Preliminary study on the clinical application of temporary treatment denture in difficult edentulous cases before com-plete denture restoration

doi:10.7518/hxkq.2018.03.009

Abstract

Abstract:

Objective To explore the clinical effects of treatment denture on difficult edentulous cases before complete denture restoration. Methods Thirty-six patients who experienced unsuccessful restoration of conventional complete dentures were included in this study. Treatment dentures were fabricated to solve issues such as abnormal occlusion, tissue surface problems, and neuromuscular dysfunction of the stomatognathic system caused by systemic diseases. The final complete dentures were fabricated by duplicating the treatment dentures. Jaw relation index, stability, and retention were evaluated at different stages. Oral health-related quality of life was measured using the Chinese version of Oral Health Impact Profile for edentulous subjects (OHIP-EDENT).Results Among the 36 patients, 33 successfully completed the final restoration with positive effects. Conclusion Treatment denture is an effective pre-restorative option that can be used to correct abnormal occlusion, improve tissue surface problems, and aid in neuromuscular rehabilitation training. Treatment dentures contribute to the successful restoration of the final complete dentures and is worthy of clinical applications.

Key words: treatment denture, complete denture, tis-sue conditioner, occlusal adjustment, dynamic functional impression

CLC Number:

R783

Wenqiao Zhou, Die Liu, Tao Chen, Yan Peng, Tingting Zhang, Changhong Hu. Preliminary study on the clinical application of temporary treatment denture in difficult edentulous cases before com-plete denture restoration[J]. West China Journal of Stomatology, 2018, 36(3): 277-281.

Figures/Tables 7

Tab 1

Fig 1

Fig 2

Tab 2

Tab 3

Tab 4

References 14

[1]	Huumonen S, Haikola B, Oikarinen K, et al.Residual ridge resorption, lower denture stability and subjective complaints among edentulous individuals[J]. J Oral Rehabil, 2012, 39(5): 384-390.
[2]	McGarry TJ, Nimmo A, Skiba JF, et al. Classification sys-tem for complete edentulism. The American College of Prosthodontics[J]. J Prosthodont, 1999, 8(1): 27-39.
[3]	Jiro A.Difficult-to-treat cases of edentulous patients pre-sented[M]. Tokyo: Ishiyaku Publishers, 2013: 3.
[4]	Pound E.Preparatory dentures: a protective philosophy[J]. J Prosthet Dent, 1965, 15(1): 5-18.
[5]	Rodrigues S, Shenoy V, Shetty T.Resilient liners: a review[J]. J Indian Prosthodont Soc, 2013, 13(3): 155-164.
[6]	Smith DE.Interim dentures and treatment dentures[J]. Dent Clin North Am, 1984, 28(2): 253-271.
[7]	张宁宁, 赵军. 治疗性全口义齿矫正不良颌位的研究[J]. 华西口腔医学杂志, 2003, 21(5): 369-371.
	Zhang NN, Zhao J.Correction of malmaxillomandibular relation with therapeutic complete denture[J]. West Chin J Stomatol, 2003, 21(5): 369-371.
[8]	Ansari IH.Duplicating an existing complete denture to make a replica[J]. J Prosthet Dent, 1994, 72(4): 445-447.
[9]	Eijiro Y, Yusuke S, Shunsuke M.A structural equation model relating oral condition,denture quality, chewing ability, satis-faction, and oral health-related quality of life in complete denture wearers[J]. J Dent, 2013, 41(5): 710-717.
[10]	He SL, Wang JH.Reliability and validity of a Chinese ver-sion of the Oral Health Impact Profile for edentulous subjects[J]. Qual Life Res, 2015, 24(4): 1011-1016.
[11]	Wakano S, Takeda T, Nakajima K, et al.Effect of experi-mental horizontal mandibular deviation on dynamic balance[J]. J Prosthodont Res, 2011, 55(4): 228-233.
[12]	Reddy SV, Kumar MP, Sravanthi D, et al.Bruxism: a litera-ture review[J]. J Int Oral Health, 2014, 6(6): 105-109.
[13]	Stróżyk P, Bałchanowski JK.Effect of foodstuff on muscle forces during biting off[J]. Acta Bioeng Biomech, 2016, 18(2): 81-91.
[14]	Miyamoto I, Yoshida K, Tsuboi Y, et al.Rehabilitation with dental prosthesis can increase cerebral regional blood volume[J]. Clin Oral Implants Res, 2005, 16(6): 723-727.

