活动义齿和固定义齿在牙周病伴牙列缺损修复治疗中的临床效果对比

Clinical effects of movable dentures versus fixed dentures in repair for patients with periodontal disease and dental defect

目的对比活动义齿与固定义齿在牙周病伴牙列缺损修复治疗中的临床效果。方法前瞻性研究,选取2022年3月至2024年2月在南阳市中心医院口腔科治疗的90例牙周病伴牙列缺损患者作为研究对象,采用随机数字表法将其分为参照组与试验组,每组45例。参照组男22例、女23例,年龄(46.52±8.14)岁,病程(3.06±1.05)年,予以活动义齿进行修复治疗;试验组男24例、女21例,年龄(46.81±8.33)岁,病程(3.11±1.12)年,予以固定义齿进行修复治疗。对比两组治疗前后咀嚼功能(最大咬合接触面积、咬合力、咀嚼效率、咬合力不对称指数)、颞下颌功能[临床功能障碍指数(DI)及颞下颌关节紊乱指数(CMI)]、口腔相关功能(口腔疼痛、口腔健康、牙齿松动度、牙龈出血)及治疗有效率。统计学方法采用t检验、χ^(2)检验。结果治疗前,两组患者咀嚼功能、颞下颌功能、口腔相关功能比较,差异均无统计学意义(均P>0.05)。治疗后,试验组最大咬合接触面积、咬合力均大于参照组[(231.05±21.52)mm^(2)比(205.49±20.03)mm^(2)、(140.05±14.32)Ibs比(131.01±13.92)Ibs],咀嚼效率高于参照组[(86.72±7.23)%比(80.80±6.81)%],咬合力不对称指数、DI、CMI及口腔疼痛、口腔健康、牙齿松动度、牙龈出血评分均低于参照组[(14.05±1.32)%比(20.01±2.92)%、(4.21±1.06)分比(5.85±1.56)分、(0.08±0.02)分比(0.14±0.03)分、(3.66±1.01)分比(4.31±1.16)分、(16.08±1.72)分比(22.72±2.23)分、(4.48±1.02)分比(7.31±1.71)分、(1.16±0.51)分比(1.81±0.66)分],差异均有统计学意义(t=5.832、3.036、3.998、12.476、5.833、7.442、2.834、15.816、9.534、5.227,均P<0.05)。试验组治疗总有效率为95.56%(43/45),高于参照组的77.78%(35/45),差异有统计学意义(χ^(2)=6.153,P=0.013)。结论相较活动义齿,固定义齿在牙周病伴牙列缺损修复治疗中能够有效恢复患者咀嚼功能,提供均衡力量分布,减少对牙周组织损伤,改善颞下颌关节紊乱症状,同时提高口腔舒适度、整体健康状况及临床治疗效果,具有较好推广价值。

Objective To compare the clinical effects of movable dentures and fixed dentures in the treatment of patients with periodontal disease and dentition defect.Methods Ninety patients with periodontal disease and dentition defect treated at Department of Stomatology,Nanyang Central Hospital from March 2022 to February 2024 were selected for the randomized controlled trial,and were divided into a reference group and an experimental group by the random number table method,with 45 cases in each group.There were 22 males and 23 females in the reference group;they were(46.52±8.14)years old;their disease course was(3.06±1.05)years.There were 24 males and 21 females in the experimental group;they were(46.81±8.33)years old;their disease course was(3.11±1.12)years.The reference group were treated with movable dentures,while the experimental group with fixed dentures.The masticatory function,temporomandibular function,oral function before and after the treatment and therapeutic effects were compared between the two groups.t and χ^(2) tests were applied.Results Before the treatment,there were no statistical differences in the masticatory function,temporomandibular function,and oral function between the two groups(all P>0.05).After the treatment,the maximum occlusal contact area,bite force,and masticatory efficiency in the reference group were higher than those in the experimental group[(231.05±21.52)mm^(2) vs.(205.49±20.03)mm^(2),(140.05±14.32)Ibs vs.(131.01±13.92)Ibs,and(86.72±7.23)%vs.(80.80±6.81)%];the asymmetry index of bite force and scores of clinical dysfunction index,temporamandibular joint disturbance index,oral pain,oral health,tooth mobility,and gingival bleeding in the experimental group were lower than those in the control group[(14.05±1.32)%vs.(20.01±2.92)%,(4.21±1.06)vs.(5.85±1.56),(0.08±0.02)vs.(0.14±0.03),(3.66±1.01)vs.(4.31±1.16),(16.08±1.72)vs.(22.72±2.23),(4.48±1.02)vs.(7.31±1.71),and(1.16±0.51)vs.(1.81±0.66)];there were statistical differences(t=5.832,3.036,3.998,12.476,5.833,7.442,2.834,15.816,9.534,and 5.227;all P<0.05).The effective rate of the experimental group was higher than that of the control group[95.56%(43/45)vs.77.78%(35/45)],with a statistical difference(χ^(2)=6.153;P=0.013).Conclusions In the treatment of patients with periodontal disease and dentition defect,fixed dentures can more effectively restore their chewing function,provide more balanced force distribution,and help reduce periodontal tissue damage.Moreover,fixed dentures are more effective in improving symptoms of temporomandibular joint disorders,oral comfort,overall health status,and clinical treatment effect,so it is worth being generalized.