不同颌位记录方法对全口义齿再修复患者咀嚼效率的影响

目的比较3种记录颌位关系方法对全口义齿再修复患者不同时期咀嚼效率的影响。方法随机选择20名全口义齿再修复患者采取自身对照的方法,每位患者分别采用直接咬合法、哥特式弓描记法、哥特式弓联合面弓转移颌位关系法制作3副全口义齿,并比较不同方法下制作的义齿在患者即刻佩戴义齿时、佩戴义齿3个月后的咀嚼效率的差异。结果患者即刻佩戴义齿时咀嚼效率测定结果显示,使用哥特式弓联合面弓转移颌位关系法制作全口义齿的患者咀嚼效率明显高于使用其他2种方法制作全口义齿的患者（P〈0．05）,而使用直接咬合法与哥特式弓描记法制作全口义齿的患者咀嚼效率没有差异;佩戴义齿3个月后,3组患者的咀嚼效率无明显差异。结论使用哥特式弓联合面弓转移颌位关系法可为患者提供更可靠的颌位记录方法,可以提高患者的即刻咀嚼效率,提高患者的满意度和医生的工作效率。     

55例总义齿修复的临床评价

目的 评价拔牙前取模减少确定颌位误差修复总义齿的临床效果。方法 记录55例患者拔牙前咬合关系，以此作为拔牙后总义齿的颌位依据，指导后期制作并评价临床应用效果；在记存模上制作即刻总义齿；常规拔牙；拔牙2个月后试验、采用闭口式印模、完成总义齿修复。结果 53例患者获得满意的效果，成功率达96％。结论 用此方法制作总义齿，减少了确定颌位关系时的麻烦与误差，修复效果良好。     

再制总义齿的颌位关系转移

戴用全口总义齿的患者,若需要重新制作一副总义齿,按常规程序转移颌位关系需几次复诊才能完成。作者自1975年以来,采用以患者的原总义齿为托盘,取制印模,用生理解剖式(牙合)架,一次性记录和转移颌位关系。共再制总义齿32副,成功率达100%。现介绍如下。     

不同材质的义齿基托对修复效果影响的分析

目的：应用复制义齿技术制作不同材质基托,研究义齿基托材料对义齿功能发挥的影响。方法选取符合纳入标准的多数牙缺失的患者,采用复制义齿技术制作不同基托材质(纯钛、钴铬合金和树脂基托)的义齿各10件。分别对3组义齿修复体进行重量等指标的比较观察,评价固位力等初戴效果。结果经过实际测量,在义齿重量方面,上颌的纯钛组与钴铬组有明显差异（P<0.05）。从患者评价方面,初戴时大多数患者感觉纯钛组义齿异物感小,固位好,质轻;金属基托从异物感和语言方面似乎更适应患者的心理要求。结论由于解剖位置和金属材料特性的原因,口腔修复材料选择时需要考虑义齿的修复效果,并不完全取决于材料的密度。     

全口义齿临床效果的回顾性研究

目的：通过统计353例全口义齿从戴入到替换期间进行的义齿重衬、基托修理和人工牙脱落等方面．对全口义齿的戴用时间和使用效果进行评价。材料和方法：所有义齿都由雷根斯堡大学医疗中心修复科在职员工根据标准治疗方案于1984—2009年制作．并统一经过检查。研究对象分为两组：组1中94位患者的上下颌均进行了全口义齿修复;组2中165人只进行了单颌的总义齿修复。结果：组1的下颌总义齿中位存留时间为158年,上颌总义齿的中位存留时间为194年。上颌义齿往往需要重衬。上颌义齿的5年免修理率为697％．下颌义齿的5年免修理率为805‘Yo。组1义齿基托折裂率为58％．而对于组2中只有下颌义齿的患者来说．基托折裂率较高,中位数为152％。人工牙脱落的发生率较少．组1为5．8％,组2为109％。在最初的5年中,组1中95％的义齿和组2中90‰的义齿都没有发生人工牙脱落。结论：全口义齿长时间的使用需要大量的维护和修理。对戴用单颌总义齿的患者应进行干预。     

运用嚼肌颞肌髁突联合触诊校对颌位关系的临床体会

运用嚼肌颞肌髁突联合触诊校对颌位关系的临床体会西安市第二人民医院口腔科李焕云第四军医大学口腔医学院施生根指导颌位关系的确定和转移是全口义齿及复杂可摘义齿修复中的一个关键步骤。义齿的生理咬合功能，必须建立在正确的颌位关系上。颌位记录有四个基本步骤：确定...     

