臺灣博碩士論文加值系統

自從植牙發明以來已帶給牙醫師在治療全口無牙的病患有很大的發揮空間,特別是結合了傳統全口假牙及植牙的覆蓋性義齒,更是適合在條件較差的病患上使用.可是這種治療方式在經過長期配戴後是否真的有比傳統全口假牙表現來的佳嗎? 病患的臨床滿意度又為何呢? 這些都是我們想知道的,因此本實驗的目的即在於比較在長庚醫院接受過種植四根植體來做桿夾式合併彈性復連體的覆蓋性義齒以及接受下顎傳統全口假牙的病患其在使用上功能上日常生活及心理上和整體滿意度上是否有差別的存在.
其結果顯示人工植牙組及傳統假牙組雖然病患大都感到滿意.可是人工植牙組除了在心理上的不舒適感及社交能力的表現上是沒有明顯的差異存在之外( 植牙組所得到的平均數為1.08,標準差為0.18. 而對照組的全口假牙組所獲得的平均分數為1.42,標準差為0.81 . 在換算 t 值後為-1.632, p值是0.124,沒有&;lt;0.05.), 其餘的均顯示人工植牙組比全口假牙組來的好且有統計上的意義.因此在面對下顎全口無牙的病患此種搭配人工植牙及附連體的覆蓋性義齒是可以作為優先考慮的治療方法.

The purpose of this study was to record subjective patient experiences with respect to long term satisfaction of mandibular implant-retained overdentures versus conventional dentures.
Methods: Completely edentulous patients (n =85) . among 85 patients ,sixty of them were treated with 4 one-stage titanium plasma sprayed or Sandblasted Large-grit Acid-etched (SLA) screw implants and overdentures retained by a cast bar with extracoronal attachments(ERA). Sixty patients were subsequently clinically evaluated over a period of up to 6 years as experimental goup. Others were treated with conventional complete denture as control group .All sixty experimental group patients responded to questions on their experiences prior to and after treatment with implant retained overdentures. However15 among 25 patient in control group responded to the questionnaire
Results: No implants or restorations failed during the observation period. T he experimental group shows significant difference than control goup
Conclusions: The use of implants to retain and support the denture improved comfort, givingthe patients more self-confidence and improved social interaction, in addition to oral rehabilitation. This study demonstrates rehabilitation of the
mandibluar arch with an implant-retained overdenture is a predictable treatment protocol

目錄
表目錄---------------------------------------------------------------------------XII
第一章 緒論 :-----------------------------------------------1
1.1 研究背景------------------------------------------------2
1.2 研究目的------------------------------------------------8
第二章 文獻回顧---------------------------------------------9
2.1 牙齒缺失對病人所造成的影響-------------------------------10
2.2 全口假牙 vs 植體固持式覆蓋義齒---------------------------10
2.3 植體固持式覆蓋義齒的植牙數之比較--------------------------11
2.4 文獻回顧-----------------------------------------------12
2.4.1 評估不同植牙數目對植體覆蓋式義齒之文獻回顧---------------12
2.4.2 評估不同植體覆蓋式義齒設計之文獻回顧--------------------12
2.4.3 評估性別不同對於假牙在臨床使用滿意度之文獻回顧-----------13
2.4.4 評估植體覆蓋式義齒與傳統全口假牙在臨床使用滿意度之文獻回顧-13
2.5 臨床滿意度的重要性--------------------------------------14
2.6 如何評估病人的滿意度------------------------------------16
2.7 評估病人滿意度的方法------------------------------------18
2.8 問卷調查表的設計----------------------------------------19

第三章 研究方法--------------------------------------------20
3.1 研究對象-----------------------------------------------21
3.2 問卷設計-----------------------------------------------23
3.3 問卷的效度分析-----------------------------------------24
3.4 問卷的信度分析-----------------------------------------25
3.5 統計分析----------------------------------------------26

第四章 結果------------------------------------------------27
4.1 受試者資料及達成率--------------------------------------28
4.2 效度分析-----------------------------------------------29
4.3 信度分析-----------------------------------------------29
4.4 統計分析-----------------------------------------------29

第五章 討論------------------------------------------------32
5.1 植牙數目與假牙設計--------------------------------------34
5.2 假牙所導致功能上的問題--------------------------------34
5.3 咀嚼能力的評估----------------------------------------35
5.4 咀嚼種類的評估-----------------------------------------36
5.5 心理及日常社交生活的影響--------------------------------36
5.6 整體滿意度--------------------------------------------37
5.7 性別差異----------------------------------------------37
5.8 年齡差異----------------------------------------------38
5.9 病患的選擇,期望值與滿意度-------------------------------38

第六章 結論------------------------------------------------40
參考文獻--------------------------------------------------42



表目錄

表格
表格 一 評估不同植牙數目對植體覆蓋式義齒之文獻回顧-------------50
表格二 評估不同植體覆蓋式義齒設計之文獻回顧-------------------51
表格三 以問卷調查方式評估性別不同病人配戴假牙滿意度分析之文獻回顧-----------------------------------------------------------53
表格四 探討植體覆蓋式假牙與傳統全口假牙比較之文獻回顧----------54
附件------------------------------------------------------57
表1 無牙病患臨床上治療結果參考因數與實際病患本身感受之
相關度評估量表------------------------------------------58
表2 問卷--------------------------------------------------59
表3 統計數據-----------------------------------------------64
表4 效度統計量---------------------------------------------65
表5 信度統計量---------------------------------------------67
表6 各項統計數據分析----------------------------------------70
表7 各項統計排序分析----------------------------------------79
表8 同意函-------------------------------------------------81

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