天然牙列咬合重建时侧方[牙合]型选择的研究进展  

Research progress of lateral occlusion scheme selection during natural dentition reconstruction

作　　者：潘心妮 孙弋 许月丹 林曳 张玲 PAN Xinni;SUN Yi;XU Yuedan;LIN Ye;ZHANG Ling(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,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,浙江杭州310000

出　　处：《口腔医学》2025年第3期229-234,共6页Stomatology

基　　金：浙江省自然科学基金(LY22H140001)。

摘　　要：咬合重建是天然牙列恢复正常咬合关系的重要方法。为实现符合生理功能的咬合重建,需要正确选择侧方[牙合]型。尖牙保护[牙合]与组牙功能[牙合]是天然牙列咬合重建的主要侧方[牙合]型。该文就侧方[牙合]型对口颌系统的影响和天然牙列咬合重建时侧方[牙合]型选择的影响因素进行综述。通过文献回顾发现,侧方[牙合]型影响口颌系统的生理功能,其中尖牙保护[牙合]与组牙功能[牙合]对颞下颌关节的影响均较小,组牙功能[牙合]比尖牙保护[牙合]产生更大的肌电活动、下颌运动速度及下颌横向自由度。天然牙列咬合重建时选用的侧方[牙合]型需根据患者侧方运动程度、正中咬合类别以及年龄等因素综合选择。对于AngleⅢ类错[牙合],骨性Ⅱ、Ⅲ类错[牙合]患者以及老年人群,建议采用组牙功能[牙合];对于青壮年人群,建议实现尖牙保护[牙合];对于最终需要实现尖牙保护[牙合]的患者,建议在侧方运动初期阶段设计组牙功能[牙合],并随着侧方位移的增大逐渐过渡到尖牙保护[牙合]。因此,临床医师需全面了解天然牙列咬合重建时侧方[牙合]型选择的影响因素,以期为患者制订个性化诊疗计划提供治疗依据。Occlusal reconstruction is an important method of restoring a normal occlusal relationship to the natural dentition.The correct choice of lateral occlusion scheme is necessary for physiological occlusal reconstruction.The main lateral occlusion schemes for the occlusal reconstruction of the natural dentition are canine protection and group function.This article reviews the effects of lateral occlusion schemes on the stomatognathic system and factors affecting the choice of lateral occlusion schemes in the occlusal reconstruction of natural dentition.According to the literature review,the lateral occlusion schemes affect the physiological functions of the stomatognathic system.Both lateral occlusion schemes have less impact on the temporomandibular joint.Group function produces greater EMG activity,jaw movement velocity,and jaw lateral freedom than canine protection.The lateral occlusion schemes of the natural dentition should be selected according to the degree of lateral movement,types of static occlusion,and age of patients.For patients with Angle’s ClassⅢmalocclusion,skeletal ClassⅡ,Ⅲmalocclusion,and the elderly,group function is recommended,while canine protection is more recommended for young adults.For patients who eventually need to achieve canine protection,it is recommended to design group function in the early stage of lateral movement,and gradually transition to canine protection with the increase of lateral movement.Thus,clinicians need to fully understand the influencing factors of lateral occlusion selection during occlusal reconstruction in natural dentition,providing a basis for the development of personalized diagnostic and treatment plans.

关 键 词：咬合重建 天然牙列 侧方[牙合]型 尖牙保护[牙合] 组牙功能[牙合] 

分 类 号：R783.4[医药卫生—口腔医学]