分类	类别	主要临床表现	例数	治疗方案
Ⅰ	咬合异常类	颌位关系不良或不稳定：下颌无法稳定在正中关系位（前伸、偏斜、滑	18	咬合调整
		动、抖动）,诱导正中关系位与习惯性咬合位偏差大于2 mm
Ⅱ	黏膜面问题类	1）由于牙槽嵴严重吸收,唇颊舌肌紧张,义齿承托区黏膜松软易动,	8	黏膜面调整
		黏膜转折边界难以界定,取模技术不成熟等原因,导致印模无法反映出
		动态功能咀嚼状态下精细的组织面形态及边界的位置和形态;2）义齿
		承托区黏膜敏感脆弱,旧义齿易导致黏膜损伤,出现疼痛、溃疡和炎
		症等,旧义齿调改后黏膜症状无改善
Ⅲ	咬合异常伴黏膜面问	同时具有上述咬合异常和黏膜面问题的临床表现	4	咬合调整+黏膜面调整
	题类
Ⅳ	全身疾病导致口颌系	因全身疾病（帕金森病、脑卒中、精神病、阿尔兹海默症等）导致口颌	6	咀嚼肌康复训练+咬合
	统神经-肌肉不协调类	系统神经-肌肉不协调,主要表现为患者难以配合,下颌位置不稳定,		调整+黏膜面调整
		口周肌肉僵硬紧张或功能退化,伴有或不伴有黏膜问题

颌位关系	治疗义齿				终义齿
指数评分	初戴	第4周	第8周	第12周	戴牙
0	22	7	1	0	0
1	6	14	1	2	2
2	0	7	20	0	0
3	0	0	6	26	26

固位力及稳	治疗义齿				终义齿
定性评分	初戴	第4周	第8周	第12周	戴牙
<6	9	8	1	1	1
6~8	3	3	6	3	3
>8	0	1	5	8	8

OHIP-EDENT量表条目	旧义齿	治疗义齿	终义齿	F值	P值
影响发音	3.33±0.78	1.36±0.55	0.55±0.67	182.76	<0.01
味觉变差	3.09±0.68	2.00±0.71	1.73±0.63	57.56	<0.01
咀嚼困难	2.92±0.55	1.22±0.48	0.56±0.61	226.94	<0.01
出现明显疼痛	3.18±0.64	1.33±0.74	1.09±0.80	85.80	<0.01
吃什么东西都吃不舒服	3.48±0.67	1.36±0.49	1.03±0.68	142.15	<0.01
出现溃疡	2.81±0.67	1.22±0.48	0.64±0.49	234.00	<0.01
不舒服的义齿	2.83±0.61	1.06±0.47	0.33±0.48	313.14	<0.01
在他人面前不自在	2.85±0.51	1.21±0.74	0.55±0.83	137.77	<0.01
紧张、不安	2.45±0.90	0.97±0.88	0.52±0.76	68.73	<0.01
对饮食不满意	3.00±0.71	1.45±0.62	1.06±0.56	124.25	<0.01
在进食过程中停下来	3.48±0.57	1.27±0.52	1.09±0.77	152.47	<0.01
不能进食	2.44±0.91	0.81±0.62	0.17±0.38	145.34	<0.01
影响休息	1.64±0.78	0.48±0.71	0.15±0.36	65.86	<0.01
有过尴尬的时候	2.06±1.00	0.82±0.68	0.42±0.56	49.57	<0.01
不被他人理解	3.11±0.71	1.56±0.61	0.89±0.57	219.04	<0.01
容易对他人发脾气	1.79±0.70	0.67±0.60	0.36±0.60	44.06	<0.01
难以完成日常工作	1.61±1.00	0.58±0.61	0.27±0.52	33.19	<0.01
觉得生活不那么令人满意	2.61±0.66	1.12±0.55	0.70±0.64	133.40	<0.01
什么事都干不成	1.21±0.93	0.18±0.39	0.21±0.48	22.86	<0.01