無歯顎者の頬舌的顎堤断面形態の診査における主観的評価と客観的評価の関係 The Relationship between Subjective Evaluation and Objective Evaluation in the Examination of the Buccolingual Residual Ridge Shape of Edentulous Patients

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目的: 日常臨床で的確な頬舌的顎堤断面形態の診査は, 総義歯治療に際して重要である.顎堤の診査において, 簡便で再現性の高い客観的評価を確立する目的で, 頬舌的顎堤断面形態に関して, 複数の歯科医師による主観的評価と模型計測による客観的評価の関係を検討した.<BR>方法: 上下顎無歯顎者の研究用模型 (100組) の左右第一大臼歯相当部顎堤を評価した. 主観的評価では, 臨床経験7年以上の者8名と, 3年未満の者8名で, 4段階 (U型, U-V中間: 中間, V型, 平坦) で評価した. 客観的評価はデジタル式ノギスにて顎堤の幅を計測した. 客観的評価と主観的評価との関係を検討した. 主観的評価の各評価の割合が逆転するときの客観的評価の計測値をもとに評価の基準値を設定した. さらに, 客観的評価と主観的評価の一致度についても検討した.<BR>結果: 臨床経験7年以上の評価者の主観的評価と客観的評価との関係から, V型と中間の評価の判別のための基準値は上顎では7mm, 下顎では5mm, 中間とU型の評価の判別のための基準値は上顎では9mm, 下顎では7mmとなった. これらの基準値に基づき主観的評価の一致度を比較したが, 臨床経験にかかわらず一致度は低かった.<BR>結論: 頬舌的顎堤断面形態の主観的評価は再現性が低かった. したがって, 今回設定した基準値をもとに, 再現性や普遍性の高い新たな顎堤診査の評価方法の確立が必要である.

Purpose: In daily clinics, appropriate examination of thebuccolingual residual ridge shape is critical for complete denture treatment. To clarify the possibility of establishing standards for improving the reproducibility of objective evaluations, the relationship between conventional subjective evaluation by several dentists and objective evaluation by model measurement was evaluated.<BR>Methods: The right and left first molar regions in study models (100 sets) of edentulous maxillas and mandibles were evaluated.<BR>Subjective evaluation using a four-grade scale (U shaped, U-V shaped, V shaped, flat) was performed by sixteen dentists (eight with less than 3 years of clinical experience, eight with more than 7 years of clinical experience).<BR>Objective evaluation (breadth of the residual ridge) was performed with digital vernier calipers. The relationship between objective evaluation and subjective evaluation was studied.<BR>Discrimination values for objective evaluation were determined at changeover points for each rate of subjective evaluation.<BR>In addition, we studied agreement between subjective evaluation and objective evaluation as determined by the discrimination values.<BR>Results: Marked variation was noted in subjective evaluation depending on the individual and number of years of clinical experience. Discrimination values were obtained from subjective evaluation by the dentists with more than 7 years of clinical experience: for the maxilla, "V" and "U-V" were 7 mm and "U-V" and "U" were 9 mm; for the mandible, "V" and "U-V" were 5 mm and "U-V" and "U" were 7 mm. Agreement of the subjective evaluation based on these discrimination values was extremely low regardless of the individual's clinical experience.<BR>Conclusions: Reproducibility of subjective evaluation of the residual ridge shape was low. Thus, we need to establish a reproducible and more universally effective evaluation method of residual ridge examination.

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  • 日本補綴歯科學會雜誌 = The journal of the Japan Prosthodontic Society  

    日本補綴歯科學會雜誌 = The journal of the Japan Prosthodontic Society 51(1), 22-31, 2007-01-10 

    Japan Prosthodontic Society

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各種コード

  • NII論文ID(NAID)
    10018731361
  • NII書誌ID(NCID)
    AN00197911
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    03895386
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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