无牙颌颞下颌关节紊乱病患者总义齿修复前后咬合垂直距离改变与髁状突在关节凹内位置的关系  

Effect of occlusal vertical dimension on condylar position in edentulous temporomandibular joint dysfunction patients after complete denture restoration

作　　者：曹均凯[1] 章捍东[1] 刘洪臣[1] 

机构地区：[1]解放军总医院口腔科,北京市100853

出　　处：《中国组织工程研究与临床康复》2007年第31期6271-6273,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察咬合垂直距离改变对无牙颌颞下颌关节紊乱病患者两侧颞颌关节髁状突位置的影响。方法:于1994-01/1997-12选择本院口腔修复门诊收治的无牙颌患者中符合颞下颌关节紊乱病诊断标准,同时垂直距离减低的患者48例。实验方案经医院伦理委员会审批,患者均知情同意。将48例无牙颌颞下颌关节紊乱病患者根据垂直距离减低程度的不同分为3组:减低1.8～6.0mm组18例,减低6.1～10.0mm组20例,减低10.1￣14.0mm组10例。通过重新制作一副全口义齿的方法治疗,咬合垂直距离恢复在合适的范围内,3组全口义齿的咬合垂直距离恢复前分别平均为63.4,60.6,54.2mm,恢复后咬合垂直距离分别平均为67.8,68.4,66.4mm,平均抬高4.4,7.8,12.2mm。通过拍摄正中颌位时颞下颌关节薛氏位X射线片测量各组前、后、上关节间隙。结果:垂直距离恢复前,减低1.8～6.0mm组关节后间隙,减低6.1～10.0mm组关节前、后间隙、减低10.1￣14.0mm组关节上、后间隙左右侧相比较,差异有显著性意义(P<0.05)。垂直距离恢复后,3组关节间隙左右侧差异无显著性意义。结论:无牙颌咬合垂直距离减低后可以导致两侧髁状突位置发生不对称改变。AIM： To observe the effect of occlusal vertical dimension on bilateral condylar position after the complete denture restoration in edentulous patients with temporomandibular joint dysfunction （TMD）. METHODS： From January 1994 to December 1997, 48 edentulous cases of TMD were recruited from the Out-patient Clinic of. Oral Prosthesis in General Hospital of Chinese PLA. The experimental scheme obtained the approval of hospital ethnic committee and informed consents of patients. According to the decrease of vertical dimension, all the cases were divided into three groups： group A （n =18） of decreasing 1.8-6.0 mm, group B （n =20） of decreasing 6.1-10.0 mm, and group C （n =10） of decreasing 10.1-14.0 mm. The vertical dimensions of all 48 cases enhanced 4.4, 7.8, 12.2 mm after complete denture restoration, respectively （63.4, 60.6, 54.2 mm; 67.8, 68.4, 66.4 mm）. Schuller＇s positional radiographs were performed to measure the joint spaces between the glenoid fossa on the centric occlusion. RESULTS： Before occlusal vertical dimension recovered, there were significant differences in posterior spaces of group A, anterior and posterior spaces of group B, superior and posterior spaces of group C （P 〈 0.05）. But there was no statistical difference after the recovery. CONCLUSION： The decrease of vertical dimension can induce the asymmetric changes of bilateral condylar position in edentulous patients.

关 键 词：颞下颌关节紊乱病 牙列缺损修复体 老年人 牙列 

分 类 号：R318[医药卫生—生物医学工程]