全口無牙病患舌頭位置對贗復治療效果之研究

背景：老年人口高齡化是全世界的趨勢，因此，老年照護是目前全世界最重要的健康政策議題之一。全口無牙的比例會隨著年齡的增長而增加（Shan, Parkash＆ Sunderam, 2004）及台灣地區老年人口腔健康狀況普遍不佳，齲齒及牙周病是造成全口無牙的主要原因。對義齒的成功與否而言，舌頭位置是一個重要因素。研究目的：1.探討全口無牙狀態與舌頭休息位置之關係。 2.探討影響舌頭休息位置之相關因素。研究方法：本研究172位病患，分為2組，86位是自然牙病患作為對照組，86位是全口無牙病患作為實驗組。全口無牙是南部某醫學中心、診所、安養中心、社區老人健檢的病患；自然牙是診所的病患，蒐集這些病患的基本資料及口腔檢查的資料。資料分析使用JAP5.01版（p＜0.05為有意義）。結果：在Wright舌頭位置分類或舌頭休息位置方面，無牙病患有較高的退縮舌或不正常舌位比例（P＜.005）。在上顎完全無牙的時間與下顎完全無牙的時間對Wright舌頭位置分類或舌頭休息位置的影響，皆未達顯著性差異（P＞0.05），但可發現兩者中，下顎無牙的時間長，其退縮舌或不正常舌位比例較高些；全口無牙的時間越久，退縮舌或不正常舌位比例較高，達顯著性差異（P＜.005）。結論與建議：瞭解全口無牙的舌頭位置的狀況及其影響因素，以提供臨床醫師在製作全口義齒時，以便制定治療計畫及製作義齒過程考量更為周詳，將有助於成功的義齒裝置。

關鍵字

全口無牙；舌頭位置；退縮舌

並列摘要

The tongue is an important attribute in denture success or failure. The purpose of this project was to study the relationship between completely edentulous patient and tongue position. It also studied the relationship between sex, age, period of edentulous state and tongue position.172 samples was included in the study. 86 patients with natural dentition was the control group and 86 patients with full edentulous ridges was the experimental group. The baseline data and oral function evaluation of both groups was collected. Furthermore, the tongue position was determined by Wright classification and Kotsiomiti & Kapari method related to edentulous state. And the retracted distance was measured by a modified periodontal probe. The relationship between tongue position and variables was evaluated by statistic method. The completely edentulous patient expressed higher rate of retracted tongue or abnormal tongue position than the natural dentition (P<.005). There were no significant difference between tongue position evaluation by Wright or Kotsiomiti & Kapari method and the completely edentulous period of upper and lower arches (P>0.05). However, the length of full mouth edentulous period significantly related to the tendency of the retracted tongue or abnormal tongue position. These results suggest the tongue position of completely edentulous patient need to be evaluated carefully when making complete dentures.