下颌牙列缺失固定种植修复的颌学研究

doi:10.7518/hxkq.2020.01.006

华西口腔医学杂志 ›› 2020, Vol. 38 ›› Issue (1): 30-36.doi: 10.7518/hxkq.2020.01.006

下颌牙列缺失固定种植修复的颌学研究

于文倩¹,李晓茜²,马丽³,马晓妮¹(),徐欣¹

1. 山东大学口腔医学院·口腔医院种植科,山东省口腔组织再生重点实验室,山东省口腔生物材料与组织再生工程实验室,济南 250012
2. 山东大学口腔医学院·口腔医院牙周科,山东省口腔组织再生重点实验室,山东省口腔生物材料与组织再生工程实验室,济南 250012
3. 山东大学口腔医学院·口腔医院特诊科,山东省口腔组织再生重点实验室,山东省口腔生物材料与组织再生工程实验室,济南 250012

收稿日期:2019-06-05 修回日期:2019-09-12 出版日期:2020-02-01 发布日期:2020-02-06
通讯作者: 马晓妮 E-mail:maxiaoni0@126.com
作者简介:于文倩,住院医师,硕士,E-mail： 792832494@qq.com
基金资助:
山东省泰山学者建设项目专项基金(ts201511106);山东大学口腔医学院青年科研基金(2018QNJJ01);山东省医药卫生科技发展计划(2017WS112);国家重点研发计划(2016YFC110-2705)

Gnathology in implant-supported fixed restoration in edentulous mandible

Yu Wenqian¹,Li Xiaoqian²,Ma Li³,Ma Xiaoni¹(),Xu Xin¹

1. Dept. of Implantology, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Ji’nan 250012, China
2. Dept. of Periodontology, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Ji’nan 250012, China
3. Dept. of Vip Center, School and Hospital of Stomatology, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Ji’nan 250012, China

Received:2019-06-05 Revised:2019-09-12 Online:2020-02-01 Published:2020-02-06
Contact: Xiaoni Ma E-mail:maxiaoni0@126.com
Supported by:
The Construction Engineering Special Fund of Taishan Scholars(ts201511106);The Youth Scientific Research Funds of School of Stomatology, Shandong University(2018QNJJ01);Shandong Medical and Health Science and Technology Development Plan(2017WS112);National Key Research and Development Program of China(2016YFC110-2705)

摘要/Abstract

摘要：

目的探讨下颌牙列缺失固定种植修复的咬合及肌电特点,为无牙颌固定种植修复的治疗提供参考。方法选取60例下颌牙列缺失固定种植修复的患者,其中A组上颌为固定种植修复,B组上颌为天然牙列,C组上颌为可摘局部义齿,每组20例患者。使用T-scan记录4种颌位的咬合特点,采用肌电仪记录静息状态及牙尖交错位最大紧咬时颞肌前束和咬肌的电位变化,探讨咬合与肌电之间的联系。结果咬合分析结果：C组的咬合接触时间、最大咬合力时左右侧咬合力平衡度及咬合力中心左右向偏移度、咬合力中心位移、前伸颌及侧方颌的咬合分离时间均大于A、B两组（P<0.05）,3组最大咬合力时咬合力中心前后向偏移度及前牙区咬合力百分比的差异均无统计学意义（P>0.05）。肌电分析结果：C组的静息状态下肌电幅值、牙尖交错位最大紧咬时咀嚼肌不对称指数大于A、B两组（P<0.05）,A、B组的牙尖交错位最大紧咬时肌电幅值大于C组（P<0.05）。结论在下颌牙列缺失固定种植修复中,当上颌为可摘局部义齿时,咬合不稳定程度及咬合力中心偏移大于上颌为固定种植修复和天然牙列的患者。咬合与肌电息息相关,上颌可摘局部义齿可造成肌电活动增加,降低咀嚼肌的潜力,双侧肌电的不对称与咬合不平衡有关。

