固定义齿、活动义齿及其联合修复对牙周病伴牙列缺损患者咀嚼功能和语言功能的修复效果比较

Comparison of the restorative effects of fixed dentures, removable dentures, and their combination on masticatory and speech functions in patients with periodontal disease and dentition defects

摘要:

目的 探讨固定义齿、活动义齿及其联合修复在牙周病伴牙列缺损患者咀嚼功能和语言功能的修复效果。方法 选取2021年7月—2023年7月在重庆市大足区人民医院口腔科就诊的牙周病伴牙列缺损患者153例，根据其修复方式将患者分为固定-活动组、固定组和活动组，每组51例。对比3组患者治疗效果，治疗前后咀嚼功能和语音功能变化，以及患者美观满意度评分。结果 固定-活动组、固定组、活动组总有效率比较，差异无统计学意义（P <0.05）。固定-活动组、固定组和活动组治疗前、治疗后1和3个月的咬合力和咀嚼效率比较，结果 ①不同时间点咬合力和咀嚼效率比较，差异均有统计学意义（P <0.05）；治疗前，3组咬合力和咀嚼效率比较，差异均无统计学意义（P >0.05）；治疗后1和3个月的咬合力和咀嚼效率比较，固定-活动组较固定组和活动组好（P <0.05）。②3组咬合力和咀嚼效率比较，差异均有统计学意义（P <0.05）。③3组咬合力和咀嚼效率变化趋势比较，差异均有统计学意义（P <0.05）。3组治疗前语音功能比较，差异均无统计学意义（P >0.05）。固定-活动组治疗后觉舌感舒适和发音轻松例数占比高于其他组（P <0.05）。固定-活动组治疗后语音清晰度高于其他组（P <0.05）。固定-活动组患者PES、WES和美观度评分均高于固定组和活动组（P <0.05）。固定-活动组基托断裂2例，基托固位不良3例，发生率为9.80%；固定组基托断裂2例，基托固位不良1例，发生率为5.88%；活动组基托断裂1例，基托固位不良3例，发生率为7.84%。3组不良反应发生率比较，差异无统计学意义（P >0.05）。结论 固定-活动义齿、固定义齿和活动义齿均可以改善患者咀嚼功能、语音功能和美观度，但固定-活动义齿效果更佳。

Abstract:

Objective To explore the restorative effects of fixed dentures, removable dentures, and their combination on masticatory and speech functions in patients with periodontal disease and dentition defects.Methods A total of 153 patients with periodontal disease and dentition defects who were treated at the Department of Stomatology of Dazu District People's Hospital were enrolled between July 2021 and July 2023. According to different repair methods. Patients were categorized into three groups based on the type of restoration: the fixed-removable group, the fixed group, and the removable group, with 51 cases in each group. The three groups were compared in terms of treatment outcomes, changes in masticatory and speech functions before and after treatment, and patient aesthetic satisfaction scores.Results There was no significant difference in the overall effective rate among the fixed-removable group, the fixed group and the removable group (P < 0.05). The occlusal force and masticatory efficiency of the three groups before treatment, 1 month after treatment and 3 months after treatment were compared, which demonstrated that they were different among the time points (P < 0.05). There was no significant difference in occlusal force and masticatory efficiency among the groups before treatment (P > 0.05), but they were better in the fixed-removable group than those in the fixed group and the removable group at 1 month and 3 months after treatment (P < 0 .05). There were significant differences in occlusal force and masticatory efficiency among the three groups (P < 0.05). The change trends of the occlusal force and masticatory efficiency were also different among the groups (P < 0.05). There was no significant difference in speech functions among the three groups before treatment (P > 0.05). The proportion of patients reporting tongue comfort and ease of pronunciation after treatment was higher in the fixed-removable group than in the other groups (P < 0.05). After treatment, the speech articulation in the fixed-removable group was higher than that in the other groups (P < 0.05). The PES, WES and aesthetic scores in the fixed-removable group were higher than those in the fixed group and the removable group (P < 0.05). In the fixed-removable group, there were 2 cases of denture base fracture and 3 cases of poor denture base retention, with an incidence rate of 9.80%. In the fixed group, 2 cases of denture base fracture and 1 case of poor denture base retention were observed, with an incidence rate of 5.88%. In the removable group, 1 case of denture base fracture and 3 cases of poor denture base retention occurred, resulting in an incidence rate of 7.84%. The comparison of adverse event incidence rates among the three groups showed no statistically significant difference (P > 0.05).Conclusions Fixed-removable dentures, fixed dentures, and removable dentures all improve masticatory function, speech function, and aesthetics, but fixed-removable dentures provide superior results.