症例の重症度は総義歯治療後の臨床的改善に違いをもたらすか？

Does case severity make a difference to clinical improvement following complete denture treatment?

抄録

目的:

本研究の目的は、新しい総義歯を作製する際に、症例の重症度が臨床結果に及ぼす影響を調査することである。

PURPOSE: The aim of this study was to investigate the effect of case severity on clinical outcomes when fabricating new complete dentures.

材料と方法:

日本補綴歯科学会が作成した無歯顎患者の症例難易度の指標を用いて，参加者を重症群と中等症群に分けた．治療前と治療後に，自己評価による咀嚼能力と口腔保健関連QOL（OHRQoL）を調べ，Mann-Whitney U検定を用いて症例の重症度に応じて比較した。また，治療前と治療後の比較にはWilcoxon signed rank testを用いた。

MATERIALS AND METHODS: Participants were separated into severe and moderate groups using the index of case difficulty for edentulous patients developed by the Japan Prosthodontic Society. Before and after treatment, self-assessed masticatory ability and oral health-related quality of life (OHRQoL) were examined, and the authors compared them according to case severity using the Mann-Whitney U test. To compare findings before and after treatment, the authors used the Wilcoxon signed rank test.

結果:

重症群では、治療後に両スコアが有意に改善した（P < 0.01）。しかし，中等度群では，食物受容性スコアで測定した自己評価咀嚼能力に，治療前後で有意な差はなかった（P＝0.11）。治療前に，Oral Health Impact Profileスコアで測定したOHRQoLは，重度のグループが中等度のグループよりも有意に高かった（P < 0.01）。しかし，治療後には両群間に有意な差は認められなかった（P = 0.92）．

RESULTS: In the severe group, both scores were significantly improved after treatment (P < .01). However, in the moderate group, there was no significant difference in self-assessed masticatory ability as measured by the food acceptance score before and after treatment (P = .11). Before treatment, OHRQoL as measured by the Oral Health Impact Profile score was significantly higher in the severe group than in the moderate group (P < .01). However, after treatment, there was no significant difference between the two groups (P = .92).

結論:

著者らは、症例の重症度が総義歯治療中の無歯顎患者のOHRQoLと自己評価した咀嚼能力に違いをもたらすと結論づけた。治療前に症例の重症度を指標で評価することは，患者と臨床家にとって臨床結果を予測するための有用なツールである．

CONCLUSIONS: The authors concluded that case severity makes a difference in the edentulous patient's OHRQoL and self-assessed masticatory ability during complete denture treatment. Evaluating case severity with the index before treatment is a useful tool for patients and clinicians to predict clinical outcomes.