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作 者:张娟[1] 张志光[2] 李彦[2] 焦国华[2] 索明环[2]
机构地区:[1]天津医科大学口腔医院,300070 [2]中山大学光华口腔医学院
出 处:《现代口腔医学杂志》2008年第3期292-295,共4页Journal of Modern Stomatology
摘 要:目的观察小型猪一侧失牙及义齿修复后颞下颌关节(temporomandibular joint,TMJ)关节内压(intra-articular pressure,IAP)的波动规律。方法将11只小型猪随机分为空白组(2只)、拔牙组(4只)和修复组(5只),将拔牙组和修复组小型猪左侧上下后牙全部拔除,修复组并于拔牙后3个月进行义齿修复,利用钛钉骨内种植的方法固定义齿。对3组小型猪双侧TMJ在3个功能位的IAP进行测定(每月1次,共6个月);并在每月同一时间记录其体重变化。结果一侧失牙不及时修复可造成双侧TMJ IAP的失调:休息位不再维持均衡的负压;被动开口出现异常增大的负压;被动闭口出现较高正压;开闭口后不能完全或只能缓慢回到原休息位压力水平;对侧牙齿严重磨耗。一侧失牙3个月后及时义齿修复可明显改善双侧TMJ IAP的失调状况:休息位恢复负压;被动开口为增大的负压;被动闭口升高为正压;开闭口后能迅速回到原休息位压力水平;左右侧压力变化协调一致;对侧牙齿磨耗减轻。3组小型猪体重变化比较P=0.064>0.05,无组间差异。结论一侧失牙可破坏咬合、TMJ、咀嚼肌的平衡,及时义齿修复可调节三者不协调的关系,使之重建新的平衡。Objective To survey the fluctuating curve of intra- articular pressure (IAP) in temporomandibular joints( TMJ ) of miniature pigs following one side posterior teeth extraction and denture restoration. Methods 11 adult female normal miniature pigs were randomly divided into 3 groups: group Ⅰ -control group (2 pigs), group Ⅱ - tooth - extraction without denture restoration (4 pigs), group Ⅲ -tooth -extraction with denture restoration (5 pigs) . In group Ⅱ and Ⅲ, pigs'left side upper and lower posterior teeth were pulled out. Co - Cr casting dentures were fabricated for the pigs in group Ⅲ 3 months after teeth missing; the dentures were fixed by implanting titanium nails through the base plate into the alveolar bone. TMJ IAPs of both sides were determined montldy at 3 jaw positions respectively; meanwhile , the weight of pigs were measured to monitor their growth. The experiment period was 6 months. Results Compared with controls, the imbalance of bilateral pressure in group II was showed: the IAP at rest could not maintain subatmospheric identically on both sides; during operator- assisted opening movement, the negative IAP was significantly lower;however, when the jaw was closed , the IAP increased to a higher positive level; and the pressure could not return to baseline or slowly decayed to original values ; the severe attrition of teeth in working side was found out. The pressure values of group III indicated that the treatment with denture timely could evidently improve the asymmetric conditions: IAP resumed to be subatmospheric;as the jaw was opened, a negative pressure was presented followed by an increased positive pressure while the mouth was closed; the IAP could immediately decayed to baseline after jaw movement; the bilateral IAP was close to equality and balance ; the attrition of teeth was alleviated. During the 6 months, the pigs maintained their weight within the normal range and grew healthily. Conclusion Missing one side teeth could disturb the balance of occ
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