不同固位方法对单侧上颌骨缺损赝复体修复疗效影响的临床研究  

A clinical study of the effect of different retention methods on the restoration of unilateral maxillary defect

作　　者：陈丽娟[1] 张红闯[1] 孟庆飞[2] CHEN Lijuan;ZHANG Hongchuang;MENG Qingfei(Department of Stomatology,Xuzhou 1st Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市第一人民医院口腔科,江苏徐州221000 [2]徐州市中心医院口腔科,江苏徐州221000

出　　处：《口腔医学》2020年第11期1005-1008,共4页Stomatology

基　　金：江苏省青年医学重点人才(QNRC2016391)。

摘　　要：目的比较3种不同固位方法对单侧上颌骨缺损赝复体修复疗效的影响。方法选取单侧上颌骨缺损患者27例,根据其赝复体固位方法不同分为3组:弯制卡环组8例,铸造卡环组10例,附着体联合铸造卡环组9例。赝复体经口内试戴并正常行使功能后1周,测定咀嚼效率、语音清晰度和患者自我满意度评分,记录相关主客观评价数据,用单因素方差分析和Tukey HDS Test分析比较3组间评价指标的差异。结果3组病例的咀嚼效率值分别为(50.29±5.48)%、(63.44±4.92)%和(69.75±6.18)%,组间差异均有显著性差异(P<0.05);语音清晰度值分别为(60.05±5.31)%、(82.74±7.12)%和(86.40±7.94)%,弯制卡环组语音清晰度最差,均显著低于其他两组(P<0.05)。在患者自我满意度评分方面,附着体组的得分最高,均显著高于弯制卡环组(P<0.05);铸造卡环组除在语音清晰度、固位稳定性和咀嚼功能得分显著高于弯制卡环组(P<0.05)外,在舒适度和美观性方面两组间评分无显著性差异(P>0.05)。结论附着体联合铸造卡环固位的赝复体可较好地改善单侧上颌骨缺损患者的咀嚼和语音功能,提高患者的满意度和生活质量,在健侧有多个健康天然牙存留时,可优先选择附着体固位的赝复体修复单侧上颌骨缺损。Objective To compare the effects of three different retention methods on the restoration of unilateral maxillary defect.Methods Twenty⁃seven patients with unilateral maxillary defects were divided into three groups according to the different retention methods of prosthesis:8 cases in the bending clasp group,10 cases in the casting clasp group,and 9 cases in the attachment combined casting clasp group.One week after the prosthesis was worn in mouth and operated normally,the masticatory efficiency,speech intelli⁃gibility and patients'self satisfaction score were measured.Then the relevant subjective and objective evaluation data were recorded.And the differences of evaluation indexes among the three groups were compared by one⁃way ANOVA and Tukey HDS test.Results The mean values of masticatory efficiency of the three groups were(50.29±5.48)%,(63.44±4.92)%and(69.75±6.18)%,respec⁃tively,with significant differences among the groups(P<0.05).The mean values of speech intelligibility were(60.05±5.31)%,(82.74±7.12)%and(86.40±7.94)%,respectively,with the worst speech intelligibility in the bending clasp group,which was signif⁃icantly lower than the other two groups(P<0.05).In terms of patients'self satisfaction score,the attachment group was the highest,significantly higher than that of the blending clasp group(P<0.05).The casting clasp group scored significantly higher than that of the bending clasp group in terms of voice clarity,denture stability and chewing function(P<0.05),but there was no significant difference between both groups in terms of comfort and aesthetics(P>0.05).Conclusion The prosthesis with attachment and cast clasp can im⁃prove the mastication and speech function of patients with unilateral maxillary defect,and improve the patients'satisfaction and quality of life.If several healthy natural teeth are left on the healthy side,the prosthesis with attachment may be the priority method for the uni⁃lateral maxillary defect restoration.

关 键 词：上颌骨缺损 固位 赝复体 

分 类 号：R782.23[医药卫生—口腔医学]