关键词: 无牙颌患者, 固定种植修复, 咬合分析系统, T-scan, 肌电仪

Abstract:

Objective This study aims to investigate the occlusal and myoelectric characteristics of implant-supported fixed denture in the mandibular region and provide reference for the design of fixed restoration. Methods Sixty edentulous patients with implant-supported fixed denture were selected and divided into three groups: group A, 20 cases with implant-supported fixed restoration in the maxillary region; group B, 20 cases with natural dentition, and group C, 20 cases with removable partial denture. The T-scan 8.0 digital occlusion analysis system was used to evaluate the occlusal characteristics of patients in the three groups at intercuspal, protrusion, and left and right lateral positions. Electromyography was used to analyze the myoelectric amplitude and bilateral asymmetry index of the anterior temporalis and masseter of the three groups in different states such as resting and clenching. The relationship between occlusion and myoelectricity was also investigated. Results In the occlusion analysis by T-scan, the occlusion time, the balance of left and right bite force, the left and right asymmetry of the occlusion center, the trajectory of central occlusion force, and the disclusion time were higher in group C than in groups A and B (P<0.05). No significant differences were observed in the anterior and posterior asymmetry of the occlusion center and percentage of bite force at anterior region among the three groups. In the analysis of myoelectricity, the myoelectric amplitude at resting state and the asymmetry index of masticatory muscles in group C were higher than those in groups A and B (P<0.05). The myoelectric amplitude during clenching in groups A and B groups was higher than that in group C (P<0.05). Conclusion In implant-supported fixed restoration at edentulous mandibular, when maxillary includes the removable partial denture, degree of occlusal instability and left and right asymmetry of occlusion center are greater than those with the natural dentition and implant-supported fixed denture at maxillary. The myoelectricity is closely related to occlusion. The removable partial denture can increase the myoelectric activity and reduce the potential of the masticatory muscle. The asymmetry of bilateral myoelectricity is related to the occlusion imbalance.

Key words: edentulous patient, implant-supported fixed denture

中图分类号:

R783

于文倩,李晓茜,马丽,马晓妮,徐欣. 下颌牙列缺失固定种植修复的颌学研究[J]. 华西口腔医学杂志, 2020, 38(1): 30-36.

Yu Wenqian,Li Xiaoqian,Ma Li,Ma Xiaoni,Xu Xin. Gnathology in implant-supported fixed restoration in edentulous mandible[J]. West China Journal of Stomatology, 2020, 38(1): 30-36.