钴铬合金铸造支架就位困难原因分析

目的：分析钻铬合金铸造支架就位困难原因，提高义齿质量，降低义齿的失败率。方法：通过分析义齿就位困难的原因，重新进行牙体预备、取模，严格按水粉比灌注石膏模型，上观测台，正确的填补倒凹，严格按操作规程翻模、焙烧，选择适当的铸造时机。结果：失败重做组未经调改就位的比率(61．5％)比一次就位成功组未经调改就位的比率(32．1％)有明显提高。失败重做组的平均试戴时间(3．8min)比一次就位成功组的平均试戴时间(9．2min)明显缩短。结论：充分的牙体预备、硅橡胶取模及严格按操作规程制作的义齿可缩短就位时间，提高义齿就位的成功率。     

制作蜡基托的简便加热法

在修复全口义齿或复杂部分义齿转移颌关系时,需制作蜡基托。在石膏模型上制作蜡基托是转移颌关系的重要步骤之一,而蜡基托与模型是否紧密贴合则直接影响咬合关系的准确和假牙的质量。以往我们护理组制作蜡基托时采用热水(60℃—70℃)加温或酒精灯火焰加温两种方法,但都存在一定的缺点,为提高工作效率,进一步提高质量,     

不同颌位关系记录法对全口义齿再修复患者义齿调胎量影响的研究

目的通过研究3种方法记录颌位关系的全口义齿再修复患者义齿调胎量的差异,为此类患者探寻最佳颌位记录方法,并为临床提供参考。方法随机选择20名全口义齿再修复患者,采用自身对照的研究,对患者分别采用直接咬合法、哥特式弓描记法、哥特式弓联合面弓转移颌位关系法制作3副全口义齿,并比较不同方法在调殆前后覆殆、覆盖的差异。结果用哥特式弓联合面弓转移颌位关系法制作的全口义齿调验前后覆殆、覆盖的变量差异大于直接咬合法及哥特式弓描记法,其差异具有统计学意义（P〈0.05）。直接咬合法与哥特式弓描记法转移颌位关系法之间无明显差异（P〉O.05）。结论使用哥特式弓描记法与哥特式弓联合面弓转移颌位关系法确定的颌位更符合生理功能,为全口义齿再修复患者提供更可靠的颌位记录方法,提高医生的工作效率和患者的满意度。     

复制义齿技术在研究全口义齿语音功能中的应用

目的：探讨应用复制义齿技术制作全口义齿,并分析初戴前后义齿基托对语音功能的影响。方法：选取符合纳入标准的患者,采用复制义齿技术基托置换的方法制作全口义齿,以患者主观自评和客观的汉语语音清晰度方法,分别测试3种基托全口义齿在初戴前、后的语音功能。结果：应用复制义齿技术可以减少影响研究义齿发音的因素;3组义齿初戴时,语音清晰程度统计分析结果,塑胶基托与金属基托间差异有统计学意义（P〈0.05）,钴铬和纯钛基托两组间无明显差异。结论：义齿基托厚度较基托材质对患者语音功能的影响更大,患者的主观感觉与实际语音功能恢复有时并不一致。     

心理干预对老年患者佩戴可摘局部义齿修复满意度的影响

目的：探讨修复前心理干预对初次佩戴复杂活动义齿的老年患者修复满意度的影响。方法：选择门诊80例初次进行复杂活动义齿修复的老年患者，实验组40例，修复前进行心理干预，对照组40例，常规修复，术后分别调查患者修复后第一个月和第三个月的义齿修复满意度。结果：实验组和对照组相比，第一个月和第三个月的舒适性、咀嚼、语音差异均有统计学意义（P〈0．05）。结论：初次进行复杂活动义齿修复的老年患者修复前心理干预可提高其义齿修复的满意度。     

