威机构指定义齿修复功能评价指标,获得义齿功能评分。采用SPSS18.0软件对纳入研究的患者基本信息及患者义齿修复情况进行统计分析。
    结果:腓骨游离皮瓣修复下颌骨缺损患者术后义齿修复率为17.5%,下颌骨良性肿瘤患者术后义齿修复率为25.0%(18/72),显著大于恶性肿瘤患者的11.0%(9/82,P<0.05)。髁突缺损患者与无髁突缺损患者的义齿功能评分在义齿修复率及义齿功能评分方面差异无统计学意义(P>0.05)。种植义齿的功能评分明显大于可摘义齿(P<0.05)。根据布朗分类,下颌前区缺损患者的义齿功能评分明显高于下颌前区缺损患者(P<0.05)。恶劣的口腔条件,比如剩余牙齿的数量减少,保留强度不足,手术区域软组织的大活动性,口腔前庭沟状况不佳成为不接受义齿修复的主要原因(37.86%)。
    结论:用血管化腓骨游离皮瓣修复下颌骨缺损的义齿修复与病理特性和口腔状况密切相关。种植义齿的临床效果已得到有效证实,是未来下颌骨重建后义齿修复的较好选择。
    OBJECTIVE: To evaluate the postoperative denture restoration and denture function in patients with mandibular defect reconstructed with vascularized free fibula flap.
    METHODS: In the study, 154 patients who underwent mandibular segment resection and used vascularized free fibula flap to repair mandibular defects due to inflammation, trauma and tumor from January 2015 to December 2020 were collected. These patients had common inclusion criteria which were stable occlusal relationship before operation, segmental defects of mandibular bone caused by lesions of mandible and adjacent parts (such as floor of mouth, tongue, cheek), free fibula flap used for repair and surviving after operation. Relevant data were reviewed and situation of denture restoration was followed up. A questionnaire related to denture functional evaluation had been proposed for those who had completed the denture rehabilitation. The evaluation index of denture restoration function was assigned by expert authority to obtain the denture function score. SPSS 18.0 software was used for statistical analysis of the basic information of the patients included in the study and the denture restoration of the patients.
    RESULTS: The rate of postoperative denture restoration in the patients with mandibular defects repaired by free fibula flap was 17.5%, and the rate of postoperative denture restoration in the patients with benign mandibular tumors was 25.0% (18/72), which was significantly greater than that in the patients with malignant tumors 11.0% (9/82, P < 0.05). There was no significant difference in denture function score between the patients with condylar defect and those without condylar defect in denture repair rate and denture function score (P>0.05). The functional score of implant denture was significantly greater than that of removable denture (P < 0.05). According to Brown classification, the denture function score of the patients with the defect invo-lving the anterior mandibular region was significantly greater than that of the patients without the anterior mandibular region involved (P < 0.05). The poor oral conditions, such as less amount of remaining teeth, insufficient retention strength, large mobility of soft tissue in the surgical area, poor oral vestibular groove condition became the main reason of not receiving denture restoration (37.86%).
    CONCLUSIONS: The denture rehabilitation of mandibular defect reconstructed with vascularized free fibula flap is closely rela-ted to pathological properties and oral conditions. The clinical outcome of implant denture has been confirmed effectively and it is a better choice for future denture restoration after mandibular reconstruction.
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