全牙弓种植固定修复体组织面菌斑附着及患者口腔清洁状况的横断面研究

Plaque accumulation at the fitting surface and cleaning status in patients with full-arch implant-supported fixed prostheses: a cross sectional study

目的观察全牙弓种植固定修复患者修复体组织面菌斑附着情况及口腔清洁状况,探究相关影响因素。方法纳入2012年1月至2020年9月于北京大学口腔医学院·口腔医院种植科就诊并完成全牙弓种植固定修复的患者28例[男性17例,女性11例;年龄(63.0±10.8)岁;修复体共40件,上颌18件,下颌22件],在永久修复满6个月后复诊时对修复体组织面进行菌斑染色并拍照,评价软垢指数,使用ImageJ软件分析菌斑面积百分比,记录修复体组织面清洁状况及患者口内清洁情况,调查患者义齿清洁习惯和满意度,比较义齿不同清洁习惯分组间菌斑附着的差异。结果40件全牙弓种植固定修复体组织面软垢指数为3.28±0.75,菌斑面积百分比为(51.6±19.0)%;下颌修复体软垢指数(3.50±0.80)和菌斑面积百分比[(58.7±20.4)%]均显著大于上颌修复体[分别为3.00±0.59和(43.0±13.1)%](P<0.05),下颌修复体前牙区舌侧有牙石附着;修复体组织面清洁间隙处菌斑附着较其他部位更多。义齿不同清洁习惯分组间菌斑面积百分比差异无统计学意义(P>0.05)。满意度调查结果显示清洁项目满意度得分较低。结论全牙弓种植固定修复患者修复体清洁不良,下颌修复体更甚,特别是下颌前牙区;未见义齿不同清洁习惯对菌斑附着的影响。

Objective To observe the plaque accumulation at the fitting surface and oral hygiene status in patients with full-arch implant-supported fixed prostheses,and explore the possible influencing factors.Methods Twenty-eight patients[17 males and 11 females,(63.0±10.8)years old]with 40 full-arch implant-supported fixed prostheses(18 maxillary and 22 mandibular)were collected from January 2012 to September 2020 in Department of Implantology,Peking University School and Hospital of Stomatology.Plaque accumulation at the fitting surfaces were evaluated during the follow-up visit after 6 months following definitive prostheses delivery,by analyzing the digital photographs recorded by ImageJ.Meanwhile,the cleanliness of the fitting surface of prostheses and oral hygiene status were recorded.The oral hygiene habits and the patients′satisfaction with the prostheses were investigated by questionnaire,and the difference of plaque accumulation between different cleaning habits of dentures were compared.Results The debris index of the fitting surface of the 40 full-arch implant-supported fixed prostheses were 3.28±0.75,and the percentage of area covered with plaque was(51.6±19.0)%.The debris index and plaque accumulation of the mandibular prostheses were significantly higher than that of the maxillary prostheses(P<0.05).In most mandibular prostheses(16/22),calculus was attached to the lingual side of the anterior tooth area.The reserved cleaning space of the restoration showed more plaque accumulation than in other parts.There was no significant difference in the percentage of area covered with plaque between groups with different cleaning habits.The satisfaction survey results indicated the"clean"project had a lowest score.Conclusions The cleanliness of patients with full-arch implant-supported fixed prostheses was poor,and the hygiene status of the mandibular prostheses was worse than that of maxillary,especially in the anterior tooth area of mandibular prostheses.The influence of different cleaning habits on plaque accumulation was not observed.