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首页> 外文期刊>The Journal of Prosthetic Dentistry >Masticatory and swallowing threshold performances with conventional and implant-supported prostheses after mandibular fibula free-flap reconstruction.
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Masticatory and swallowing threshold performances with conventional and implant-supported prostheses after mandibular fibula free-flap reconstruction.

机译：下颌腓骨游离皮瓣重建后常规和植入物支持的假体的咀嚼和吞咽阈值表现。

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STATEMENT OF PROBLEM: Significant strides in microvascular surgical techniques allow predictable restoration of bony and soft tissue orofacial defects. In combination with prosthetic rehabilitation, varying degrees of improvement in esthetics, speech intelligibility, and swallowing have been noted; however, the relative impact of conventional and implant-supported prostheses on restoration of masticatory function are not known. PURPOSE: The purpose of this study was to determine whether conventional or implant-supported dental prostheses and current surgical reconstructive procedures restore patients' masticatory function to presurgical levels. MATERIAL AND METHODS: Of the 46 subjects enrolled in this study, 23 (7 edentulous and 16 partially dentate) completed conventional prosthesis (CP) treatment and masticatory evaluation, and of these, 15 (3 edentulous and 12 partially dentate) completed treatment and evaluation with an implant-supported prosthesis (IP). Standardized masticatory performance tests with peanuts and carrots as the test food were made on the defect and nondefect sides. Tests of swallowing threshold performance were made with carrots as the test food. Statistical analysis included repeated-measures analysis of variance (ANOVA) with post hoc Tukey HSD tests (alpha=.05). RESULTS: Masticatory function at entry was markedly compromised. Further performance declines were noted following surgery (PS) on both the defect and nondefect sides. Restoration with CP and IP produced improvements (significant for defect side only, P<.05) in performance over the PS interval and were not significantly different from performances at entry prior to surgery. In addition, the performance on the defect side with the IP was significantly greater than the performance with the CP (P<.001). CONCLUSION: Impairment in masticatory ability remains following free-flap reconstruction prior to prosthetic rehabilitation. Both CP and IP may provide improved masticatory ability, permitting patients to regain the functional level they possessed prior to surgical intervention. The IP may contribute to greater support and stability of the prosthesis, resulting in increased use for mastication and superior performance on the defect side compared to the CP.
机译：问题陈述：微血管外科技术的重大进步可以使骨和软组织口面部缺损得到可预测的修复。与假肢康复相结合，人们注意到美学，语音清晰度和吞咽程度均有不同程度的改善。然而，尚不清楚传统假体和植入物支持的假体对咀嚼功能恢复的相对影响。目的：本研究的目的是确定常规的或植入物支持的假牙以及当前的外科手术重建程序能否将患者的咀嚼功能恢复到术前水平。材料和方法：在本研究的46名受试者中，有23名（7名无牙和16名部分牙齿）完成了常规的假体（CP）治疗和咀嚼评估，其中15名（3名无牙和12名部分牙齿）完成了治疗和评估。植入物支持的假体（IP）。在缺陷和无缺陷的一侧进行了标准的咀嚼性能测试，以花生和胡萝卜作为测试食品。吞咽阈值性能的测试以胡萝卜作为测试食品。统计分析包括使用事后Tukey HSD测试（alpha = .05）的重复测量方差分析（ANOVA）。结果：进入时的咀嚼功能明显受损。术后（PS）缺陷侧和非缺陷侧的性能进一步下降。 CP和IP的恢复在PS间隔内的性能得到了改善（仅对于缺损侧有意义，P <.05），并且与手术前进入时的性能无显着差异。此外，使用IP的缺陷方面的性能显着高于使用CP的性能（P <.001）。结论：假肢康复前的自由瓣重建后咀嚼能力仍然存在。 CP和IP均可提高咀嚼能力，使患者能够在手术干预之前恢复其拥有的功能水平。与CP相比，IP可能有助于增加假体的支撑性和稳定性，从而增加了咀嚼的使用量和在缺损侧的优越性能。

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