经验丰富医师和初级医师使用咬合平面板确定全口义齿咬合平面的精度比较

目的：比较经验丰富的口腔医师和初级医师使用咬合平面板确定全口义齿咬合平面的准确性。方法15位经验丰富的医师和15位初级医师分别使用咬合平面板确定仿真头颅模型蜡堤的咬合平面,测量蜡堤上咬合平面与参考平面的夹角,分析2组测量值之间的差异。结果经验丰富的医师和初级医师所确定的前牙区咬合平面与参考平面的夹角分别为(0.2±0.1)°和(0.6±0.2)°,差异有统计学意义(t=-4.668,P<0.001),但夹角都接近于0°,差异无临床意义。经验丰富的医师和初级医师所确定的后牙区咬合平面与参考平面的夹角分别为(0.9±0.4)°和(3.4±0.6)°,差异有统计学意义(t=-13.378,P<0.001),经验丰富的医师所确定的咬合平面与参考平面的夹角更接近0°。结论对于经验丰富的口腔医师,使用咬合平面板确定咬合平面是一种精度较高的方法。初级医师使用咬合平面板确定前牙区咬合平面也很准确,但对后牙区咬合平面的观测能力较差,需要在这方面加强训练。     

激光快速成型技术制作头颅模型的仿真分析

目的：检测并验证建立头颅模型的激光快速成型技术的精确性。方法：对牙列完整的干头颅进行CT扫描，将CT数据转换为STL格式，采用快速成型技术（液态光敏树脂选择性固化）建立头颅模型。对头颅模型及干头颅进行骨至骨，牙至牙以及骨至牙标志的测量。采用Pearson相关系数及线性回归检验进行统计学分析。结果：快速成型技术建立的头颅模型能通过CT数据反映骨性结构。骨性标志的测量中，头颅模型与干头颅的平均差别为0．41mm±0．56mm；牙至牙的测量中，平均差别为0．05mm±0．21mm；骨至牙的测量中平均差别为0．16mm±0．19mm。结论：激光快速成型技术建立的头颅模型，其几何外形与头颅骨标本基本一致，精度符合颌面外科要求，可用于术前设计、规划及手术模拟，具有临床实用性。     

仿真头颅模型用于口腔修复学教学的效果评价

目的：证明与传统的临床前期教学相比，仿真头颅模型教学是否提高口腔修复学教学质量。方法：向武汉大学口腔医学院接受仿真头颅模型教学的2000级学生发放问卷调查，及对额外接受10h仿真头颅模型教学的2000级和只接受传统实验室教学的1998两个年级学生的牙体预备质量进行评价。结果：绝大多数学生对仿真头颅模型在教学中的作用给予了肯定，额外的10h仿真头颅模型训练对学生的操作水平有显著提高。结论：仿真头颅模型提高了修复学教学质量，是值得推广的教学工具。     

总义齿咬合平面定位对最大咬合力的影响

为观察总义齿咬合平面定位设计与患者咀嚼功能的关系，选择１０名无牙颌患者，分别为每个患者各作４副总义齿，其中有一副义齿（标准义齿）的咬合平面以上中切牙近中切角为基准或向后上、或向后下、或向左右方向倾斜５°。测定患者戴各义齿用单侧尽最大力咬合时的力值，发现患者戴标准义齿时平均最大咬合力值显著高于其它义齿。该结果提示：总义齿的咬合平面平分颌间距离且与耳屏鼻翼线平行最有利于无牙颌患者咀嚼功能的发挥     

全口义齿咬合接触三维重建和测量系统的研究

目的:探讨对全口义齿上、下颌人工牙列咬合位置关系确定和重建的数字化方法。方法:应用非接触式激光三维扫描和三维数字化技术,采用上、下颌共6个定位球,对10副全口义齿人工牙列牙合面进行三维扫描,同时对正中牙合时上、下颌人工牙列咬合位置关系的确定和重建进行研究。结果:初步建立了全口义齿咬合接触三维重建和测量系统。结论:本研究对三维确定和重建全口义齿咬合位置关系作了初步尝试,为进一步分析和研究全口义齿人工牙列的三维咬合创造了条件。     

平面咬合板对伴咀嚼肌疼痛型夜磨牙的治疗作用

目的研究平面咬合板对伴咀嚼肌疼痛型夜磨牙治疗作用。方法选择21例患夜磨牙且伴咀嚼肌疼痛的患者,通过咬合诱导板诱导下颌做前伸或正中运动,确定平面咬合板治疗位,咬合用硅橡胶固定该治疗位,面弓转移关系,上颌架,制作平面咬合板,测量开口度达到正常与缓解疼痛以及盘突关系恢复时间。结果正常开口度所需的时间平均为(12±1.6)d,疼痛指数<2所用时间为(7±1.4)d,恢复正常盘突关系的时间为(128±13.2)d。结论平面咬合板在缓解疼痛以及缩短恢复盘突关系时间上具有一定意义。     