Effect of new dentures on interocclusal distance during speech

PURPOSE: The aim of this study was to investigate the changes in interocclusal distance during the pronunciation of /m/ and /s/ sounds in the Portuguese language, in partially edentulous patients before and after insertion of new dentures. MATERIALS AND METHODS: Subjects were divided into a control group consisting of 18 completely dentate patients and an experimental group consisting of 18 patients who were edentulous in the maxilla and classified as Kennedy Class I in the mandible. The experimental group had new dentures placed and the occlusal vertical dimension corrected. A magnetic jaw-tracking device measured the interocclusal distance during pronunciation of the /m/ and /s/ phonemes. Interocclusal distance evaluations were carried out in a single session for the control group. In the experimental group, the measurements were carried out before insertion of new dentures; immediately after insertion; and after 6 and 24 hours; 2 days; 1 and 2 weeks; 1, 2, 3, and 6 months; and 1 year. RESULTS: Comparison between groups revealed significant difference in interocclusal distance for the /m/ sound both before and after insertion of dentures up to 2 months. For the /s/ phoneme, there was no difference between the groups before prosthesis insertion, or after 3, 6, and 12 months of prosthesis use. There were significant differences for the /m/ sound only at 6 and 12 months after new denture insertion, and for the /s/ sound at all periods evaluated. CONCLUSION: Insertion of new dentures, with the vertical dimension corrected, changes the interocclusal distance of speech during phonation of /m/ and /s/ sounds.     

Setting up of teeth in the neutral zone and its effect on speech

Rational goals for denture construction are basically directed at the restoration of esthetics and masticatory function and the healthy preservation of the remaining natural tissues. Little concern has been given to the perfection and optimization of the phonetic quality of denture users. However, insertion of prosthodontic restorations may lead to speech defects. Most such defects are mild but, nevertheless, can be a source of concern to the patient. For the dental practitioner, there are few guidelines for designing a prosthetic restoration with maximum phonetic success. One of these guidelines involves the setting up of teeth within the neutral zone. The aim of this study was to evaluate, subjectively and objectively, the effect on speech of setting up teeth in the neutral zone. Three groups were examined: group I (control) included 10 completely dentulous subjects, group II included 10 completely edentulous patients with conventional dentures, and group III included the same 10 edentulous patients with neutral zone dentures. Subjective assessment included patient satisfaction. Objective assessment included duration taken for recitation of Al-Fateha and acoustic analysis. Subjectively, patients were more satisfied with their neutral zone dentures. Objectively, speech produced with the neutral zone dentures was closer to normal than speech with conventional dentures.     

Investigation of new complete denture quality and patients' satisfaction with and use of dentures after two years

OBJECTIVES: To investigate if clinical quality of new complete dentures predicts patient satisfaction with and usage of those dentures two years after insertion in the same way that it did initially and three months after insertion. METHODS: Four hundred and seventeen patients recruited to a denture outcome study two years previously were surveyed. In each case aspects of denture quality had previously been rated according to a validated method at the first post-insertion visit and patients had completed a postal questionnaire three months after denture insertion. When the dentures were two years old, patients were sent another postal questionnaire to assess denture usage and satisfaction with the dentures. RESULTS: The response rate to the postal survey was 87%. Data were analysed using structural equation modelling and Bayesian belief networks. No significant associations were found between aspects of new denture quality and patient satisfaction with and use of complete dentures after two years. These results contrast with the three month returns from the same patients that demonstrated significant associations between new denture quality and satisfaction with and use of new complete dentures. CONCLUSIONS: The authors conclude that initial clinical quality of new complete dentures is not a significant factor in determining patients' satisfaction with and use of these complete dentures two years after insertion.     

