总义齿、覆盖义齿和种植覆盖义齿修复后咀嚼效率和下颌运动型的比较

目的　比较总义齿 (completedenture ,CD )、覆盖义齿 (completeoverdenture ,COD )和种植覆盖义齿 (implant supportedoverdenture ,IOD)修复后患者的咀嚼效率和下颌运动轨迹的差异。 方法　分别选取CD、COD和IOD修复后患者各 14名 ,在义齿正常戴用半年后测量患者的咀嚼效率和下颌运动轨迹。对下颌运动轨迹从规则程度、末端集中性、额状面的分型和咀嚼运动中的接触滑动4个方面进行评价 ,测试用食物为杏仁和小枣。结果　IOD组患者咀嚼枣和杏仁的效率均显著高于CD组 (P <0 0 1) ;COD组患者咀嚼杏仁的效率显著高于CD组 (P <0 0 1)。COD组患者咀嚼枣的效率高于CD组 ,且IOD组患者咀嚼枣和杏仁的效率高于COD组 ,但其间差异无显著性。IOD组患者下颌运动轨迹的规则程度显著优于CD组 (P <0 0 5 ) ,末端轨迹集中性也显著优于CD组 (P <0 0 1)。结论　IOD和COD修复有利于提高无牙颌患者或口内只保留个别残根患者的咀嚼效率。IOD修复患者较CD修复患者具有更加规则的下颌运动型。

A comparative study of masticatory efficiency and mandibular movement pattern among patients with CD, COD and IOD

Objective To compare the masticatory effeciency and the character of mandibular movement trace of the patients with complete denture (CD), complete overdenture (COD) and implant supported overdenture (IOD). Methods A total of 42 subjects were rehabilitated with CD, COD and IOD respectively and wore the dentures at least half a year. Each study group was composed of 14 subjects. The masticatiory founction of patients were investigated by means of masticatory efficiency and mandibular movement trace. The characters of mandibular movement trace were evaluated from four aspects: the regulation of chewing cycle, centralization of end traces, the type of the contact slides and the type of the trace on the frontal plane. Results The average chewing efficiency of almond and jujube in the IOD patients was higher than that in the CD group ( P <0.01), and the chewing efficiency of almond in COD group was higher than that in the CD group ( P <0.01). In the IOD group, there were more patients with regular chewing cycle ( P <0.05) and centralized end traces ( P <0.01) in mandibular movement than those in the CD group and COD group. Conclusions IOD and COD benefit the fully or partially edentulous patients with a relatively good masticatory function The patients with IOD have more regular mandibular movement than those with CD