348例老年人活动义齿修复临床探讨

目的了解老年修复患者口腔情况,探讨老年人牙列缺失缺损后的修复特点.方法分析348例老年人牙列缺损缺失的情况,采取不同方法进行修复,并进行5年随访.结果老年人牙列缺失缺损在注意咬牙合重建、抬高咬合、防止食物嵌塞情况下进行活动义齿修复.结论 活动义齿是老年人修复治疗的主要方法,老年人活动义齿修复应注意咬合重建,防止食物嵌塞.     

The cerebral representation of temporomandibular joint occlusion and its alternation by occlusal splints

Occlusal splints are a common and effective therapy for temporomandibular joint disorder. Latest hypotheses on the impact of occlusal splints suggest an altered cerebral control on the occlusion movements after using a splint. However, the impact of using a splint during chewing on its cerebral representation is quite unknown. We used functional magnetic resonance imaging (fMRI) to investigate brain activities during occlusal function in centric occlusion on natural teeth or on occlusal splints in fifteen healthy subjects. Comparisons between conditions revealed an increased activation for the bilateral occlusion without a splint in bilateral primary and secondary sensorimotor areas, the putamen, inferior parietal and prefrontal cortex (left dorsal and bilateral orbital) and anterior insular. In contrast, using a splint increased activation in the bilateral prefrontal lobe (bilateral BA 10), bilateral temporo‐parietal (BA 39), occipital and cerebellar hemispheres. An additionally applied individually based evaluation of representation sites in regions of interest demonstrated that the somatotopic representation for both conditions in the pre‐ and postcentral gyri did not significantly differ. Furthermore, this analysis confirmed the decreasing effect of the splint on bilateral primary and secondary motor and somatosensory cortical activation. In contrast to the decreasing effect on sensorimotor areas, an increased level of activity in the fronto‐parieto‐occipital and cerebellar network might be associated with the therapeutic effect of occlusal splints. Hum Brain Mapp, 2012. © 2011 Wiley Periodicals, Inc.