MEAW技术矫治咬合平面偏斜的应力分析

目的：利用有限元分析法分析MEAW弓丝在矫治咬合平面偏斜时的应力分布情况。方法：应用CAD软件建立上颌MEAW的实体模型,将模型导入ANSYS软件,采用Solid45实体单元进行网格划分,在两侧弓丝＂L＂曲水平部位加载方向相反的力垂直向控制位移。结果：整体弓丝应力分布较均匀,并且弓丝每个＂L＂曲水平部位应力较适度。结论：控制位移使弓丝两侧产生的方向相反、均匀适度的应力,为临床进行咬合平面偏斜的矫正提供一定的理论依据。     

全口义齿咬合接触的三维测量分析

目的采用三维数字化方法对咬合接触参数进行测量分析。方法应用非接触式激光三维扫描和三维数字化技术,在三维扫描和重建10副全口义齿人工牙面以及正中时咬合状态的基础上,测定咬合接触的数目和部位,并与T-Scan咬合仪的测量结果进行配对t检验。结果⑴咬合接触参数的测量结果显示,咬合接触区域主要集中在磨牙和前磨牙区;⑵应用激光扫描系统测量和T-Scan系统测量的咬合接触部位和数目比较,P>0.05,在统计学上无显著性差异。结论本研究将激光扫描技术引入全口义齿咬合接触研究领域,通过测量全口义齿咬合接触部位和数目,并与T-Scan系统的测量结果进行比较,进一步验证了该方法进行咬合检测的可靠性,为今后咬合接触的研究提供了新的思路。     

儿童咬合诱导学习班通知

经国家继续医学教育委员会批准，第四军医大学口腔医院儿童口腔科定2009年10月12日至10月16日，在古城西安举行为期5天的儿童咬合诱导学习班，主要面对广大基层口腔专业医师，尤其是从事儿童口腔专业的从业医师，针对儿童乳牙列和混合牙列时期的咬合诱导基本知识、基本理论、基本技能进行讲授与训练，并通过技术先进的儿童乳牙专用实验室仿真头颅模型，为学员在实验室操作提供模拟临床的操作条件。     

SD大鼠咬合创伤模型的建立

目的:观察并筛选得到最有效诱导SD大鼠咬合创伤的建模方法.方法:选用实验级雄性SD大鼠,体重150～200 g,鼠龄10～12周.麻醉后,在其上颌后牙分别用Super-bond和Multi-link粘结不锈钢方丝、树脂、铸造半冠、铸造半冠联冠、使用选择性激光熔积(selective laser melting,SLM)技术制作的半冠、SLM半冠联冠.粘结后,每天观察实验装置脱落率.采用SAS8.2软件包的Fisher精确概率法,分析不同方法之间的差异.结果:采用Super-bond或Multi-link 2种方式,对脱落率的影响无显著差异.在黏结方式不影响脱落率的前提下,分析不同实验装置之间对脱落率的影响,组间差异具有显著性(P＜0.0001).结论:应用SLM技术制作的修复体,在SD大鼠咬合创伤模型中诱导咬合高点是有效的、可行的.     

Inclination of the occlusal plane and occlusal guidance as contributing factors in mastication

Objectives: The purpose of the present study was to compare the inclination of the occlusal plane with occlusal guidance as a contributing factor to masticatory movement.

Methods: Masticatory movements of 41 young adults were measured using a 3-D mandibular movement analysing system. The inclination of the occlusal plane was measured in the sagittal plane using a 3-D digitizer. The contribution of the occlusal guidance and the inclination of the occlusal plane to the direction of the masticatory path of closure was evaluated at various closing levels.

Results: The masticatory path of closure outside the intercuspal range was influenced mainly by the inclination of the occlusal plane, and the masticatory path of closure near the intercuspal range was only influenced by occlusal guidance. The so-called gliding type masticatory pattern was observed predominantly in subjects with a posteriorly inclined occlusal plane. In contrast, a chopping type masticatory pattern was observed predominantly in subjects with an anteriorly inclined occlusal plane.

Conclusions: The contribution of the inclination of the occlusal plane to masticatory movement was greater than that of occlusal guidance throughout the closing phase except near the intercuspal range.     