图/表 5

图 1

图 2

图 3

表 1

表 2

参考文献 15

[1]	易新竹 . 颌学[M]. 北京: 人民卫生出版社, 2011.
	Yi XZ. Gnathology[M]. Beijing: People’s Medical Publishing House, 2011.
[2]	Madani AS, Nakhaei M, Alami M , et al. Post-insertion posterior single-implant occlusion changes at different intervals: a T-scan computerized occlusal analysis[J]. J Contemp Dent Pract, 2017,18(10):927-932.
[3]	赵颖, 丁张帆, 康龙 , 等. TeeTester与T-scanⅢ咬合分析仪对正常颌青年学生咬合力特征的比较[J]. 中国组织工程研究, 2015,19(51):8289-8293.
	Zhao Y, Ding ZF, Kang L , et al. TeeTester versus T-Scan Ⅲ: assessment of occlusal characteristics in young students with normal occlusion[J]. Chin J Tissu Eng Res, 2015,19(51):8289-8293.
[4]	李晓茜, 马晓妮, 徐欣 . 无牙颌种植固定修复的咬合分析[J]. 华西口腔医学杂志, 2018,36(6):628-632.
	Li XQ, Ma XN, Xu X . Occlusal analysis of implant-supported fixed denture in edentulous patients[J]. West China J Stomatol, 2018,36(6):628-632.
[5]	Owashi Vallejo KP, Sapin-de Brosses E, Bonnet AS . Electromyography of the masticatory muscles during biting[J]. Comput Methods Biomech Biomed Engin, 2017,20(Suppl 1):155-156.
[6]	Baldini A, Nota A, Cozza P . The association between occlusion time and temporomandibular disorders[J]. J Electromyogr Kinesiol, 2015,25(1):151-154.
[7]	侯潇, 汲平, 马慧芬 , 等. 利用咬合力计指导调颌治疗颞下颌关节紊乱病[J]. 口腔颌面修复学杂志, 2008,9(1):54-57, 66.
	Hou X, Ji P, Ma HF , et al. Clinical effect of occlusion adjustment in the treatment of temporomandibular disorders evaluated with T-Scan Ⅱ system[J]. Chin J Prosthodont, 2008,9(1):54-57, 66.
[8]	Haralur SB . Digital evaluation of functional occlusion parameters and their association with temporomandibular disorders[J]. J Clin Diagn Res, 2013,7(8):1772-1775.
[9]	贾洪诚, 王璇 . 应用T-scanⅢ型系统分析牙周基础治疗前后咬合变化的临床研究[J]. 实用口腔医学杂志, 2015,31(4):484-487.
	Jia HC, Wang X . The occlusal changes after initial periodontal therapy in patients with chronic periodontitis analysed by T-scan Ⅲ occlusal analysis system[J]. J Pract Stomatol, 2015,31(4):484-487.
[10]	Liu CW, Chang YM, Shen YF , et al. Using the T-scan Ⅲ system to analyze occlusal function in mandibular reconstruction patients: a pilot study[J]. Biomed J, 2015,38(1):52-57.
[11]	李雪铃, 林雪峰, 滕伟 , 等. 磨牙症患者咀嚼肌肌电特征的研究[J]. 华西口腔医学杂志, 2008,26(6):640-643.
	Li XL, Lin XF, Teng W , et al. The characteristics of masticatory muscle activity in bruxers[J]. West China J Stomatol, 2008,26(6):640-643.
[12]	刘翠玲, 杨丽媛, 郑政 , 等. 3种方法确定水平颌位关系的全口义齿咀嚼肌肌电活动及咀嚼效率分析[J]. 华西口腔医学杂志, 2016,34(5):493-497.
	Liu CL, Yang LY, Zheng Z , et al. Evaluation of electromyogram activity and masticatory efficiency in edentulous individuals whose maxillomandibular horizontal relationship records were obtained with three different methods[J]. West China J Stomatol, 2016,34(5):493-497.
[13]	Kerstein RB, Radke J . The effect of disclusion time reduction on maximal clench muscle activity levels[J]. Cranio, 2006,24(3):156-165.
[14]	Wright NR . Electromyographic and computer analyses of patients suffering from chronic myofascial pain-dysfunction syndrome: before and after treatment with immediate complete anterior guidance development[J]. J Prosthet Dent, 1991,66(5):677-686.
[15]	Kirveskari P . Assessment of occlusal stability by measuring contact time and centric slide[J]. J Oral Rehabil, 1999,26(10):763-766.

组别	右侧颞肌前束	左侧颞肌前束	右侧咬肌	左侧咬肌
A	2.146±0.178	2.194±0.183	1.716±0.113	1.648±0.123
B	2.157±0.162	2.144±0.152	1.719±0.130	1.826±0.149
C	2.645±0.150	2.703±0.146	2.143±0.151	2.271±0.125

组别	右侧颞肌前束	左侧颞肌前束	右侧咬肌	左侧咬肌
A	16.140±1.113	16.100±0.980	14.170±1.159	13.920±1.132
B	15.300±1.092	16.060±0.945	13.590±0.888	13.730±0.939
C	12.130±0.859	12.860±0.772	10.310±0.910	9.640±0.907

下颌牙列缺失固定种植修复的颌学研究

Gnathology in implant-supported fixed restoration in edentulous mandible

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 15

相关文章 1

编辑推荐

Metrics

本文评价