摘要
目的评价不同种类咬合重建修复的临床效果，探讨老年咬合异常患者咬合重建的临床分类、诊断与修复方法选择的原则。方法42例（203颗牙）咬合异常的老年患者，根据修复前检查、诊断，进行修复设计、咬合重建修复，并对修复效果进行评价。修复方法包括固定修复、固定和活动联合修复及活动修复，于修复前、后分别检查义齿使用情况与患者满意度、颞下颌关节健康状况及基牙健康状况。结果咬合重建修复1年后，全部患者对咬合重建修复效果满意。义齿舒适度和对发音影响与活动修复比较，患者对固定修复固定和联合活动修复满意度较高，差异有统计学意义（分别为x^2=4．15和x^2=4．71，均为P〈0．05）；8例颞下颌关节病中7例治愈，关节区疼痛和关节弹响治疗前、后比较，差异有统计学意义（分别为x^2=0．031和x^2=0．038，均为P〈O．05）；203颗基牙中，30颗（14．8％）为牙周炎和继发龋，采用活动修复的基牙问题发生率高于平均水平。结论对于需要进行咬合重建修的老年患者，根据其临床分类及诊断选择不同修复方法，可取得满意的临床效果。
Objective To evaluate the clinical effects and clinical classification of occlusal rehabilitation in elderly patients with abnormal occlusion, and to discuss the diagnosis principles and the practical techniques of the dental prosthesis for occlusal rehabilitation. Methods Forty two elderly patients with abnormal occlusion were treated with occlusal rehabilitation with fixed dentures, fixed-removable dentures and removable partial dentures. Eight patients among them simultaneously had temporomandibular joint （TMJ） disorder. After the clinical procedures including examination, diagnosis, prosthesis design, manufacture, application of occlusal rehabilitation and post-treatment evaluation, the using condition of dentures, patients＇ satisfaction ratings, TMJ functions and abutment teeth healthy status were examined before and after treatment. Results All the patients were satisfied with their dentures＇ general functions 1 year after treatment. Compared with the removable partial dentures, the other two types of prosthesis showed better clinical outcomes （x^2=4.15,P〈0.05） and compacts on phonation of the dentures （x^2=4.71,P〈0.05）. In the 8 patients with TMJ disorder, 7 cases were cured completely. The treatment effects of TMJ pain （x^2=0. 031, P〈0.05）and TMJ click （x^2= 0.038, P〈0.05）had statistical differences. 30 teeth of the 203 abutment teeth （14.8%） had the problems of periodontal diseases and secondary caries and the incidences of these problems were higher in using removable partial dentures treatment than in the other two methods. Conclusions After the systematic diagnosis and the prosthesis design procedures of occlusal rehabilitation, it is important to choose a proper prostheses for the elderly patients according to their physical and psychological features, which may give the patients satisfactory results.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2009年第4期283-286,共4页
Chinese Journal of Geriatrics
