固定义齿修复牙列缺损的效果及对咀嚼功能和龈沟液TNF-α、IL-1β水平的影响

Efficacy of fixed dental prosthesis in repairing dentition defects and its impact on masticatory function and gingival crevicular fluid levels of TNF-α and IL-1β

摘要:

目的 探讨固定义齿修复牙列缺损的效果及对咀嚼功能和龈沟液肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）水平的影响。方法 纳入2021年3月—2023年3月榆林市第一医院收治的86例牙列缺损患者，按照掷硬币法分为对照组和观察组，每组43例。对照组予以活动义齿修复，观察组予以固定义齿修复，比较两组修复前、修复3个月后的牙周指数［牙龈指数（GI）、牙菌斑指数（PI）、龈沟出血指数（SBI）］、咬合功能、咀嚼功能、口腔健康状况［口腔健康影响程度量表（OHIP-14）］、龈沟液炎症指标［TNF-α、IL-1β、淀粉蛋白A（SAA） ］。结果 观察组修复前后GI、PI和SBI牙周指数的差值较对照组高（P <0.05）；观察组咬合功能优良率为93.02%，对照组为74.42%，观察组咬合功能优良率高于对照组（P <0.05）；观察组修复前后咀嚼效率、OHIP-14评分的差值较对照组高（P <0.05）；观察组修复前后TNF-α、IL-1β、SAA水平的差值较对照组高（P <0.05）。结论 固定义齿修复能有效改善牙列缺损患者的牙周健康状况、咬合和咀嚼功能，降低龈沟液TNF-α、IL-1β和SAA水平，从而提高口腔健康质量，改善整体生活质量。

Abstract:

Objective To explore the efficacy of fixed dental prostheses in repairing dentition defects and its impact on masticatory function and the levels of TNF-α and IL-1β in gingival crevicular fluid.Methods The study included 86 patients with dentition defects treated at Yulin First Hospital from March 2021 to March 2023. Using a coin-flipping method, participants were divided into a control group (43 patients) treated with removable dentures and an observation group (43 patients) treated with fixed dental prostheses. The two groups were compared before and three months after treatment in terms of periodontal indices [Gingival Index (GI), Plaque Index (PI), Sulcus Bleeding Index (SBI) ], occlusal function, masticatory function, oral health status [Oral Health Impact Profile-14 (OHIP-14) ], and inflammatory markers in gingival crevicular fluid [tumor necrosis factor-α (TNF-α), interleukin-1 β (IL-1β), serum amyloid A (SAA) ].Results The observation group showed greater improvements in GI, PI, and SBI after treatment compared with the control group (P < 0.05). The excellent occlusal function rate was 93.02% in the observation group compared with 74.42% in the control group, indicating a better outcome in the observation group (P < 0.05). The differences of masticatory efficiency and OHIP-14 scores before and after treatment were greater in the observation group than in the control group (P < 0.05). The differences of levels of TNF-α, IL-1β, and SAA before and after treatment were also greater in the observation group compared with the control group (P < 0.05).Conclusions Fixed dental prosthesis effectively improves the periodontal health status, and occlusal and masticatory functions of patients with dentition defects, and reduces the levels of TNF-α, IL-1β, and SAA in the gingival crevicular fluid, thereby enhancing oral health and overall quality of life.