| For edentulous jaws patients,we choose traditional complete dentures prosthetic method;but some problems exist.According to literature,more than 50% of the patients complained about loss of retention and stability of their mandible complete dentures,which caused chewing difficulties,mucosal tenderness and reduced life quality.Compared with traditional complete dentures,implant supported denture uses the implant and the attachment on it to provide retention,stability and support to the denture,and thus can improve the function of denture.So far,the domestic research about implant supported denture mainly concentrates on objective indicators such as retention power,masticatory efficiency and success rate of repairing,etc.,or concentrates on comparison between different types of implant supported dentures;but there is little research on patients' subjective feelings after receiving implant supported denture,such as life quality and satisfaction.Research shows that there is no significant difference in masticatory efficiency and satisfaction in patients who received complete denture before and after implant supported denture repair.In clinical work,situations that after implant supported denture repair,patients reflect to their doctors that they find no significant difference between implant supported denture and their original complete denture,also exit.Aims:This research plan to study the influence of alveolar ridge condition of edentulous patients on area of complete denture base and denture retention evaluation by model measure and questionnaire,in order to speculate proper indicators for predicting retention evaluation after production of complete denture.With whether the indicator is positive as the standard,we divide the patients in the clinical trial into two groups;all patients receive complete denture repair;then we perform implant supported denture repair on two mandibular implants locator;we compare the changes of masticatory efficiency,life quality and satisfaction before and after implant supported denture in the two groups with self-control method in order to further verify the clinical meaning of the indicators.We aim to attain a proper indicator for evaluation in order to provide reference for providing proper repair projects in clinical work and to guide clinical treatment,and to evaluate the clinical therapy effect of implant supported denture.Methods:1.The influence of morphology of mandibular alveolar ridge on area of complete denture base: 30 edentulous patients were included;complete dentures were re-made and mandibular plaster models were saved;by measuring the models,we attained data of the area of mandibular complete denture base,the height and width of alveolar ridge of midline,bilateral premolars and front edges of bilateral retromolar pads,buccal and lingual width and cross-sectional area;using statistical method,we studied the influence of morphology of alveolar ridge on area of complete denture base.2.The influence of morphology of mandibular alveolar ridge on area of complete denture base:Three months after the patients in trial 1 fully adjusted to the new dentures,they were required to fill out questionnaires.Based on the data of height and width of alveolar ridge of mandibular midline,bilateral premolars and front edges of bilateral retromolar pads,buccal and lingual width and cross-sectional area,combined with the questionnaires about denture satisfaction,we chose statistical method to research the relationship between morphology of mandibular alveolar ridge and evaluation of complete denture,and speculated the retention effect after complete denture repair.3.Comparison of the influence of complete denture and implant supported denture with supporting retention on oral function and life quality Based on indicators attained from trial 2,the patients included in trial 1 were divided into two groups by whether the indicators were positive;3 months after the patients fully adjusted to the new dentures,they filled out questionnaires and got their masticatory efficiency measured;then we performed implant supported denture repair on two mandibular implants locator;3 months after the patients fully adjusted to the new dentures,they filled out questionnaires and got their masticatory efficiency measured again;we compared the influence of dentures to life quality and oral function before and after implant supported denture repair to verify the validity of indicators attained from trial 2.Results:1.Although certain linear relationship existed between the height,width and cross-sectional area of alveolar ridge and the area of denture base(P<0.050),in multivariate linear regression analysis,regression equation only included the height and cross-sectional area of alveolar ridge;the influence of the height of alveolar ridge on area of denture base exceeded the cross-sectional area of alveolar ridge.Among influence of different height of alveolar ridge on area of denture base,front edges of bilateral retromolar pads > premolar zone > midline;among influence of different cross-sectional area of alveolar ridge on area of denture base,premolar zone > front edges of bilateral retromolar pads while the influence of midline zone on area of denture base was not statistically significant(P>0.05).2.Spearman rank correlation analysis of the height and width of alveolar ridge of midline,bilateral premolars and front edges of bilateral retromolar pads,buccal and lingual width and cross-sectional area and retention evaluation showed that besides buccal width of alveolar ridge of midline,bilateral premolars and front edges of bilateral retromolar pads and lingual width of alveolar ridge of midline,all the other variates corelated with retention evaluation(P<0.05).Logistic regression analysis showed that only cross-sectional area of alveolar ridge of bilateral premolars was included into the regression equation(P<0.05);the accuracy of prediction of retention effect was 86.7%.3.The differences of masticatory efficiency,life quality and oral function before and after implant supported denture repair on two mandibular implants locator in patients with positive indicators in trial 2 were not statistically significant(P>0.05);the differences in masticatory efficiency,life quality and oral function before and after implant supported denture repair in patients with negative indicators in trial 2 were statistically significant(P< 0.05).Conclusion:For morphology of mandibular alveolar ridge,the fullness of alveolar ridge of premolars had the largest influence on retention effect after mandibular denture repair,indicating that model measurement could be used for predicting retention effect of complete denture repair. |
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