摘要
目的：评价美国修复学院（American College of Prosthodontics，ACP）分类方法对临床无牙颌患者修复工作的指导意义，并分析医师对无牙颌患者修复预后的预期与患者自身评价间的关系。方法：采用ACP分类法，对107例老年无牙颌患者进行临床检查，用全口曲面断层片测量下颌骨最小垂直高度并分类，由医师评价患者全口义齿修复难度。全口义齿修复后半年，采用麦吉尔大学义齿满意度Visual Analog Scale（VAS）评价系统评估患者对下颌修复体的满意度。采用相关分析和多元线性回归法分析临床医师对无牙颌患者修复难易程度的评价，以及医师评价与患者报告满意度间的关系。结果：约80％（83／105）老年无牙颌患者可见重度剩余牙槽骨吸收。不同医师采用ACP分类法对下颌骨高度分类，测量者复测信度为0．96，测量者之间信度为0．90°对于下颌牙槽嵴高度低，形态较差（如刃状，不规则或低平）的患者，以及下颌牙槽嵴黏膜松软活动、末次义齿戴用年限长的患者，医师评估其下颌义齿修复难度大，在VAS评估法中体现为下颌骨最低高度小于11mm的患者较之大于11mm的患者，医师评估其难度高8．8％～16．1％（P〈0．05）。医师评估修复难度与修复后患者义齿满意度间相关系数r〈0．1。结论：由McGarry等医师于1999年提出的ACP无牙颌分类法具有较好的信度，为评价临床患者口腔条件，及医患交流提供了有力工具。然而，尽管医师能够较为准确地评价无牙颌患者的口腔解剖条件，但医师对病例修复难度的预测与患者修复后义齿满意度间并无相关性。
Objective：To evaluate clinical application of American College of Prosthodontics classification system for complete edcntulism ; and to analyze the relationship between clinician＇ s rating of general degree of difficulty of each case and patients＇ rating of denture satisfaction. Methods：One hundred and seven edentulous patients were examined clinically using American College of Prosthodontics （ACP） classification for complete edentulism. The least heights of patients＇ mandible were measured on panoramic radiographs. Clinician rated general degree of difficulty of each case on visual analogue scale. Six month following denture delivery, patients rated their denture using Mcgill satisfaction Visual Analog Scale （VAS）. Multivariate linear regression analysis were conducted to analyze the relationship between clinican＇ s rating of general degree of difficulty and mandibular bone height adjusting for confounding factors such as mandibular ridge form, soft tissue quality etc. Pearson correlation analysis was conducted to analyze the correlation between clinician＇ s rating of case difficulty and patients＇ rating of denture satisfaction. Results： Advanced residual ridge resorption were found in around 80% （83/105） of all the cases. When the least mandibular bone height were measured on panoramic radiographs,intra-examiner reliability was 0. 96, inter-examiner reliability was 0. 90. Cases were rated as more difficult when patients showed lower mandibular bone height, unfavoriate ridge form （knife ridge and irregular ridge）, mobile soft tissue and longer period of wearing time of their previous dentures. No significant correlation （r 〈 0. 1 ） was found between clinician＇ s rating of degree of difficulty of each case and patients＇ rating of denture satisfaction 6 month following delivery of prostheses. Clinician rated cases in which patient＇ s mandibular bone height was lower than 11 mm as 8.8% -16. 1% more difficult than those in which patient＇ s mandibular bone height was higher than 11 mm （ P 〈 0. 05 ）. Conclusion： ACP classification for complete edentulism showed good intra- and inter-examiner reliability, and is an useful tool for clinical evaluation of edentulous patients＇ oral condition. However, there was no significant correlation between elinicicans＇ rating of difficulty of cases and patients＇ rating of denture satisfaction.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2009年第1期86-89,共4页
Journal of Peking University:Health Sciences
关键词
颌
无牙
牙槽突
义齿
全口
病人满意度
Jaw, edentulous
Alveolar process
Denture, complete
Patient satisfaction
