改良型治疗性义齿在颞下颌关节紊乱综合征患者咬合重建中的应用

doi:10.7518/hxkq.2018.02.009

华西口腔医学杂志 ›› 2018, Vol. 36 ›› Issue (2): 162-166.doi: 10.7518/hxkq.2018.02.009

改良型治疗性义齿在颞下颌关节紊乱综合征患者咬合重建中的应用

张皓(), 李斯文, 付佳欢, 李施施, 王艳红, 史秀娣, 白露, 马红梅()

中国医科大学附属口腔医院综合科,沈阳 110002

收稿日期:2017-10-05 修回日期:2017-12-28 出版日期:2018-04-10 发布日期:2018-04-10
作者简介:
张皓,硕士,E-mail：522378571@qq.com
基金资助:
辽宁省自然科学基金（2015020468）;中国医科大学口腔医学院院级教学研究基金（J101593-15-01）

Improved temporary and treatment partial denture in the rehabilitation of patients with temporomandibular joint disorder syndrome

Hao Zhang(), Siwen Li, Jiahuan Fu, Shishi Li, Yanhong Wang, Xiudi Shi, Lu Bai, Hongmei. Ma()

General Dentistry, Hospital of Stomatology, China Medical University, Shenyang 110002, China

Received:2017-10-05 Revised:2017-12-28 Online:2018-04-10 Published:2018-04-10
Supported by:
Supported by: Liaoning Natural Science Foundation (2015020468);The Education Research Fund of Stomatology Hospital of China Medical University (J101593-15-01).

摘要/Abstract

摘要：

目的探讨改良型治疗性义齿在颞下颌关节紊乱综合征患者咬合重建中的应用。方法使用改良型治疗性义齿对20例牙列缺损伴有颞下颌关节区器质性病变的患者进行咬合重建,分别在使用治疗性义齿期间及更换最终修复体后调查患者的主观感觉,检查临床症状,并采用Friction颞下颌关节紊乱指数（CMI）进行评估,采用SPSS 17.0软件进行统计分析。结果患者佩戴治疗性义齿1个月后,关节区症状缓解有效率达到100%;佩戴最终修复体后,关节区舒适性以及修复体使用方面均能达到满意的疗效;CMI较治疗前明显下降（P<0.05）。结论对于牙列缺损伴有颞下颌关节紊乱综合征（骨关节病）的患者,改良型治疗性义齿在咬合重建过程中可获得理想的疗效。

关键词: 治疗性义齿, 颞下颌关节紊乱综合征, 咬合重建

Abstract:

Objective This study aims to study the effect of the improved partial denture treatment in the rehabilitation of patients with temporomandibular joint disorders (TMD). Methods Twenty middle-aged and old patients suffering from osteoarthrosis were treated with the improved partial denture treatment. These patients were followed up during the partial denture treatment and after the rehabilitation. Both the clinical symptoms and Fricton’s craniomandibular index were used to evaluate the clinical effects. Data were analyzed using SPSS17.0. Results The effective rate reached 100% when the patients wore partial dentures for 1 month. All of the 20 patients were comfortable with temporomandibular joint, and they expressed ultimate satisfaction with the denture. The Fricton indexes of 20 patients decreased significantly after the treatment (P<0.05). Conclusion Partial denture treatment is an ideal method in rehabilitation for patients with TMD (osteoarthrosis) and dentition defect.

Key words: temporary and treatment partial denture, temporomandibular joint disorder syndrome, rehabilitation

中图分类号:

R782.6

张皓, 李斯文, 付佳欢, 李施施, 王艳红, 史秀娣, 白露, 马红梅. 改良型治疗性义齿在颞下颌关节紊乱综合征患者咬合重建中的应用[J]. 华西口腔医学杂志, 2018, 36(2): 162-166.

Hao Zhang, Siwen Li, Jiahuan Fu, Shishi Li, Yanhong Wang, Xiudi Shi, Lu Bai, Hongmei. Ma. Improved temporary and treatment partial denture in the rehabilitation of patients with temporomandibular joint disorder syndrome[J]. West China Journal of Stomatology, 2018, 36(2): 162-166.

