循证医学分析下颌牙列缺失患者对不同修复方式的满意度差异

Evidence-based analysis of patient satisfaction of different prosthetic options in mandibular edentulous patients

目的:从患者满意度角度分析比较种植覆盖义齿和全口义齿两种修复方式对下颌牙列缺失患者治疗效果的差异,为下颌牙列缺失患者修复方式的临床选择提供参考依据。方法:检索1990-2012年间国内外关于下颌牙列缺失患者对上述两种修复方式满意度比较的前瞻性随机临床试验报道,根据文献纳入标准最终筛选出18篇文献,应用循证医学方法进行分析。结果:经Excel2010卡方检验,接受种植覆盖义齿的下颌牙列缺失患者整体满意度显著高于全口义齿修复者。种植覆盖义齿的优势主要体现在义齿固位和稳定性好、咀嚼效能强、对美学及社会心理影响小(P<0.05);全口义齿的优势在于方便清洁、花费小、时间占用率低(P<0.05)。两者在对味觉的影响和义齿气味等方面无显著差异(P>0.05)。结论:总体而言,种植覆盖义齿患者满意度高于全口义齿。临床上应根据患者的具体需求,结合两者的不同优势,为患者推荐最适宜的修复方式,以期获得最满意的修复效果。

Objective： To analyze and compare the differences between prosthetic effects of implant-retained mandibular overdentures and conventional mandibular complete dentures in terms of patient satisfaction, thus providing a better prosthetic option for mandibular edentulous patients. Methods： Prospective randomized clinical trials published between 1990 and 2012 were searched for those focused on the comparison of patient satisfaction between implant-retained mandibular overdentures and conventional mandibular complete dentures. 18 literatures were screened out according to the inclusion criteria, and they were analyzed by means of evidence-based medicine. Results： Statistical analysis was carried out using chi-square test by Excel 2010. Significantly better satisfaction was found in patients with implant-retained mandibular overdentures than those with conventional mandibular complete dentures. Advantages of the former lay mainly in better retention and stability, stronger masticatory function and lower aesthetic and psychosocial impact （P 〈0.05）. In contrast, the latter was shown to be more convenient in cleaning and lower in costs of time and money （P 〈0.05）. No significant difference were found in their smell and their influence on taste （P 〉0.05）. Conclusion： Patients were more satisfying to implant retained mandibular overdentures as a whole. In order to obtain the best prosthetic effects, The dentists should combine the needs of patients with the advantages of both types of dentures and recommend the most suitable prosthetic option to patients.