下颌定位仪指导下颌稳定性垫调磨对髁突运动中心位置的影响  

Effect on movement center of mandibular condyle through adjustment of stabilized mandibular occlusion——application of electronic position analysis

作　　者：杨晓江[1] 李湲[1] 华美珍[1] 徐蔚瑶 刘月华[1] 

机构地区：[1]首都医科大学北京口腔医院外二科颞下颌关节疾病诊治中心,100050

出　　处：《实用口腔医学杂志》2007年第2期187-190,共4页Journal of Practical Stomatology

基　　金：北京市卫生局科研基金(2004-局-064);首都医学发展奖金(2003-3060);教育部留学回国人员科研启动基金(2004);北京市卫生局留学回国人员科研基金

摘　　要：目的:观察垫对髁突运动中心位置的影响,并探讨下颌定位技术测定髁突运动中心电子位置(ele-ctronic position analysis,EPA)指导垫调磨的方法。方法:从3158例颞下颌关节紊乱病患者中,选择46例(92侧关节)有下颌绞锁运动症状的颞下颌关节紊乱病患者,接受下颌稳定垫治疗;常规调磨后,为患者戴入合垫,再用超声三维下颌定位仪(3D-ultrasonic navigator)进行髁突运动中心电子位置及下颌运动功能分析,观察常规方法调磨后垫治疗对髁突运动中心的影响;对引起双侧髁突运动中心不均衡位移的病例,则根据EPA的测试,对垫进行修正性调磨。结果:常规调磨后,67.4%(31/46)的患者双侧髁突运动中心在矢状位的位移距离明显不均衡;63%(29/46)的患者双侧髁突运动中心的位移方向不一致;而根据EPA检测修正性调磨后,91.3%(42/46)的患者双侧髁突运动中心的位移方向达到了一致。常规调磨与修正性调磨对垫引起髁突运动中心位移时双侧的均衡性与方向一致性上的差异均具有统计学意义。结论:稳定垫治疗颞下颌关节紊乱病过程中,超声三维下颌定位仪中的EPA检测指导下进行修正性调磨可以提高双侧髁突运动中心的位移距离和方向的一致性。Objective： To analysis the effects of splint adjustment hased on 3D-ultrasonic mandibular navigator （ARCUS digma） on condyle movement center shift in temporonlandibular joint （TMJ） , and then to evaluate the adjustment of the splint under the gut（lance of detected electroronic position analysis （EPA）. Methods：46 patients （92 TMJs） with close locking symptoms were selected to receive stabilized mandibular occlusion （SMO） splint treatment and detected by ARCUS during the treatment. The regular adjustment of the splint was based on occlusion-test paper only. After regular adjustment, the splint was applied to the patients anti then those patients were detected by ARCUS. Condyle eleetronic position analysis （EPA） was used to evaluate tile shift of condyle center and to guide the further adjustment of the splint. Results：After regular adjustment, 67.4% （31/46） patients were found unbalance shift of the condyle movement center on two sides, and 63% （29/46） patients were found in different directions. After the accurate adjustment of the splint under the guide of EPA, shift of TMJ in 91.3% （42/46） patients became to same direction . The unbalance shift of condyle movement center on two side of TMJ shows significant difference before and after accurate adjustment of the splint, either in distance or in shift directions （P 〈 0. 001 ）. Conclusions： SMO splint may lead to unbalance shift of the condyle movement center on two sides of TMJ, and accurate adjustment under the guidance of ARCUS may help to balance condyle center position trace.

关 键 词：[牙合]垫 下颌骨髁突 髁突运动中心 颞下颌关节紊乱病 

分 类 号：R782.6[医药卫生—口腔医学]