老年可摘义齿佩戴者口腔健康相关生活质量的影响因素分析

Analysis of influencing factors on oral health related quality of life for elderly removable denture wearers

目的分析老年可摘义齿佩戴者口腔健康相关生活质量(oral health-related quality of life,OHRQoL)的影响因素及相互关系。方法选取牙列缺损/牙列缺失患者86名作为义齿佩戴组,行可摘义齿修复且义齿远端至少延伸到第一磨牙。选择天然牙列保留至第一磨牙的无可摘义齿患者72名作为对照组。采用Eichner分类法记录上下颌之间的咬合单位和咬合支持数量,口腔健康影响程度量表(Oral Health Impact Profile,OHIP)评价OHRQoL,接触定位法确定主要咬合区,双侧第一磨牙作为测量部位评估最大咬合力,粘性凝胶法评估咀嚼效率,食物接受度问卷评估咀嚼能力。结果义齿佩戴组的OHIP评分以及心理不适和生理能力受限两个分量表的评分高于对照组(P<0.05)。OHIP评分与余留牙数、咬合支持数量、最大咬合力和咀嚼能力呈显著负相关。下颌余留牙数、咬合支持数量、下颌主要咬合区是否为天然牙以及咀嚼能力是OHIP评分的显著影响因素。结论老年可摘义齿佩戴者口腔健康相关生活质量与余留牙咬合关系和主要咬合区存在相关性,其中保留下颌第一磨牙是一个关键影响因素。

Objective To analyze the influencing factors and interrelationships of oral health-related quality of life(OHRQoL)of elderly removable denture wearers.Methods A total of 86 patients with dental defects/edentulous jaws were selected as the denture wearing group.Removable dentures were performed and the distal end of dentures extended at least to the first molar.A total of 72 patients without removable dentures whose natural dentition was preserved to the first molar were selected as the control group.The Eichner classification was used to record the occlusal units and occlusal support quantity between the upper and lower jaw.The Oral Health Impact Profile(OHIP)was used to evaluate OHRQoL.The contact positioning method was used to determine the main occluding area.The bilateral first molars were used as the measurement site to evaluate the maximal occlusal force.The gummy jelly method was used to evaluate the masticatory performance.The questionnaire on food acceptance was used to evaluate the masticatory ability.Results The OHIP score and scores on the two subscales of psychological discomfort and physiological ability limitation in the denture wearing group were higher than those in the control group(P<0.05).The OHIP score was significantly negatively correlated with the number of remaining teeth,number of occlusal supports,the maximum occlusal force,and masticatory ability.The number of remaining teeth in the mandible,the number of occlusal supports,whether the main occlusal area of the mandible was natural teeth,and masticatory ability was significant influencing factors of OHIP score.Conclusion There is a correlation between the quality of life related to oral health of elderly removable denture wearers and the remaining bite relationship and the main occluding area,with the retention of the first mandibular molar being a key influencing factor.