フルアーチ即時装填プロテーゼ後の患者の満足度と快適性

Patient satisfaction and comfort after a full-arch immediate loaded prosthesis.

• Elena Dellepiane
• Francesco Pera
• Paola Zunino
• Maria Grazia Mugno
• Paolo Pesce
• Maria Menini

抄録

本研究の目的は、Columbus Bridge Protocol（CBP）に基づいたインプラント支持型のフルアーチ即時荷重リハビリテーションの完了前、完了中、完了後の患者の口腔保健関連QOL（OHRQoL）を評価することであった。歯列に障害のある25名の患者がCBPに従ってリハビリテーションを受け、この研究のために特別に考案され、OHIP（Oral Health Impact Profile）質問票に触発された4つの質問票を用いて、OHRQoLの評価を行いました。患者は、手術前、治癒期（手術後1週間と2ヶ月）、最終的な補綴治療後（手術後4ヶ月）に自己評価を行いました。質問紙は、患者の痛み、落ち着き、家庭での口腔衛生習慣、審美性に関する満足度、咀嚼能力、音声学、治療に対する一般的な満足度を具体的に調査した。審美性と咀嚼能力に統計学的に有意な改善が認められた。4ヶ月後には92％の患者が笑顔に緊張感を感じず、96％の患者が人との関わりや笑顔に問題を感じず、92％の患者が一部の食べ物を食べることに困難を感じなかった。音声学は、特に治癒の中間段階において重要な問題であることが判明しました。術後1週間で、音声学に非常に満足している患者の割合は48％から36％にわずかに減少した。フルアーチ即時負荷インプラント治療に関連した患者のOHRQoLの評価は、患者のQOLの有意な改善を示した。ここで紹介した質問票は，口腔リハビリテーションに対する患者の反応を評価するための有効なツールとなり得る．

The aim of this study was to assess oral health related quality of life (OHRQoL) of patients before, during and after completion of implant-supported full-arch immediate loading rehabilitation according to the Columbus Bridge Protocol (CBP). 25 patients with compromised dentition were rehabilitated according to the CBP and were assessed for OHRQoL using 4 questionnaires specifically realized for this study and inspired to the OHIP (Oral Health Impact Profile) questionnaire. Patients assessed themselves before surgery, during the healing period (1 week and 2 months after surgery) and after definitive prosthodontic treatment (4 months after surgery). The questionnaires specifically investigated patients' pain, confort, home oral hygiene habits, satisfaction related to esthetics, masticatory ability, phonetics and general satisfaction toward the treatment.Patients reported an improvement of OHRQoL after full-arch immediate loading rehabilitation. A statistically significant improvement in aesthetic and chewing ability was found. After 4 months 92% of the patients did not feel tense with their smile, 96% did not show problems to relate with other people or smiling, 92% did not show difficulty to eat some foods. Phonetics was found to be a critical issue, especially in the intermediate phase of healing. One week after surgery the percentage of patients who was very satisfied with phonetics slightly decreased from 48% to 36%. The assessment of patients' OHRQoL related to full-arch immediate loading implant therapy exhibited a significant improvement of their quality of life. The questionnaires herein presented could be an effective tool to evaluate patients' reaction to oral rehabilitation.