咬合重建:科学与艺术的结合  

Full-mouth occlusal reconstruction:science and art

作　　者：金晓婷 赵维家 罗洁 傅柏平[1] JIN Xiao-ting;ZHAO Wei-jia;LUO Jie;FU Bai-ping(Department of Prosthodontics,Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine,Zhejiang Provincial Clinical Research Center for Oral Diseases,Key Laboratory of Oral Biomedical Research of Zhejiang Province,Cancer Center of Zhejiang University,Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属口腔医院修复科·浙江大学口腔医学院·浙江省口腔疾病临床医学研究中心·浙江省口腔生物医学研究重点实验室·浙江大学癌症研究院·口腔生物材料与器械浙江省工程研究中心,杭州310000 [2]浙江大学医学院附属口腔医院·浙江大学口腔医学院·浙江省口腔疾病临床医学研究中心·浙江省口腔生物医学研究重点实验室·浙江大学癌症研究院·口腔生物材料与器械浙江省工程研究中心,杭州310000

出　　处：《口腔颌面修复学杂志》2023年第1期1-6,共6页Chinese Journal of Prosthodontics

基　　金：国家自然科学基金面上项目(项目编号:81771120,81970982);浙江省重点研发计划项目(项目编号:2020C03037)。

摘　　要：咬合重建过程复杂,治疗时间长,涉及因素众多,现有诊治方案通常依据“临床艺术”,缺乏循证医学证据。咬合重建的决定因素包括上前牙显露量、上前牙切端位置、瞳孔连线、鼻翼耳屏线和垂直距离;相关因素包括年龄、性别、牙冠的宽长比、发音、脸型、面下1/3高度、息止间隙、大致平分颌间隙和最小修复空间;主观因素主要指面部表情观察法。本文从平面、垂直关系、水平关系三个方面来讨论咬合重建中的决定因素、相关因素和主观因素,分析咬合重建过程中的相互影响因素,探讨咬合重建的科学证据与临床艺术结合的临床诊疗策略。Full-mouth occlusal reconstruction comprises a complicated clinical procedure,involving a time-consuming process with multiple interactive factors.Clinical treatment plans are mainly based on so-called clinical art at this time,which is lack of sufficient scientific evidences.The multiple interactive factors could be divided into the decisive factors,the relevant factors,and subjective factors in the process of full-mouth occlusal reconstruction.The decisive factors include the exposure of maxillary anterior teeth,the incisal position of maxillary anterior teeth,inter-pupillary line,Camper’s line,and occlusal vertical dimension.The relevant factors include age,gender,width length ratio of crown of upper central incisors,pronunciation,face shape,free-way space,a rough bisection of the inter-jaw space and minimum restorative space.The subjective factors mainly refer to the facial expression observation.The decisive,relevant and subjective factors related to occlusal plane,occlusal/resting vertical dimension and horizontal relationship of jaws are discussed on the interactive influences,exploring the scientific evidence and clinical art for clinical treatment plans.

关 键 词：咬合重建 垂直距离 颌位关系 

分 类 号：R783[医药卫生—口腔医学]