低位咬合患者(牙合)重建效果的综合评估  

Synthetical evaluation of the occlusal reconstruction in patients with infraocclusion

作　　者：王璐 安虹 李悦欣 WANG Lu;AN Hong;LI Yue-xin(Department of Special Dental Care,Xi’an Jiaotong University College of Stomatology,Xi’an,Shaanxi 710004,China;Department of stomatology,Xi’an rehabilitation hospital,Xi’an,Shaanxi 710061,China)

机构地区：[1]西省康复医院口腔科,陕西710061 [2]西安交通大学附属口腔医院特诊科,陕西710004 [3]西安交通大学附属口腔医院修复科,陕西710004

出　　处：《口腔颌面修复学杂志》2019年第5期272-277,共6页Chinese Journal of Prosthodontics

基　　金：陕西省科学技术研究发展计划项目(项目编号：S2017-ZDYF-YBXM-SF-0250)

摘　　要：目的:通过关节适应性,咀嚼肌力发挥、咬合平衡及稳定三方面的综合分析,评价咬合重建的治疗效果。方法:选取30例低位咬合患者,进行咬合重建序列治疗,利用锥束CT(cone-beam CT,CBCT)测量治疗前后颞下颌关节间隙及髁突位置;运用Bio-Pak肌电图仪分析治疗前、后咀嚼肌肌电反应及肌平衡性;使用T-ScanⅢ咬合分析仪分析治疗前、后咬合平衡性及咬合接触时间。对治疗前后所得相关数据进行统计学分析。结果:治疗后与治疗前相比髁状突发生前移且关节前间隙减小;息止位咀嚼肌力明显下降同时伴有牙尖交错位时咀嚼肌力增加,咀嚼肌对称性明显改善;咬合接触时间及咬合平衡度明显增加。结论:咬合重建治疗后,患者髁突位置、咀嚼肌肌力的发挥、咬合力及咬合平衡性与治疗前相比均有显著改善,说明咬合重建序列治疗对低位咬合患者是一种行之有效的治疗方法。Objective: Through the methods of systematic and comprehensive investigation on masticatory muscles、temporomandibular and occlusion statistics, this study provide an evaluation method for occlusal reconstruction treatment.Methods: we selected 30 infraocclusion patients, using cone beam CT(CBCT) for the image of temporomandibular joint taken before and after treatment and computer technology for linear measurement to analyze the change of joint space.Bio-Pak EMG and T-Scanning system were used before and after treatment respectively for the survey of masticatory muscles、biting force distribution and occlusion time. Results: The condyle position in the glenoid fossa was shifted forward and anterior joint space decreased compared with occlusal reconstruction treated before, the EMG amplitudes of masseter and anterior temporal muscles at the rest position decreased and increased dramatically at the maximum clenching position after three months of the restoration. In addition, the balance of occlusal force and masticatory muscles got greatly improved. Conclusions: after occlusal reconstruction, temporomandibular joint position, occlusal force and balance of occlusal force are all remarkably improved. Occlusal reconstruction is effective for treating patients with infraocclusion.

关 键 词：低位咬合 咬合重建 颞下颌关节 咀嚼肌 咬合接触 

分 类 号：R783[医药卫生—口腔医学]