舌向集中式和解剖式对老年全口义齿修复患者咬合功能和咀嚼系统功能恢复的影响比较 ^*

Comparison of the effects between lingual centralized occlusion and anatomical occlusion on functional recovery of occlusal and masticatory systems in elderly patients with complete dentures

摘要

目的 比较舌向集中式和解剖式对老年全口义齿修复患者咬合功能和咀嚼功能的影响。方法 选取2021年8月—2024年3月中国人民解放军总医院第八医学中心综合门诊口腔科收治的80例老年无牙颌患者进行回顾性分析, 患者均采用全口义齿修复治疗。采用舌向集中式的40例为观察组, 采用解剖式的40例为对照组, 比较两组治疗前和治疗3个月后的咬合功能、咀嚼效率、颞下颌关节紊乱指数, 治疗后3个月和6个月牙槽骨骨吸收量、治疗后满意度和治疗中不良反应发生情况。结果 治疗3个月后, 观察组最大咬合力大于对照组 (P<0.05), 咬合接触时间、色调值标准差和咬合力中心偏移值均小于对照组 (P<0.05), 颞下颌关节紊乱指数低于对照组 (P<0.05)。在治疗后3个月和6个月时, 观察组的前牙区和后牙区牙槽骨骨吸收量均少于对照组 (P<0.05)。观察组对美观度的满意度低于对照组 (P<0.05), 对舒适度、固位功能、语言功能的满意度均高于对照组 (P<0.05)。两组均未出现义齿脱落、基托裂纹等其他不良反应, 两组疼痛发生率比较差异无统计学意义 (P>0.05)。结论 对于老年义齿修复患者, 舌向集中式的咬合功能和咀嚼功能比解剖式更佳。舌向集中式能够提高患者的舒适度、固位功能、语言功能, 减小咬合力中心偏移、颞下颌关节紊乱和牙槽骨骨吸收; 而解剖式相较舌向集中式具有更高的美观度。

Abstract

Objective To compare the effects between lingual centralized occlusion and anatomical occlusion on functional recovery of occlusal function and masticatory systems in elderly patients with complete dentures. Methods The clinical data of 80 elderly patients with edentulous jaws admitted to the department of prosthodontics of the 8th Medical Cente in Chinese PLA General Hospital from August 2021 to March 2024 were retrospectively collected. All patients were treated with complete denture. Among them, 40 cases were treated with lingual centralized occlusion as the observation group. Another 40 patients were treated with anatomical occlusion as the control group. The occlusal function, chewing efficiency, temporomandibular joint disorder index, alveolar bone resorption at 3 and 6 months after treatment, satisfaction after treatment and adverse reactions during treatment were compared between the two groups before and 3 months after treatment. Results After 3 months of treatment, the maximum bite force of the observation group was greater than that of the control group (P<0.05), the occlusal contact time, standard deviation of Hue value and bite force center offset value were less than those of the control group (P<0.05), and the temporomandibular joint disorder index was lower than that of the control group (P<0.05). At 3 months and 6 months after treatment, the absorption of alveolar bone in the anterior and posterior teeth of the observation group was less than that of the control group (P<0.05). The satisfaction of aesthetics in the observation group was lower than that in the control group (P<0.05), and the satisfaction of comfort, retention function and language function was higher than that in the control group (P<0.05). There were no other adverse reactions such as denture loss and base crack in the two groups. There was no significant difference in the incidence of pain between the two groups (P>0.05). Conclusion For elderly patients with denture restoration, the occlusion function and chewing function of lingual centralized occlusion is better than that of anatomical occlusion. Lingual centralized occlusion can improve the comfort, retention function and language function of patients, and reduce the center deviation of bite force, temporomandibular joint disorder and alveolar bone resorption. Anatomical has higher aesthetics than lingual centralized.

关键词

全口义齿 / 舌向集中式 / 解剖式 / 咬合功能 / 咀嚼系统功能

Key words

Complete denture / Lingual centralized occlusion / Anatomical occlusion / Occlusal function / Masticatory systems function

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基金资助

^*国家自然科学基金项目(81701018)