Study On The Application Effect Of "Medical Care Integration Model" In Oral Implantology For Elderly Patients

Objective To investigate the oral health status of the elderly and its influencing factors,and to explore the application value of intergrated medical-nursing care model in oral implantation for the elderly.Methods(1)The aged who visited department of stomatology in a tertiary hospital in Changsha,Hunan Province from March 1st to September 30th2018 were recruited for a cross-sectional study.Questionnaire of missing teeth,dental check table,oral health knowledge,behavior factors questionnaireand oral cavity scale were used to investigate the oral health status and its influencing factors.(2)A total of 116 elderly patients with oral cavity planting were recruited from 270 patients with tooth loss in the intervention study,and they were divided into intervention group and control group randomly.The control group membersreceived the routine care,the intervention group patients received the care with the integration of medical-nursing care model,the general demographic data,the PLI SBI,PD values,operation success rate,postoperative SAS/SDS score,postoperative nursing satisfaction and postoperative complication rate were used to compared between the two groups.Results(1)Among the 443 elderly patients,270 of whom with tooth lossing,the overall incidence was 60.9%.and there were 223 male patients and220 female patients.The highest proportion of tooth loss was in the population of people over 75 years old(74.4%,93/125).The rate of tooth loss in age groups of 60 ~ 65,66 ~ 70,and 71 ~ 75 were 42.9%(45/105),54.1%(60/111)and 70.6%(72/102)respectively.The incidence of diabetes mellitus,coronary heart disease,hypertension and stroke were17.8%(48/270),12.6%(34/270),35.6%(96/270)and 7.4%(20/270),respectively.(2)The univariate analysis showed that: Gender,age,basic diseases,oral health knowledge(is it normol for gums to bleeed when brushing),and oral health behaviors(frequency of tooth brushing and flossing)are risk factors that affect tooth loss in the elderly(P < 0.05).(3)Befor the intervention,thebaseline data of two groups,including gender,living area,educational level,age,personal income,,basic diseases(diabetes,coronary heart disease,high blood pressure,stroke),oral health knowledge(bleeding gums when brushing is normal),oral health behavior(single brushing time and frequency of tooth brushing),history of smoking,drinking,implant surrounding periodontal health status(PLI SBI,PD values),SAS and SDS score were no significant difference(P> 0.05).(4)After the intervention,the scores of oral health knowledge and behavior of the intervention group were higher than those of control group;In the time points of 1 month,3 months and 6 months after oral implantation,the PD values of the intervention group members were lower than those in the control group,and the difference was statistically significant(P < 0.05).In 3 and 6 months after surgery,the proportion of patients in the intervention group with PIL class 0(no plaque in the Resultsgingival margin region)was higher than that in the control group,and the difference was statistically significant(P < 0.05);the SAS and SDS scores in the intervention group were lower than those in the control group,with statistically significant differences(P < 0.05);the satisfaction of the intervention group was higher than the control group,and the difference was statistically significant(P < 0.05);the overall incidence of complications in the intervention group(3.4%)was significantly lower than that in the control group(10.3%),(P < 0.05).Conclusion(1)The tooth loss rate of the elderly remain in a high status,and the lack of oral health knowledge and poor oral health behavior is not optimistic.Gender,age,underlying diseases,health awareness of gingival bleeding,frequency of tooth brushing and frequency of dental floss are independent risk factors for tooth loss in the elderly.(2)The model of medical care integration was applied in oral implantology for the elderly.strengthened oral health knowledge,helped establish good oral health behavior,thereby improved periodontal health and relieved anxiety and pain levels,and helpd to improve clinical efficacy and nursing satisfaction,and is worthy of clinical promotion.