オーバーデンチャー、総入れ歯、天然歯での噛み合わせ・噛み合わせ

Biting and chewing in overdentures, full dentures, and natural dentitions.

• F A Fontijn-Tekamp
• A P Slagter
• A Van Der Bilt
• M A Van 'T Hof
• D J Witter
• W Kalk
• J A Jansen

抄録

歯科インプラントを提供することで、重度の下顎骨吸収のある被験者の口腔機能が改善され、従来の総入れ歯の装着者が満足しているレベルまで機能が回復する可能性があることが示唆されてきた。しかしながら，これまで定量的な比較は行われたことがなく，研究の方法が大きく異なるため，文献からの情報を得るのは困難である．このような比較を行うために，我々は，オーバーデンチャー，総入れ歯，天然歯を装着した被験者を対象に，同一の方法で咬合力と咀嚼効率を測定した．その結果，インプラント上のオーバーデンチャーで達成された咬合力は，人工歯列と天然歯列で達成された咬合力の中間であることが示された．咀嚼効率は総入れ歯（下顎が低い）の被験者に比べて有意に高かったが，総入れ歯（下顎が高い）およびオーバーデンチャー（裸歯）の被験者に比べて依然として低かった．また，下顎の高さの違いにより，総入れ歯群と総入れ歯群では咀嚼効率に有意な差が認められた．また，歯列弓が短縮された被験者は，完全天然歯列の被験者と同様の咬合力を発揮したが，咬合面積が減少しているため，咀嚼効率は制限されていた．すべての群を合わせた場合、最大咬合力と咀嚼効率の間には有意な相関関係が認められた。咀嚼効率の変動の半分近くは咬合力のみで説明された。

It has been suggested that the provision of dental implants can improve the oral function of subjects with severely resorbed mandibles, possibly restoring function to the level experienced by satisfied wearers of conventional complete dentures. Nevertheless, a quantitative comparison has never been made and can be drawn from the literature only with difficulty, since studies differ greatly in methodology. To make such a comparison, we measured bite force and chewing efficiency by using identical methods in subjects with overdentures, complete full dentures, and natural dentitions. Our results indicated that bite forces achieved with overdentures on dental implants were between those achieved with artificial and natural dentitions. Chewing efficiency was significantly greater than that of subjects with full dentures (low mandible), but was still lower than that of subjects with full dentures (high mandible) and overdentures on bare roots. Differences in the height of the mandible revealed significant differences in chewing efficiency between the two full-denture groups. Furthermore, subjects with a shortened dental arch exerted bite forces similar to those of subjects with a complete-natural dentition, but their chewing efficiency was limited due to the reduced occlusal area. For all groups combined, a significant correlation was found between maximum bite force and chewing efficiency. Nearly half of the variation in chewing efficiency was explained by bite force alone.