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北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (2): 406-412. doi: 10.19723/j.issn.1671-167X.2021.02.029

• 论著 • 上一篇    下一篇

可摘局部义齿适合性方法的评价

尹祯敏1,王子轩1,陈俊锴1,孙玉春2,刘云松1,叶红强1,Δ(),周永胜1,Δ()   

  1. 1.修复科, 北京大学口腔医学院·口腔医院, 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081
    2.口腔医学数字化研究中心, 北京大学口腔医学院·口腔医院, 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081
  • 收稿日期:2019-04-04 出版日期:2021-04-18 发布日期:2021-04-21
  • 通讯作者: 叶红强,周永胜 E-mail:yhqfy@163.com;zhouysh72@163.com
  • 基金资助:
    首都卫生发展科研专项(首发 2018-2-4101);国家自然科学基金(81801015);北京大学口腔医学院新技术新疗法(PKUSSNCT-17A03)

Evaluation of methods for fitness of removable partial denture

YOON Jung-min1,WANG Zi-xuan1,CHAN Chon-kai1,SUN Yu-chun2,LIU Yun-song1,YE Hong-qiang1,Δ(),ZHOU Yong-sheng1,Δ()   

  1. 1. Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2019-04-04 Online:2021-04-18 Published:2021-04-21
  • Contact: Hong-qiang YE,Yong-sheng ZHOU E-mail:yhqfy@163.com;zhouysh72@163.com
  • Supported by:
    Capital’s Funds for Health Improvement and Research(首发 2018-2-4101);National Natural Science Foundation of China(81801015);New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-17A03)

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摘要：

目的: 评价可摘局部义齿(removable partial denture, RPD)适合性的三种方法的异同及适应证。方法: 在下颌牙列缺损石膏模型上制作RPD,用硅橡胶印模材复制RPD与模型表面的间隙形成硅橡胶薄膜样本。在RPD各组件处的薄膜样本上,用硅橡胶膜切片测量法并选择不同数量的测量点测量获得薄膜平均厚度,再用单因素方差分析和独立样本t检验比较基托、大连接体、牙合支托处测量点数量不同对测量结果的影响。采用硅橡胶膜切片测量法、石膏模型三维分析法和翻制模型三维分析法测量RPD各组件处硅橡胶薄膜的厚度,用单因素方差分析比较三种方法的测量结果差异是否有统计学意义。结果: 硅橡胶膜切片测量法选取测量点数量不同测得的基托和大连接体处硅橡胶薄膜的平均厚度差异有统计学意义(P<0.05),牙合支托处硅橡胶薄膜的平均厚度差异无统计学意义(P>0.05)。三种评价方法测得的RPD各组件和总体的硅橡胶薄膜厚度差异均有统计学意义(P<0.01),多重比较表明,石膏模型三维分析法和翻制模型三维分析法的测量结果较硅橡胶膜切片测量法的薄(P<0.05),石膏模型三维分析法和翻制模型三维分析法测量的硅橡胶薄膜厚度差异无统计学意义(P>0.05)。结论: 硅橡胶膜切片测量法的测量结果受测量点数量影响,其测量结果可靠性较差;石膏模型三维分析法、翻制模型三维分析法较硅橡胶膜切片测量法能更全面、有效地评价RPD的适合性,石膏模型三维分析法适用于体外评价,翻制模型三维分析法适用于体内评价。

关键词: 可摘局部义齿, 数字化, 适合性

Abstract:

Objective: To compare the differences and indications of three evaluation methods for fitness evaluation of removable partial denture (RPD). Methods: A RPD was fabricated and seated on the stone cast of a partially edentulous mandible, and the spaces between RPD and stone cast were recorded with polyvinyl siloxane (PVS) impression material forming PVS replicas. Using cross sectional measurement, the average thicknesses of PVS replicas were measured under stereomicroscope with different numbers of selected measuring points in the denture base, major connector, occlusal rest of the RPD, and the average thicknesses of the PVS replicas measured with different numbers of measuring points were compared using one-way analysis of variance (ANOVA) and independent sample t test. Three kinds of method, including cross sectional measurement, three-dimensional analysis on the stone cast, and three-dimensional analysis on the polyether cast, were applied to measure the average thicknesses of the PVS replicas, and the average thicknesses of the PVS replicas measured by these three evaluation methods were compared with ANOVA. Results: For cross sectional measurement, statistically significant differences were found in the average thicknesses of the PVS replicas in the denture base and the major connector among the different numbers of measuring points (P<0.05), but no differences were found in the average thicknesses of the PVS replicas in the occlusal rest (P>0.05). There were significant differences among the average thicknesses of the PVS replicas measured by these three evaluation methods in each component of the RPD (P<0.01). The average thickness measured by three-dimensional analysis on the stone cast and three-dimensional analysis on polyether cast were smaller than that measured by cross sectional measurement (P<0.05). And there were no differences between the average thicknesses of PVS replicas measured by three-dimensional analysis on stone cast and three-dimensional analysis on polyether cast (P>0.05). Conclusion: For cross sectional measurement, the average thickness of the PVS replicas was influenced by the number of measuring points, and the measurement accuracy of cross sectional measurement was not reliable enough. Three-dimensional analysis on stone cast which is suitable for evaluation in vitro and three-dimensional analysis on polyether cast which is suitable for evaluation in vivo can evaluate the fitness of RPD more comprehensively and effectively than that of cross sectional measurement.

Key words: Removable partial denture, Digital, Fit

中图分类号: 

  • R783.4

图1

获取硅橡胶薄膜样本"

图2

硅橡胶薄膜上不同数量测量点选择示意图"

图3

体视显微镜镜下硅橡胶薄膜厚度测量"

图4

石膏模型三维分析法"

图5

翻制模型三维分析法"

表1

不同数量测量点时基托处硅橡胶薄膜厚度($\bar{x} \pm s$, /μm)"

Items 6 equal parts (15 MP) 3 equal parts (6 MP) 2 equal parts (3 MP) P
Denture base 302.4±56.8* 301.7±54.2* 254.8±51.5 0.030
Extension denture base 240.8±36.2 208.1±43.1# 203.1±42.7# 0.031
Non-extensive denture base 364.0±92.1* 395.4±94.2* 286.8±88.1 0.007

表2

不同数量测量点时大连接体和牙合支托处硅橡胶薄膜厚度($\bar{x} \pm s$, /μm)"

Items 8 equal parts 4 equal parts 2 equal parts P
Major connector 130.0±40.6* 130.5±41.4* 96.5±41.0 0.043
44 occlusal rest 246.7±56.0 227.2±58.3 0.843
47 occlusal rest 325.9±112.6 359.6±154.4 0.360
35 occlusal rest 244.4±71.2 230.3±72.3 0.805
Occlusal rest total 272.3±63.8 272.4±74.7 0.562

表3

三种评价方法测量的硅橡胶薄膜厚度($\bar{x} \pm s$, /μm)"

Items CSM group TAS group TAP group P
Denture base 302.4±56.8 179.7±39.9* 173.3±24.5* <0.001
Major connector 130.0±40.6 61.9±28.4* 81.9±37.7* <0.001
Occlusal rest 272.3±63.8 159.5±44.1* 162.9±32.7* <0.001
Total 234.9±44.3 166.1±36.6* 168.1±22.1* <0.001
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