牙齿重度磨耗伴牙列缺损患者经[牙合]垫式可摘局部义齿修复治疗疗效评价

Evaluation of the therapeutic effect of occlusal pad removable partial denture in patients with severe tooth wear and dentition defect

目的探究[牙合]垫式可摘局部义齿(RPD)修复治疗牙齿重度磨耗(SOA)伴牙列缺损(DD)患者的效果。方法回顾性收集我院60例牙齿SOA伴DD患者(2019年12月至2022年12月),按治疗方案不同分成A组(30例)、B组(30例)。B组接受传统RPD修复,A组接受垫式RPD修复。对比2组咀嚼功能[咬合力(BF)与咀嚼效率(ME)]、咀嚼肌功能肌电图[双侧颞肌前束(TA)、咬肌(MM)均值及牙尖交错位(ICP)最大紧咬平均峰值电位]、临床症状发生率、炎性因子指标[白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)]、并发症发生率。结果修复3个月A组ME、BF较B组高(P<0.05);修复3个月A组ICP最大紧咬平均峰值电位TA、MM值较B组高,息止位肌电图TA、MM值较B组低(P<0.05);修复3个月A组食物嵌塞、颞下颌关节疼痛发生率较B组低(P<0.05);修复3 d A组龈沟液TNF-α、IL-6含量较B组低,IL-10含量较B组高(P<0.05);2组并发症发生率相比差异无统计学意义(P>0.05)。结论与传统RPD修复治疗牙齿SOA伴DD患者相比,应用[牙合]垫式RPD修复治疗于改善临床症状、提高咀嚼肌功能及咬合功能方面更具优势,且对机体炎性应激反应影响更小。

Objective To explore the effect of occlusal pad removable partial denture(RPD)in the treatment of severe tooth wear(SOA)with dentition defect(DD).Methods Sixty patients with dental SOA accompanied by DD(from December 2019 to December 2022)in our hospital were retrospectively collected and divided into group A(n=30)and group B(n=30)according to different treatment regiments.B group received traditional RPD restoration,A group received pad RPD restoration.The masticatory function[bite force(BF)and masticatory efficiency(ME)],the electromyography(EMG)of masticatory muscle function[mean value of bilateral temporal tract(TA)and masseter muscle(MM)and the mean peak value of the maximum biting potential at the apex interlacing position(ICP)],the incidence of clinical symptoms,inflammatory factor indexes[interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α)]of the 2 groups were compared],complication rate.Results After 3 months of repair,ME and BF in group A were higher than those in group B(P<0.05).After 3 months of repair,the values of TA and MM of ICP maximum clamping peak potential in group A were higher than those in group B,and the values of TA and MM in stop EMG were lower than those in group B(P<0.05).After 3 months of repair,the incidence of food impaction and temporomandibular joint pain in group A was lower than that in group B(P<0.05).The contents of TNF-αand IL-6 in gingival crevicular fluid of group A were lower than those of group B,and the contents of IL-10 were higher than those of group B(P<0.05).There was no significant difference in the incidence of complications between 2 groups(P>0.05).Conclusion With the traditional RPD restoration treatment teeth,compared to patients with DD with SOA application pad RPD restoration treatment to improve clinical symptoms,improve masticatory muscle function and occlusal function has more advantages,and a smaller effect on the body′s inflammatory stress response.