以功能性牙缺失为策略指引适老性口颌系统功能修复的实践和挑战

doi:10.7518/hxkq.2025.2024188

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (1): 15-27.doi: 10.7518/hxkq.2025.2024188

以功能性牙缺失为策略指引适老性口颌系统功能修复的实践和挑战

程怡婷(), 满毅, 刘洋, 蔡和, 程然, 程立, 吴芳龙, 吴红崑, 余钒源, 廖雪阳, 孙一民, 王婧, 杨雪, 朱锦怡, 程兴群, 易祖木, 叶玲, 胡涛()

口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心口腔医学+前沿医学创新中心四川大学华西口腔医院，成都 610041

收稿日期:2024-05-11 修回日期:2024-08-20 出版日期:2025-02-01 发布日期:2025-01-22
通讯作者: 胡涛 E-mail:cyt_1021@163.com;hutao@scu.edu.cn
作者简介:程怡婷，硕士，E-mail：cyt_1021@163.com|胡涛，教授/主任医师，博士生导师，四川大学华西口腔医（学）院口腔预防科主任、口腔预防医学教研室主任。中华口腔医学会口腔预防专业委员会副主任委员，四川省预防医学会副会长，四川省口腔医学会口腔预防专业委员会主任委员。入选教育部新世纪优秀人才支持计划。发表学术论文150余篇，主编学术专著3部，参编6部。主持1项国家973前期计划、8项国家自然科学基金、2项国家重点研发项目课题等。获得2021年度四川省科技进步一等奖、2011年度二等奖各1项；获得2021年四川省科普微视频一等奖、四川省教学成果二等奖。主持和参与制定多项国际、行业标准等，获得多项发明专利。
基金资助:
国家重点研发计划(2023YFC3605600);国家自然科学基金(72104162);四川大学华西口腔医院探索与研发项目(LC-YJ-ZD-202301)

Practice and challenge of age-friendly functional restoration of stomatognathic system based on the strategy of functional tooth loss

Cheng Yiting(), Man Yi, Liu Yang, Cai He, Cheng Ran, Cheng Li, Wu Fanglong, Wu Hongkun, Yu Fanyuan, Liao Xueyang, Sun Yimin, Wang Jing, Yang Xue, Zhu Jinyi, Cheng Xingqun, Yi Zumu, Ye Ling, Hu Tao()

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2024-05-11 Revised:2024-08-20 Online:2025-02-01 Published:2025-01-22
Contact: Hu Tao E-mail:cyt_1021@163.com;hutao@scu.edu.cn
Supported by:
National Key Research and Development Program(2023YFC3605600);National Natural Science Foundation of China(72104162);Research and Development Program of West China Hospital of Stomatology, Sichuan University(LCYJ-ZD-202301)

摘要/Abstract

摘要：

随着老龄化趋势的加剧，老年口腔保健和诊疗面临巨大挑战。老年人牙列、肌肉、关节的增龄性改变使其咀嚼功能、修复需求等均有所下降，且因全身健康状况的不同，个体差异较大。在考虑功能需求、口颌及全身健康的兼容性及卫生经济学等因素后，笔者认为，老年人的口腔修复不应仅仅局限于传统的缺失牙逐一替换方案，而应寻求更加个性化和更适合老年人的修复方案。“功能性牙缺失”这一全新概念，更新了老年人口颌修复的最低标准，引入了适老性口颌功能修复理念。本文基于“功能性牙缺失”概念，阐述了牙体牙列、牙周黏膜、肌肉、关节、全身健康及其他相关诊疗策略，提出了“适老性口颌软硬组织一体化修复”的全新理念：关注口颌系统与全身健康之间的联系，完善“可及功能判定”；兼顾患者个人需求，综合评估口颌系统客观情况，优化“适宜功能评估”；利用人工智能等辅助技术与设备，为老年人精准实施适配性的功能修复方案，实现“诊疗计划制定”；通过随访、宣教、预防保健等措施，加强“健康管理及维护”，以期有效提高老年人群生活质量，并最终实现健康老龄化的目标。

关键词: 口颌系统, 功能恢复, 健康老龄化, 牙缺失, 共病, 咀嚼功能

Abstract:

Geriatric oral health care encounters significant challenges with the increase in the proportion of older individuals. Age-related changes in the dentition, muscles, and joints result in a decline in objective masticatory function, subjective restoration requirements, and acceptability among the elderly population, with individual variations influenced by systemic health. Considering functional requirements, the adaptability of stomatognathic and systemic health conditions, health economics and other factors, the authors believe that it should not be limited to the conventional “one-to-one” strategy for replacing missing teeth in geriatric prosthodontics. There is an urgent need for a precise and adaptable restoration strategy that is more suitable for older individuals. The proposal of a new concept of functional tooth loss updates the minimal restoration standards for elderly patients and establishes the theory of age-friendly functional restoration. Based on the restoration strategy of functional tooth loss, this paper proposes a new concept termed “age-friendly functional restoration of the stomatognathic system”, which integrates treatment considerations including endodontics, periodontology, mucosa, muscles, temporomandibular joint, and systemic health. Efforts should be made in four areas as follows. Firstly, the “assessment of accessible function” should be enhanced by considering the interrelationship between stomatognathic and systemic health. Secondly, the “evaluation of appropriate function” is supposed to be optimised in view of subjective needs and objective evaluation of the stomatognathic system. Moreover, the “formulation of treatment plans” needs to be accomplished with the aid of assistive technologies, such as artificial intelligence, to accurately exert appropriate functional restoration. Lastly, the “management and maintenance of health” is likely to be strengthened through follow-ups, propaganda and education, and preventive healthcare, so as to improve quality of life and ultimately achieve healthy ageing among older individuals.

Key words: stomatognathic system, functional restoration, healthy aging, tooth loss, multimorbidity, masticatory function

中图分类号:

程怡婷, 满毅, 刘洋, 蔡和, 程然, 程立, 吴芳龙, 吴红崑, 余钒源, 廖雪阳, 孙一民, 王婧, 杨雪, 朱锦怡, 程兴群, 易祖木, 叶玲, 胡涛. 以功能性牙缺失为策略指引适老性口颌系统功能修复的实践和挑战[J]. 华西口腔医学杂志, 2025, 43(1): 15-27.

Cheng Yiting, Man Yi, Liu Yang, Cai He, Cheng Ran, Cheng Li, Wu Fanglong, Wu Hongkun, Yu Fanyuan, Liao Xueyang, Sun Yimin, Wang Jing, Yang Xue, Zhu Jinyi, Cheng Xingqun, Yi Zumu, Ye Ling, Hu Tao. Practice and challenge of age-friendly functional restoration of stomatognathic system based on the strategy of functional tooth loss[J]. West China Journal of Stomatology, 2025, 43(1): 15-27.

图/表 3

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以功能性牙缺失为策略指引适老性口颌系统功能修复的实践和挑战

Practice and challenge of age-friendly functional restoration of stomatognathic system based on the strategy of functional tooth loss

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