老年人动态咬合下的接触特征的初步研究  

A preliminary study on the contact characteristics of the aged under the dynamic occlusion

作　　者：孙强[1] 王冠超[1] 廉云敏[2] 张英怀[3] 陈磊[2] 

机构地区：[1]卫生部中日友好医院口腔医学中心,主治医师北京100029 [2]河北医科大学第二医院口腔修复科,主任医师教授石家庄050000 [3]河北医科大学第二医院口腔颌面科,主任医师教授石家庄050000

出　　处：《中华老年口腔医学杂志》2013年第1期26-30,共5页Chinese Journal of Geriatric Dentistry

摘　　要：目的:通过研究老年人多种颌位的咬合观察及前伸咬合运动中前牙的接触模式与牙弓形状的关系,探讨老年人的动态咬合下的接触特征,为临床修复重建提供理论依据。方法:本研究共86例老年患者,通过口内视诊确定牙弓形态。采用厚度为8um的Bausch咬合测试膜检查下颌各个非正中颌位的接触:侧方移动至包括下颌0.5mm、尖对尖接触位置及前伸移动至前牙切对切接触位置。结果:下颌侧方移动至0.5mm时,30.2%受试者为双侧组牙功能,20.1%为混合尖牙保护和组牙功能。下颌侧方移动至尖对尖接触位置时,45.3%的受试者为双侧尖牙保护,17.4%为双侧组牙功能。下颌向前滑动至上、下前牙切对切接触位置时,80.2%的受试者前牙存在接触,后牙分离。前牙的牙合接触模式与牙列形状的关系:71.4%方圆型牙弓受试者是I型前牙接触模式;63.9%尖圆型牙弓受试者为II型前牙接触模式;对于卵圆型牙弓受试者,前牙接触模式I型和II型均占40%。结论:老年患者具有特殊的动态接触特征。前伸咬合运动中前牙的接触模式与牙弓形状关系密切,修复重建需要考虑这种关系。[ Abstact] Objective： To study the occlusal contacts with different occlusion and the relationships between patterns of anterior occlusal contacts in protrusion and the types of dental arches in the aged patients and evaluate the characteristics of various dynamic occlusion contacts schemes.Methods： The dynamic occlusion and the type of dental arch were investigated in a sample of 86 elder patients.The types of dental arches were determined by intraoral examination.Dynamic occlusion was inspected in guided lateral（0.5mm and cusp-to-cusp position） and protrusive movements of the mandible by intraoral examination with the aid of shim stock.Results： At the 0.5mm lateral excursion,30.2% had bilateral group function and 20.1% mixed group function and canine protected occlusion.At the cusp-to-cusp position,45.3% had canine protected occlusion,17.4% had bilateral group function.In terms of the anterior guidance pattern,a predominant anterior contact with posterior disocclusion（80.2%） was noted.Examination of the relationship between patterns of anterior occlusal contacts and the types of dental arch revealed that for square and round shaped arch,the pattern of anterior occlusal contacts was predominantly type I（71.4%,occlusal contacts between all upper and all lower incisors）.While for tip circular shaped arch,the pattern of anterior occlusal contacts was predominantly type II（63.9%,occlusal contacts between upper central incisors and 2-4 lower incisors）.For patients with egg circular shaped arch,The patterns of anterior occlusal contacts was 40% for both type I and type II.Conclusion： In aged patients,there is a special characteristic in dynamic occlusion contacts.The patterns of anterior occlusal contacts were significantly influenced by the types of dental arches.When full-arch restorative rehabilitation was performed,much attention should be paid on the relationship.

关 键 词：动态咬合 老年人 牙弓形态 尖牙保护[牙合] 组牙功能[牙合] 

分 类 号：R783[医药卫生—口腔医学]