Inference to Tongue Pressure during Swallowing by Wearing Palatal Plate

目的：大型上颌义齿基托修复覆盖了机械感受器密集分布的腭部粘膜。用义齿基托覆盖腭部粘膜会导致生理和功能障碍，如不适、呕吐反射和对舌头的识别能力差。方法：对21名受试者进行调查，男12人，女9人，平均年龄25岁，年龄22~29岁。所有受试者在实验前都获得了书面知情同意。受试者被要求直立地坐在牙椅上以测量最大自主舌压，吞咽时的舌压是根据Hayashi等人描述的方法测量的。这些压力在两种情况下被记录了三次：用实验腭板完全覆盖腭黏膜和不覆盖。对于最大自愿舌压记录，受试者被指示以他们最大的自愿舌力在舌头和硬腭前部之间压缩一个特别设计的小气球7秒。为了记录吞咽时的舌压，受试者被指示尽可能自然地吞咽5ml明胶饮料，并将气囊预先放置在舌头和腭前部之间，并记录吞咽过程中舌压的峰值。结果：两种情况下的最大自主舌压和吞咽时的舌压比较，差异无统计学意义。结论：硬腭板覆盖硬腭时，最大自主舌压和吞咽时的舌压不受影响。

Objectives : Prosthodontic treatments by large sized maxillary denture base extensively cover the palatal mucosa where mechanoreceptors are densely distributed. Covering the palatal mucosa with a denture base causes physiological and functional hindrances such as unpleasantness, gag reflex and poor recognition of the tongue. The aim of this study was to clarify inference of tongue pressure during swallowing by wearing palatal plate.Methods : Twenty one subjects (12 males and 9 females, mean age;25 years, age range;22-29 years) were investigated. All subjects gave their written informed consent to participate in this study prior to the experiments.Subjects were asked to sit upright in a dental chair in order to measure the maximum voluntary tongue pressure and the tongue pressure during swallowing were measured based on the method described by Hayashi et al. These pressures were recorded three times under two conditions : palatal mucosa completely covered using an experimental palatal plate and uncovered. For the maximum voluntary tongue pressure recordings, the subjects were instructed to compress a specially designed small balloon between the tongue and the anterior part of the hard palate for 7 seconds with their maximum voluntary tongue effort. To record tongue pressure during swallowing, the subjects were instructed to swallow 5 ml of gelatin drink, as naturally as possible with the balloon pre-placed between the tongue and the anterior part of the palate, and the peak value of tongue pressure during swallowing was recorded. Differences obtained were compared by using the paired-sample t-test (p<0.05).Results : When the results of maximum voluntary tongue pressure and the tongue pressure during swallowing were compared between the two conditions, significant difference wasn't observed.Conclusion : The maximum voluntary tongue pressure and the tongue pressure during swallowing didn't have influence, when the hard palate was covered by a palatal plate.