Influence of Changes in Removable Partial Dentures on Stress Hormone in Saliva.

本研究的目的是探讨可摘局部义齿不适与患者压力之间的关系。18例患者（14名女性，4名男性，平均年龄62.3岁）佩戴RPD，并感到不适、疲倦、疼痛或咀嚼困难。患者分为3组，分别由3位牙医对其义齿进行治疗。所有受试者在牙科椅上保持直立姿势，并要求咀嚼棉花卷（唾液盒）2分钟，以收集唾液样本。唾液采集的阶段分别是：面谈后立即采集、治疗前采集、治疗后立即采集和第一次就诊出院前采集。在第二次预约，治疗前后。唾液样品在检测前立即冷冻-50℃保存，用ELISA试剂盒检测皮质醇和嗜铬粒蛋白A。采用重复测量的方差分析方法对RPD治疗前后的比较进行分析。治疗前首次就诊时游离唾液皮质醇和嗜铬粒蛋白浓度显著高于治疗后。2 .当患者第二次就诊时对义齿治疗（调整、修复、组织调理等）满意时，唾液皮质醇和嗜铬粒蛋白A浓度较第一次就诊时明显降低。唾液皮质醇和嗜铬粒蛋白A的浓度在同一时间在家里就诊与在医院没有显著差异。目前的数据表明，与RPD相关的不适成为压力的来源，缓解不适应减少压力。

The purpose of this study is to elucidated relationship between uncomfortable removable partial dentures (RPD) for patients and their stresses.Eighteen patients (14 females and 4 males, average 62.3 year-old) who wore RPD(s) and felt discomfort, tiredness, pain or difficulty of chewing, were participated in this study. They were divided into 3 groups and were treated their denture by 3 dentists. All subjects were rested in an upright position on the dental chair, and asked to chew a cotton roll (salivette) for 2 min, which was to collect their saliva sample. The stages of saliva collection were immediately after interviewing, just before treatment, immediately after treatment, and before leaving hospital on the first visit. In the second appointment, before and after treatment.Saliva samples were immediately frozen -50℃ for storage prior to assay, and cortisol and chromogranin A was measured by ELISA kit. Comparisons between before and after treatment of RPD were analyzed using an ANOVA with repeated measures.1.The concentrations of free salivary cortisol and chromogranin before treatment for the RPD at the first time of visit were significantly higher than those after treatment.2.When the patients were satisfied with their denture after treatment (adjustments, repair, tissue conditioning etc.) at the second appointment, the concentration of salivary cortisol and chromogranin A decreased significantly compare with the first visit.3.The concentration of salivary cortisol and chromogranin A on same time as at a clinic visit at home was no significantly difference from in the hospital.The present data suggest that discomfort associated with RPD became a source of stress and that a relief of the discomfort should reduce the stress.