Longitudinal study on forces transmitted from denture base to retainers of lower free-end saddle dentures with Aker''s clasps

The aim of this study was to make a longitudinal analysis of the forces transmitted from denture base to retainers of lower free-end saddle dentures with Aker's clasps using a newly developed transducer. The experimental apparatus consisted of two components, a metal framework and a denture base embedded with a force-detecting unit. This device was the transducer, which could detect changes in lateral and vertical forces transmitted from denture base to retainers at the same time. Forces were measured on several separate occasions from the insertion of new dentures to about 4 months afterwards. The result are summarized as follows: (i) the maximal mean value of vertical forces transmitted from denture base to retainers was decreased after 1 week of insertion of new dentures, then increased and reached a constant level (about 10N) 4-6 weeks after the insertion of new dentures; (ii) there were large differences in the maximal mean value of lateral forces between subjects.     

舌侧集中（牙合）全口义齿咀嚼效率的研究

目的比较舌侧集中（牙合）与常规半解剖（牙合）全口义齿修复牙列缺失后的咀嚼效能。方法选取牙列缺失患者132例,其中刃状牙槽嵴64例、低平牙槽嵴68例。刃状牙槽嵴和低平牙槽嵴的患者分别用随机数字表法分为试验组和对照组,状牙槽嵴患者的试验组和对照组各32例,低平牙槽嵴患者的试验组和对照组各34例。试验组患行采用舌侧集中输全口义街修复,对照组患者采用常规半解剖（牙合）全口义齿修复,并于佩戴义齿1、3、6、12个月时采用吸光度法检测每位患者的咀嚼效率,并对结果进行t检验。结果义齿佩戴1个月时刃状牙槽嵴或低平牙槽嵴患者的试验组咀嚼效率与对照组比较,差异均无统计学意义（P〉0．05）。义齿佩戴3、6、12个月时刃状牙槽嵴或低平牙槽嵴患者的试验组咀嚼效率均明显高于对照组,差异有统计学意义（P〈0．05）;试验组咀嚼效率住义齿佩戴3个月时达到最大,且以后较为稳定。试验组患者中刃状牙槽嵴患者的咀嚼效率高于低平牙槽嵴患者,但差异无统计学意义（P〉0．05）。结论对于牙槽嵴吸收严重的无牙颌患者．佩戴义齿3个月后,舌侧集中（牙合）全口义齿的咀嚼效率比半解剖（牙合）全口义齿更高。     

The influence of the accuracy of the intermaxillary relations on the use of complete dentures: a clinical evaluation

The aim of this study was to investigate possible associations between the accuracy of intermaxillary relations and complete denture usage 3 months and 3 years after their insertion. A total of 600 patients were provided with new complete dentures. Willis gauge and Woelfel's method were used to assess the quality of the existing complete dentures and the use of these dentures. Three years after insertion the remaining 250 patients took part in a follow-up examination. Three months post-insertion, significant relationships were found between adequate interocclusal rest space or quality of registration of centric relation and daily wearing of complete dentures and between quality of registration of centric relation and use of dentures for eating. Three years after insertion the adaptation to denture wearing was generally satisfactory. However, no significant relationship was observed between the accuracy of intermaxillary relations and complete denture usage.     

自主行为能力减弱的老年无牙颌患者应用义齿稳固剂临床效果分析

目的：探讨自主行为能力减弱的老年无牙颌患者应用义齿稳固剂的临床效果.方法：选择23例患有脑血管疾病后遗症、帕金森病或阿尔茨海默病的无牙颌患者,为其重衬原义齿基托并为部分患者更换新人工牙.教授患者的固定看护人使用义齿稳固剂的方法,以帮助患者日常使用全口义齿,随访观察6个月,评价使用义齿稳固剂前、后义齿固位效果并记分,记录患者体重指数（BMI）变化,对结果行配对t检验.结果：患者使用义齿稳固剂后义齿脱位次数记分值大于使用前记分值,差异有显著性（P＜0.05）;使用义齿稳固剂后6个月患者BMI高于使用前及使用后3个月,差异有显著性（P＜0.05）,使用前和使用后3月BMI差异无显著性（胗0.05）.结论：义齿稳固剂可以增强自主行为能力减弱的老年无牙颌患者全口义齿的固位和稳定.