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参考文献 13

[1]	陈婷, 廖天安, 詹若军, 等. 不同类型咬合板缓解TMD疼痛症状的研究[J]. 临床口腔医学杂志, 2012, 28(11):664-666.
	Chen T, Liao TA, Zhan RJ, et al.Pain control in the treat-ment of temporomandibular disorders by two different kinds of occlusal splints[J]. J Clin Stomatol, 2012, 28(11):664-666.
[2]	Wilkes CH.Internal derangements of the temporomandi-bular joint. Pathological variations[J]. Arch Otolaryngol Head Neck Surg, 1989, 115(4):469-477.
[3]	Fricton JR, Schiffman EL.Reliability of a craniomandibu-lar index[J]. J Dent Res, 1986, 65(11):1359-1364.
[4]	Kuzmanovic Pficer J, Dodic S, Lazic V, et al.Occlusal sta-bilization splint for patients with temporomandibular disor-ders: meta-analysis of short and long term effects[J]. PLoS One, 2017, 12(2):e0171296.
[5]	傅开元, 张寒冰, 赵燕平, 等. 急性和慢性不可复性盘前移位临床对比研究[J]. 中华口腔医学杂志, 2004, 39(6):471-474.
	Fu KY, Zhang HB, Zhao YP, et al.Comparative study on the clinical appearances between acute and chronic anterior disc displacement without reduction[J]. Chin J Stomatol, 2004, 39(6):471-474.
[6]	Marquezan M, Figueiró C.Temporomandibular disorder treatment in a patient wearing removable prostheses: a case report[J]. Cranio, 2017, 35(2):122-127.
[7]	马绪臣, 张震康. 颞下颌关节紊乱病双轴诊断的临床意义和规范治疗的必要性[J]. 中华口腔医学杂志, 2005, 40(5):353-355.
	Ma XC, Zhang ZK.Clinical significance of dual-axis diag-nostic criteria and the necessity of treatment for temporo-mandibular disorders[J]. Chin J Stomatol, 2005, 40(5):353-355.
[8]	Tanne K, Asakawa-Tanne Y, Mitsuyoshi T, et al.Current status of temporomandibular joint disorders and the thera-peutic system derived from a series of biomechanical, his-tological, and biochemical studies[J]. APOS Trend Ortho-dont, 2015, 5(1):4-21.
[9]	王美青. 颞下颌关节紊乱病咬合病因研究进展[J]. 中国实用口腔科杂志, 2009, 2(3):131-134.
	Wang MQ.Progress of etiological researches on role of occlusion in temporomandibular disorders (TMD)[J]. Chin J Pract Stomatol, 2009, 2(3):131-134.
[10]	Kim MH, Heo SJ, Kim SK, et al.Full mouth rehabilitation of destroyed dentition with rotational path removable partial denture: a case report[J]. J Adv Prosthodont, 2010, 2(2):46-49.
[11]	张宁宁, 赵军. 治疗性全口义齿矫正不良颌位的研究[J]. 华西口腔医学杂志, 2003, 21(5):369-371.
	Zhang NN, Zhao J.Correction of malmaxillomandibular relation with therapeutic complete denture[J]. West Chin J Stomatol, 2003, 21(5):369-371.
[12]	康宏, 王建卫. 咬合板治疗口颌系统疾病[J]. 中国实用口腔科杂志, 2011, 4(4):212-216.
	Kang H, Wang JW.Treatment of stomatognathic dysfunc-tion with occlusal splints[J]. Chin J Pract Stomatol, 2011, 4(4):212-216.
[13]	Abduo J, Lyons K.Clinical considerations for increasing occlusal vertical dimension: a review[J]. Aust Dent J, 2012, 57(1):2-10.

项目	计分方法	分值范围
MM	阳性项目数	0~16
TN	阳性项目数	0~4
TP	压痛点数	0~6
DI	DI=(MM+TN+TP)/26	0~1
EP	压痛点数	0~18
IP	压痛点数	0~6
NP	压痛点数	0~12
PI	PI=(EP+IP+NP)/36	0~1
CMI	CMI=(DI+PI)/2	0~1

时间	显效	有效	无效	有效率/%
1周	6	12	2	90
1个月	14	6	0	100
3个月	16	4	0	100

时间	CMI	DI	PI
治疗前	0.398±0.117^a	0.403±0.112^a	0.393±0.130^a
治疗后1个月	0.108±0.024^b	0.182±0.046^b	0.034±0.032^b
治疗后3个月	0.065±0.025^c	0.112±0.047^c	0.020±0.018^b
最终修复后1个月	0.054±0.024^c	0.095±0.045^c	0.013±0.018^b

改良型治疗性义齿在颞下颌关节紊乱综合征患者咬合重建中的应用

Improved temporary and treatment partial denture in the rehabilitation of patients with temporomandibular joint disorder syndrome

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