正中关系的临床决策

doi:10.7518/hxkq.2024.2024147

华西口腔医学杂志 ›› 2024, Vol. 42 ›› Issue (5): 558-565.doi: 10.7518/hxkq.2024.2024147

正中关系的临床决策

于海洋(), 颜哲彬, 解晨阳, 吴秦

口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院修复科，成都 610041

收稿日期:2024-04-14 修回日期:2024-05-20 出版日期:2024-10-01 发布日期:2024-09-21
通讯作者: 于海洋 E-mail:yhyang6812@scu.edu.cn
作者简介:于海洋，教授，博士，E-mail：yhyang6812@scu.edu.cn|于海洋，二级教授、博士研究生导师、一级临床专家。擅长显微美容修复、数字种植修复和数字化可摘局部义齿修复等。现任中华口腔医学会修复专业委员会主任委员、国家口腔医学中心修复分中心副主任、国家口腔医学质控中心口腔修复专业副组长、口腔修复国家临床重点专科负责人，主编出版规划教材《口腔固定修复学》《口腔医学美学》以及专著《数字引导式显微修复学》《引导式精准植入术》《口腔微距摄影速成》等30部。提出口腔TRS数论、美学修复形—色—心三要素四维辩证论，发明了“TRS可测量种植导板”“备牙定深孔导板”等多项临床技术方案；研发的多项软件及医疗器械产品已经成功转化临床。
基金资助:
国家自然科学基金(82071145);四川大学华西口腔医院资助临床研究项目(LCYJ2022-BZ-2)

Clinical decision of centric relation

Yu Haiyang(), Yan Zhebin, Xie Chenyang, Wu Qin

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2024-04-14 Revised:2024-05-20 Online:2024-10-01 Published:2024-09-21
Contact: Yu Haiyang E-mail:yhyang6812@scu.edu.cn
Supported by:
National Natural Science Foundation of China(82071145);Clinical Research Program of West China Hospital of Stomatology, Sichuan University(LCYJ2022-BZ-2)

摘要/Abstract

摘要：

正中关系（CR）最初应用于无牙颌的全口义齿修复，后来逐渐应用于有牙颌的临床诊疗。关于CR在有牙颌中的应用，一方面对其合理性有不少质疑，如在颞下颌关节紊乱病治疗中，CR是否应作为诊疗核心？咬合重建修复治疗中，CR是否应作为建颌位？正畸治疗中，CR是否应作为目标颌位？但另一方面，CR的各种临床运用却是客观存在的。根据现有认知，本文汇总整理了争议不大的几种主要临床场景的适用条件，初步提出了CR临床应用时的决策树，供临床参考。

关键词: 正中关系, 最大牙尖交错位, 髁突, 全口义齿, 颞下颌关节紊乱病, 咬合重建, 正畸治疗

Abstract:

Centric relation (CR) was used in the complete dentures for edentulous jaws firstly. Then, CR was gradually applied in the clinical diagnosis and treatment of dentate jaws. Regarding the application of CR in dentate jaws, there are many doubts about its rationality. For instance, should CR be the core of diagnosis and treatment of temporomandibular disorders? Should CR be used as the jaw position of establishing occlusion in occlusal reconstruction? Should CR serve as the target jaw position in orthodontic treatment? Meanwhile, varieties of CR clinical applications are objective. According to the existing evidence, this paper summarizes the applicable conditions of several main clinical situations with little controversy. We preliminarily put forward the decision tree for the clinical application of CR, which can be used as a reference in clinical practice.

Key words: centric relation, maximal intercuspal position, condyle, complete denture, temporomandibular disorder, occlusal reconstruction, orthodontic treatment

中图分类号:

R783

于海洋, 颜哲彬, 解晨阳, 吴秦. 正中关系的临床决策[J]. 华西口腔医学杂志, 2024, 42(5): 558-565.

Yu Haiyang, Yan Zhebin, Xie Chenyang, Wu Qin. Clinical decision of centric relation[J]. West China Journal of Stomatology, 2024, 42(5): 558-565.

图/表 2

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时间/ 年	词典	收录词条总数	CR的定义要点
1956	GPT-1	716	髁突最后位+下颌最后位
1960	GPT-2	874	髁突最后位+下颌最后位、下颌最后位
1968	GPT-3	940	下颌最后位
1977	GPT-4	1 081	髁突最后位（×2）、下颌最后位
1987	GPT-5	2 346	髁突前上位
1994	GPT-6	2 766	髁突前上位、下颌最后位（×2）、髁突最后位+下颌最后位、髁突最中最上位、髁突最上最后位、髁突前最上位
1999	GPT-7	2 875
2005	GPT-8	3 068
2017	GPT-9	3 210	髁突前上位
2023	GPT-10	3 611	髁突前上位

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正中关系的临床决策

Clinical decision of centric relation

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