牙槽嵴骨吸收程度不同下颌中性区外形变化初探  

Change of pofished surface contours on mandibular complete denture base in different residual ridge resorption situation： a pilot study

作　　者：刘向晖[1] 徐军[1] 

机构地区：[1]北京大学口腔医学院·口腔医院修复科,100081

出　　处：《中华口腔医学杂志》2010年第4期228-232,共5页Chinese Journal of Stomatology

基　　金：“十一五”国家科技支撑计划（2007BA118B05）

摘　　要：目的观察无牙颌患者在牙槽嵴骨吸收程度不同的情况下下颌中性区外形的变化，以期寻找恰当的义齿磨光面设计。方法选择20例无牙颌患者，根据患者上下颌弓关系，分为3组。第一组：牙槽嵴轻度吸收患者：第一类无牙颌，上下颌弓关系正常，共6例；第二组：牙槽嵴中度吸收患者：第二类无牙颌，上下颌弓关系正常，共7例；第三组：牙槽嵴重度吸收患者：第三类无牙颌，上下颌弓关系为反耠，共7例。通过患者充分主动的肌功能整塑，较准确地形成中性区外形，以此作为义齿磨光面，使用三维牙颌模型激光扫描仪对上下颌模型及磨光面进行三维激光扫描和重建。分别在双侧磨牙区和前磨牙区作垂直于磨光面轴线的垂面，将磨光面及上下颌模型一并切开，得到截面。观察截面形态，并在各截面上测量下颌舌侧磨光面外形曲线拟合直线与殆平面所成的角度。结果从截面形态可见，第一组患者颊舌侧磨光面形态均为凹形；第二组患者颊舌侧磨光面形态均未见明显凹陷，为略凸或直形；第三组患者磨光面形态呈倾斜状。第一、二、三组患者下颌舌侧磨光面外形曲线拟合直线与耠平面所成的角度分别为（80．40±3．51）°、（90．38±2．71）°和（96．59±5．00）°。结论牙槽嵴骨吸收程度不同，下颌中性区外形有所不同，提示临床上在设计义齿磨光面外形时，应考虑牙槽嵴的吸收程度及上下颌弓关系。Objective To investigate the profile of madibular denture polished surface in edentulous patients with different residual ridge resorption （RRR） using neutral zone record. Methods Twenty randomly selected edentulous patients with different category of RRR were investigated, which were divided into three groups according to ridge resorption grade and the relationships between upper and lower jaws： group 1 ： Class Ⅰ edentulous patients （ n = 6）, group 2 ： Class Ⅱ edentulous patients （ n = 7 ）, group 3 ： Class Ⅲ edentulous patients and crossbite jaw relationship （n = 7）. All subjects were asked to perform sufficient functional movement with silicon registration material in their mouth to record the shape, which were interpreted as the ideal shape of denture polished surface. Three-dimentional laser scanner was used to record the data of the outline of the maxillary and mandibular ridge and the silicon record of the polished surface. Digital model reconstruction was then conducted on the workstation. Sagittal surface of the model in the cut-in point on first molar and first premolar was made and data of the outline of these surfaces was collected. Results Both the buccal and the lingual polished surfaces were concave, straight or slight protuberant and inclined respectively in group 1,2 and 3. The average angles between the horizontal and the lingual polished surface were （ 80. 40 ＋ 3.51 ）°, （ 90. 38 ＋ 2. 71 ） ° and （ 96. 59 ＋ 5.00 ） °respectively. Conclusions The polished surfaces were changed with different progress of RRR in edentulous patients. It was suggested that the degree of residual ridge resorption and the realationship between upper and lower jaws should be considered when clinicians design the polished surface of denture.

关 键 词：义齿 全口 义齿基托 剩余牙槽嵴骨吸收 

分 类 号：R783.6[医药卫生—口腔医学]