机构地区:[1]解放军总医院第一医学中心口腔科,北京100853 [2]解放军医学院,北京100853
出 处:《华西口腔医学杂志》2022年第4期457-467,共11页West China Journal of Stomatology
基 金:国家自然科学基金(81970957);解放军总医院医疗大数据与人工智能研发项目(2019MBD-013)。
摘 要:目的 采用TeeTester数字化咬合系统比较分析伴颞下颌关节紊乱病(TMD)症状的偏侧咀嚼者和非偏侧咀嚼者的咬合情况。方法 根据调查问卷和口腔检查筛查出80名受试者,分为4组:伴TMD症状的偏侧咀嚼者20名,不伴TMD症状的偏侧咀嚼者20名,伴TMD症状的非偏侧咀嚼者20名,不伴TMD症状的非偏侧咀嚼者20名。使用TeeTester数字化咬合系统测定4组对象的全牙列最大接触面积、全牙列最大咬合力、力不对称指数、咬合力中心点、咬合接触时间、分离时间等。采用SPSS 25.0软件进行统计分析。结果 牙尖交错位时,4组的全牙列最大咬合力、最大咬合接触面积差异有统计学意义(P<0.05);伴/不伴TMD症状的偏侧咀嚼组习惯侧与非习惯侧咬合力分布比较差异有统计学意义(P<0.05);4组的咬合力中心点、中心点偏移方向、中心点距中线垂直距离差异有统计学意义(P<0.05)。经Spearman相关性分析,习惯侧最大咬合力、习惯侧最大接触面积、咬合力中心点与偏侧咀嚼呈正相关(P<0.05),全牙列最大咬合力、最大接触面积与TMD呈负相关(P<0.05)。结论 1)伴TMD症状的偏侧咀嚼者和伴TMD症状的非偏侧咀嚼者的咬合特点存在一定的差异,数字化咬合系统为动态评估偏侧咀嚼者的咬合情况提供了客观参数。2)咬合分析指标中习惯侧最大咬合力、最大接触面积、咬合力中心点与偏侧咀嚼呈正相关。偏侧咀嚼引起的异常咬合(全牙列最大咬合力,最大接触面积)与TMD呈负相关。Objective In this study,TeeTester digital occlusal analysis system was used to analyse the occlusal characteristics of chewing side preference(CSP)and non-CSP patients with TMD symptoms.Methods According to the questionnaire and oral examination,80 subjects were screened and divided into four groups:20 CSP patients with TMD symptoms,20 CSP patients without TMD symptoms,20 non-CSP patients with TMD symptoms,20 non-CSP patients without TMD symptoms.TeeTester digital occlusal system was applied to measure the occlusal characteristics in all four groups,including total contect area(TCA),total occlution force(TOF),distribution of occlusal force(DOF),asymmetric index of occlusal force(AOF),occlusal time(OT),disclusion time(DT)and center of occlusal force(COF).SPSS 25.0 was used to analyze the statistical data.Results At intercuspal position,the data reveals significant differences in the maximum TOF and TCA among the four groups(P<0.05).There was significant difference in the distribution of occlusal force between the preferred side and the other side of CSP patients with or without TMD symptoms(P<0.05).Among the four groups,there were statistically significant difference in the position of the center point of occlusal force,the direction of the center point of occlusal force,and the vertical distance between the center point of occlusal force and the center line(P<0.05).The COF,maximum TOF and TCA of the preferred side of dentition were significantly positive correlated with CSP(P<0.05),according to Spearman correlation analysis.However,the maximum TOF and TCA of the both side of dentition were significantly negative correlated with TMD symptoms(P<0.05).Conclusion 1)The occlusal characteristics of CSP patients and non-CSP patients with TMD symptoms are different.Tee Tester digital occlusal analysis system provides objective parameters for the dynamic evaluation of occlusion.2)Among all the occlusal characteristics,maximum TOF,TCA and COF of the preferred side of dentition were positively correlated with CSP.The abnorm
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