摘要目的:探讨数字化技术制作可摘局部义齿（RPD）在老年人Kennedy Ⅰ、Ⅱ类牙列缺损修复中的临床效果。方法:随机对照研究。纳入2020年1月—2023年12月利辛县人民医院口腔科门诊Kennedy Ⅰ、Ⅱ类牙列缺损伴颌骨结构改变的老年患者40例，其中男16例、女24例，年龄69.5~97.5（79.2±5.6）岁；Kennedy Ⅰ类17例、Ⅱ类23例；按颌骨结构改变分类：C类9例、D类17例、E类14例；按颌骨缺损部位分类：上颌骨缺损11例、下颌骨缺损15例、上下颌骨均缺损14例。40例患者按照数字表法随机分为2组：观察组20例采用数字化技术制作钴铬合金RPD，对照组20例采用传统方法制作钴铬合金RPD。评价指标：观察患者牙列缺损修复情况；RPD修复后1个月，采用称重法计算患者5种日常食物（牛肉、花生米、馒头、苹果、黄瓜）的咀嚼效率，采用视觉模拟评分法（VAS）评价2组患者在义齿舒适度、美观度、咀嚼功能、食物嵌塞、稳固性5个方面的满意度，并进行组间比较。结果:观察组和对照组患者年龄、性别、牙列缺损Kennedy分类、颌骨结构改变分类、颌骨缺损部位、牙齿缺失数量等基线资料比较，差异均无统计学意义（ P值均>0.05）。40例患者义齿修复牙列缺损均获成功。观察组患者义齿修复1个月后，牛肉、花生米、馒头、苹果、黄瓜的咀嚼效率分别为61.35%±3.54%、66.00%±3.91%、92.45%±3.52%、71.00%±4.64%、81.80%±4.06%，均高于对照组的47.10%±5.22%、58.05%±3.19%、84.50%±5.92%、66.35%±3.44%、77.10%±3.32%；在义齿舒适度、美观度、咀嚼功能、食物嵌塞、稳固性5个方面的满意度VAS评分分别为（8.89±0.87）、（8.56±0.93）、（7.89±1.01）、（8.90±1.06）、（8.64±1.06）分，均高于对照组的（7.11±1.65）、（7.46±1.23）、（6.01±1.37）、（7.67±1.16）、（7.52±1.14）分：组间比较差异均有统计学意义（ t=10.10、7.05、5.17、3.60、4.01、4.26、3.19、4.94、3.52、3.19， P值均<0.05）。 结论:与传统方法制作的RPD相比，使用数字化技术制作的RPD修复老年人KennedyⅠ、Ⅱ类牙列缺损，可提高患者的咀嚼效率和对义齿的满意度。

abstractsObjective:This study aimed to investigate the clinical efficacy of digital technology in the fabrication of removable partial dentures (RPDs) for elderly patients with Kennedy Ⅰ and Ⅱ type dentition defect.Methods:A randomized controlled study was conducted on 40 patients with Kennedy Ⅰ and Ⅱ type dentition defect accompanied by changes in jaw structure who underwent RPD restoration at the Department of Oral Surgery, Lixin County People's Hospital from January 2020, to December 2023. Among them, 16 were males and 24 were females, with an average age of 69.5-97.5(79.2±5.6) years, and the Kennedy Ⅰ and Ⅱ types were 17 and 23 patients, respectively. Classified by changes in jaw structure, there were 9 patients in class C, 17 patients in class D and 14 patients in class E. There were 11 patients of maxillary defects, 15 patients of mandibular defects, and 14 patients of both maxillary and maxillary defects.The patients were randomly divided into two groups by using a random number table. The observation group included 20 patients who used digital technology to design and manufacture cobalt-chromium alloy RPD. The control group included 20 patients who used traditional methods to manufacture cobalt-chromium alloy RPD. The evaluation indicators were as follows: to observe the dental arch defect restoration of patients with RPD; to calculate the chewing efficiency of five daily foods (beef, peanuts, steamed bread, apples, and cucumbers) of the two groups 1 month after RPD restoration by using a weighing method; to evaluate the satisfaction of two groups of patients in five aspects of denture comfort, aesthetics, chewing function, food impaction and stability after RPD restoration for 1 month by using visual analogue scale (VAS).Results:The baseline data of age, gender, Kennedy classification of dentition defect, classification of jaw structure change, jaw defect site, tooth loss in the observation and control groups were compared, and no significant differences were found (all P values>0.05). Both groups had successfully repaired dental arch defects. One month after RPD was repaired, the chewing efficiencies of the above five foods (beef, peanuts, steamed bread, apples, and cucumbers) in the observation group were 61.35%±3.54%, 66.00%±3.91%, 92.45%±3.52%, 71.00%±4.64%, and 81.80%±4.06%, which were all higher than the control group (47.10%±5.22%, 58.05%±3.19%, 84.50%±5.92%, 66.35%±3.44%, and 77.10%±3.32%). The VAS satisfaction scores in five aspects of RPD (comfort, appearance, chewing function, food impaction, and stability) in the observation group were 8.89±0.87, 8.56±0.93, 7.89±1.01, 8.90±1.06, and 8.64±1.06 points, respectively, which were all higher than the control group (7.11±1.65, 7.46±1.23, 6.01±1.37, 7.67±1.16, and 7.52±1.14 points). The differences between the two groups were statistically significant ( t=10.10, 7.05, 5.17, 3.60, 4.01, 4.26, 3.19, 4.94, 3.52, 3.19; all P values<0.05). Conclusion:Compared with RPD produced by traditional methods, using digital technology to fabricate RPDs for the repair of Kennedy Ⅰ and Ⅱ type dentition defect in the elderly can improve patients' chewing efficiency and satisfaction.