临床路径在可摘局部义齿修复游离端牙列缺失患者中的应用价值

The application value of the clinical pathway in the repairing distal extension removable partial denture

目的研究临床路径在可摘局部义齿修复游离端牙列缺失患者中的应用价值。方法选择130例肯氏Ⅰ、Ⅱ类牙列缺损患者,按口腔内余留牙和牙槽嵴黏膜条件相近、肯氏分类及亚类相同的2例为一对,分为65对,均分为临床路径组和传统修复组。比较2组的适应期调改次数,适应期结束后咀嚼是否有力,咀嚼时游离端基托是否存在肉眼可见活动度、基牙龋坏、基齿松动和食物嵌塞情况。结果临床路径组在适应期调改次数低于传统方法组[1.0(1.0,2.0)次vs.3.0(2.0,4.0)次];适应期结束后调改后咀嚼有力的比例(93.85%vs.76.96%)高于传统方法组,出现肉眼可见动度(0 vs.15.38%)、基牙龋坏(1.54%vs.13.85%)、基牙松动(0 vs.12.31%)及食物嵌塞(1.54%vs.15.38%)比例均低于传统方法组(均P<0.05)。结论临床路径可以提高可摘局部义齿的固位和稳定,遵循临床路径方法制作可摘局部义齿能够减小功能状态下义齿的不稳定性,具有良好的推广前景。

Objective To study the application value of the clinical pathway in the repairing distal extensionremovable partial denture. Methods One hundred and thirty patients with free-end dentition defect were selected in thisstudy. In the oral cavity, the conditions of the mucosa were similar in terms of the residual teeth and alveolar crest mucosa,and the two groups of the same species were divided into 65 pairs. The random digital table method was used to dividepatients into clinical path group and traditional repair group. The frequency of adjustments during the adaptive phase,masticatory efficiency of the denture at ending of the adaptive phase, visible movement of the extension base during themasticatory, decay of abutment, abutments loosen and food embedded plug were compared between the two groups. Results The frequency of adjustments during the adaptive phase was significantly lower in clinical path group than that of traditionalrepair group [1.00(1.00, 2.00) times vs. 3.00(2.00, 4.00) times]. The masticatory efficiency of the denture was higher inclinical path group than that of traditional repair group(93.85% vs. 76.96%). The visible movement of the extension baseduring mastication(0 vs. 15.38%), decay of abutment(1.54% vs. 13.85%), abutments loosen(0 vs. 12.31%) and foodembedded plug(1.54% vs. 15.38%) were significantly lower in clinical path group than those of traditional repair group(P<0.05). Conclusion The retention and the stabilization of the removable partial denture can be improved by means ofclinical pathway. By following the clinical path method, the removable partial denture shows reduced unstable state of thedenture in the functional state and has a good prospect for clinical application.