舌杆与舌板修复设计在下颌双侧游离牙缺失治疗中的应用比较

Comparison of two mandibular major connector designs： the sublingual bar and the lingual plate in distally extended removable partial dentures

目的 评价舌杆与舌板两种设计方法修复下颌双侧游离牙缺失对患者牙周组织健康及满意度的影响.方法 选取68例老年患者,各制作2副不同设计（舌杆与舌板）的下颌义齿,戴用后根据患者自己的感受对其发音、咀嚼效果、舒适度、满意度等方面进行评价,并对其牙周情况及牙松动度进行检查.结果 两种义齿佩戴后情况均基本稳定,未出现不良反应.舌板设计优势更明显,其固定功能、舒适性及语音功能满意度均明显高于舌杆设计（P＜0.05或0.01）,而咀嚼功能、美观程度及方便程度无明显差异（P ＞0.05）.两种修复方式修复后余留牙牙龈出血指数、探诊后出血阳性率、牙周探诊深度的差异均无统计学意义（均P ＞0.05）.两种设计方法均能有效改善余留牙的松动状态,舌板设计较之舌杆设计改善有效率更高（P＜0.05）.结论 在基牙牙周病有效控制后,使用舌板设计可以更有效分散■力,对松动牙起夹板作用,舌板设计更适用于下颌双侧游离牙缺失的修复.

Objective To compare the effect and satisfaction of lingual plate and subligual bar as a major connector in distally extended removable partial dentures （RPDs）. Methods Two mandibular removable partial dentures, with a sublingual bar or with a lingual plate as the major connector, were constructed respectively for 68 patients. The speaking, chewing and comfort of partial dentures were evaluated according to the subjective judgment of patients. Index of the periodontal health and the teeth mobility were examined at the same time. Results Periodontal conditions was stable at the end of the test and there was no side effect. There were no significant differences in gingival bleeding index, bleeding on probe, probing depth between two groups（P 〉0.05）. However, lingual plate-type RPDs demonstrated less mobility （P〈0.05） and higher satisfaction in speaking, stability and comfort（P〈0.05 or P〈0.01 ）, when compared to sublingual bar. There were no statistically significant differences in aesthetics, mastication, functional convenience between two designs（P 〉0.05）. In general, patients adapted better to major connectors with lingual plate. Conclusion Results indicate that the design of lingual plate in distally extended removable partial dentures is more favorable than the sublingual bar in patients＇ satisfaction and periodontal health of the abutment teeth.