无牙颌患者数字化全口义齿的修复效果及对咀嚼功能和稳定性的影响

Restorative Outcomes of Digital Complete Dentures in Edentulous Patients and the Effect on Masticatory Function and Stability

目的:探讨无牙颌患者数字化全口义齿的修复效果以及对咀嚼功能和稳定性的影响。方法:将笔者医院2019年4月-2021年9月收治的60例无牙颌患者根据随机数字表法分为传统全口义齿组和数字化全口义齿组,每组30例。两组患者采取对应的治疗方式,分别在修复后3、6、12个月测定患者颞下颌关节紊乱指数(Craniomandibular index,CMI)、咀嚼功能、牙槽骨骨吸收量、咬合力以及咬肌表面肌电图(Surface electromyography,sEMG)并进行满意度评分。结果:修复后3、6、12个月,两组患者CMI均较修复前降低,且数字化全口义齿组低于传统全口义齿组(P<0.05)。两组患者咀嚼效率和咬合力均较修复前升高,且数字化全口义齿组高于传统全口义齿组(P<0.05)。数字化全口义齿组前牙区和后牙区下牙槽骨吸收量均低于传统全口义齿组,患者满意度评分均高于传统全口义齿组(P<0.05)。与修复前比较,两组患者修复后12个月紧咬棉棒5 s和牙尖交错位最大自主紧咬的sEMG值均增大,且数字化全口义齿组高于传统全口义齿组(P<0.05),而修复后下颌姿势位的sEMG值较修复前减小,且数字化全口义齿组小于传统全口义齿组(P<0.05)。结论:数字化全口义齿对无牙颌患者具有更好的修复效果,可有效提高患者的咀嚼效率和咬合力,减少牙槽骨吸收,提高患者满意度,增强佩戴稳定性,值得临床推广应用。

Objective To investigate the restorative effect of digital complete dentures in edentulous patients and the effect on masticatory ability and stability.Methods Sixty edentulous patients admitted to the author's hospital from April 2019 to September 2021 were divided into a conventional complete denture group and a digital complete denture group according to the random number table method,with 30 patients in each group.The corresponding treatment modalities were adopted in both groups,and the patients'temporomandibular disorder index(CMI),masticatory function,alveolar bone resorption,occlusal force,and surface electromyography of the occlusal muscles(sEMG)were measured and scored for satisfaction at 3,6,and 12 months after restoration,respectively.Results At 3,6,and 12 months after restoration,CMI decreased in both groups compared with the pre-prosthetic period,and was lower in the digital complete denture group than in the conventional complete denture group(P<0.05).Masticatory capacity and occlusal force increased in both groups compared with the pre-prosthetic period,and were higher in the digital complete denture group than in the conventional complete denture group(P<0.05).The digital complete denture group had lower resorption of inferior alveolar bone in the anterior and posterior regions than the traditional complete denture group,and the patient satisfaction scores were higher than those of the traditional complete denture group(P<0.05).Compared with the pre-prosthetic period,the sEMG values of clenching cotton swabs for 5 s and maximum voluntary clenching in the cusp interdigitated position increased in both groups 12 months after restoration,and were higher in the digital complete denture group than in the conventional complete denture group(P<0.05),while the sEMG values of the mandibular postural position decreased after restoration compared with the pre-prosthetic period,and were smaller in the digital complete denture group than in the conventional complete denture group(P<0.05).Conclusion Digital complete denture has better restorative effect on edentulous patients,can effectively improve patients'chewing ability and occlusal force,reduce alveolar bone resorption,improve patient satisfaction and enhance wearing stability,and is worthy of clinical application and promotion.