RW(牙合)板对伴颞下颌关节紊乱病的安氏Ⅱ类错(牙合)患者颌位及咬合关系的影响  

The effect of the RW-splint on the position and occlusal relationship of class Ⅱ malocclusion patients with temporomandibular disorder

作　　者：刘俊峰 刘从华 张文忠 肖珲 李少冰 LIU Junfeng;LIU Conghua;ZHANG Wenzhong;XIAO Hui;Li Shaobing(Department of Orthodontics,Stomatological Hospital,Southern Medical University,Guangzhou 510280,China;Department of Stomatology,The First People's Hospital of Kashi Region,Kashi Region 844000,China;Department of Implant,Stomatological Hospital,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学口腔医院正畸科,广东广州510280 [2]喀什地区第一人民医院口腔科,新疆维吾尔自治区喀什地区844000 [3]南方医科大学口腔医院种植科,广东广州510280

出　　处：《口腔疾病防治》2020年第4期224-230,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省科技创新战略专项基金(2018YJ038);广东省援疆农村科技(特派员)项目(KTP20190282)

摘　　要：目的探讨RW[牙合]板(RW-splint)对伴颞下颌关节紊乱病(temporomandibular disorder,TMD)的安氏Ⅱ类错[牙合]患者颌位及咬合关系的影响,以期为此类患者的诊断及设计提供参考。方法收集15例伴有TMD的安氏Ⅱ类错[牙合]患者,采用RW-splint治疗8个月后,通过髁突移位测量仪记录治疗前后髁突在正中关系位(centric relation,CR)和正中[牙合]位(centric occlusion,CO)时颌位(∠ANB,∠SN-MP,S-G0/N-Me)及咬合关系(磨牙、尖牙位移及前牙覆[牙合]覆盖值)的变化值。结果 RW-splint治疗后,15例患者∠ANB值(t=4.971,P=0.001)、∠SN-MP值(t=9.895,P <0.01)均显著增加,S-G0/N-Me变小(t=5.342,P=0.005)。15例患者下颌左右侧第一磨牙相对上颌第一磨牙远中移动均值分别为(1.57±0.79)mm,(1.69±1.29)mm;下颌左右侧尖牙均向远中移动均值分别为(1.54±0.50)mm,(1.51±1.08)mm;前牙覆[牙合]减小,覆盖增加,其均值分别为(1.16±0.60)mm,(1.99±0.85)mm。结论经RW-splint治疗后伴TMD的安氏Ⅱ类患者下颌皆发生顺时针旋转,磨牙及尖牙相对位置均有明显改变。Objective To explore the effect of RW splints on the position and occlusal relationship of classⅡ malocclusion patients with temporomandibular disorder(TMD) to provide a basis for the diagnosis and design of this kind of patient.Methods Fifteen patients with class Ⅱ malocclusions with TMD were enrolled in this study. After 8 months of RW-splint treatment, the changes in jaw position(∠ANB, SN-MP, ∠S-G0/N-Me) and occlusal relationship(molar,cuspid teeth displacement and anterior overbite/overjet value) were recorded by a condylar displacement measuring instrument at the CR position and CO position.Results After RW-splint treatment, the mean values of ∠ANB(t=4.971, P=0.001) and ∠SN-MP(t=9.895, P < 0.01) were increased in all 15 patients, and the mean value of S-G0/NMe(t=5.342, P=0.005) was decreased. The mean values of the distal movement of the first molars on the left and right sides of the mandible were(1.57 ± 0.79) mm and(1.69 ± 1.29) mm, respectively;the mean values of the distal movement of the canines on the left and right sides of the mandible were(1.54 ± 0.50) mm and(1.51 ± 1.08) mm, respectively;and the mean values of the overbite were(1.16 ± 0.60) mm and(1.99 ± 0.85) mm, respectively.Conclusion After RW-splint treatment, the jaw rotates clockwise, and the relationship between the molars and canines changes obviously inclass Ⅱ patients with TMD,which provides a reference for the diagnosis and treatment plan of this kind of patient.

关 键 词：RW板 颞下颌关节紊乱病 颌位 安氏Ⅱ类 咬合关系 正畸修复 颞下颌关节疼痛 功能性移位 

分 类 号：R78[医药卫生—口腔医学]