Reliability of Anatomic Reference Planes in Establishing the Occlusal Plane in Different Jaw Relationships: A Cephalometric Study

The purpose of this study was to evaluate the reliability of different anatomic reference planes in determination of Occlusal plane in dentulous and edentulous subjects with Angle’s class I and class II Maxillomandibular relationship. Eighty subjects were included in the study which was divided into four Groups based on dentition and skeletal relationship. The Group I (n = 20) and Group II (n = 20) includes young and completely dentulous subjects in Angle’s class I and class II relationship, respectively. The Group III (n = 20) and Group IV (n = 20) subjects were completely edentulous in Angle’s class I and class II relationship, respectively. For all subjects, right lateral cephalograms were taken and cephalometric analysis was done and data obtained from cephalometric tracings were then statistically analyzed. The results showed no significant difference of angle between Occlusal plane and Frankfort Horizontal plane, Camper’s plane and Palatal plane when Group I and Group III, and Group II and Group IV subjects were compared. The Frankfort Horizontal plane, Camper’s plane and the Palatal plane may be used as a reliable guide to establish Occlusal plane in edentulous subjects in both Angle’s class I and class II Maxillomandibular relationships.     

Fabrication of maxillary single complete denture in a patient with deranged mandibular occlusal plane: A case report

Construction of a single complete denture (SCD) is a challenging clinical situation especially when the opposing natural dentition is not in a normal plane of occlusion. Mal-aligned, tilted or supra-erupted teeth in the opposing arch are some of the problems that should be corrected to achieve a balanced occlusion in patients who require SCD. Achieving harmonious occlusal plane is a primary objective of any restorative procedure to facilitate natural mandibular movements and ease of mastication. Establishment of normal occlusal plane in opposite arch is pre-requisite to maintain the stability of the SCD. This clinical report describes restoration of mandibular teeth (with severe attrition and deranged occlusion) by establishing normal plane of occlusion with the help of custom made occlusal plane template (OPT) followed by construction of a complete denture in maxillary arch.     

计算机辅助分析全口义齿咬合特征

目的本文通过计算机辅助咬合分析的方法,观察全口义齿修复后的咬合接触特征,定量研究咬合接触分布的变化。方法戴用3个月及30个月的全口义齿修复患者各14例。采用T-ScanII咬合分析仪进行体内咬合分布特征及咬合时间的测定。记录全121义齿左右侧咬合面积不对称指数,咬合力中心值,咬合力前后向分布比率,咬合时间,最大负载时间。结果戴用全口义齿30个月的患者,咬合面积不对称指数、咬合时间及最大负载时间略有缩短,咬合力中心略有前移,但2组间无统计学差异。结论全口义齿戴用30个月后,患者对全口义齿有较好的适应能力,咬合平衡性稳定提高。     

前牙区(牙合)平面横向倾斜的临床研究

目的 探讨前牙区(牙合)平面横向倾斜的矫治方法.方法 选取16例原发性前牙区(牙合)平面横向倾斜的正畸临床患者,常规固定矫治器排齐牙列,使用颌间垂直牵引、直线型弓、不对称形摇椅弓,配合使用前牙平面导板等方法整平前牙区(牙合)平面.结果 经正畸治疗后,14例患者(牙合)平面完全平直,2例原发性伴有骨性畸形的双平面(上颌平面、下颌平面)均倾斜的患者经治疗后基本平直.结论 常规固定矫治技术配合局部垂直牵引、直线型弓、不对称形摇椅弓等特殊手段可有效纠正前牙区(牙合)平面横向倾斜.     

Management of occlusal canting with miniscrews

A 14-year-old boy with a skeletal Class II malocclusion and open bite whose chief complaint was a posterior crossbite showed a canted occlusal plane with asymmetric gummy smile and mandibular deviation at clinical examination. The treatment with miniscrews focused on the bilateral intrusion of the maxillary posterior teeth and, after resolving the open bite, a new biomechanical technique involving joined miniscrews was applied for an en masse intrusion of the left side. This treatment strategy achieved optimal occlusion with improvements to the sagittal, vertical, and transverse relationships and achieved a harmonious smile.     

三种牙合型全口义齿咀嚼效能的比较

目的：比较长正中、半解剖、平面(牙合)3种(牙合)型全口义齿的咀嚼效率。方法：收集刃状、低平或凹型牙槽嵴患者60例,随机分成3组,分别用长正中(牙合)型、半解剖(牙合)型与平面(牙合)型人工牙制作全口义齿（n ＝20）。采用固定咀嚼时间和咀嚼次数2种方法,测定患者戴牙1、2、3、6个月后的咀嚼效率,比较三者的咀嚼效率。SPSS 22．0软件包对数据进行统计学分析。结果：长正中(牙合)型、半解剖(牙合)型全口义齿咀嚼效率无显著差异（P ＞0．05）,长正中(牙合)型全口义齿的咀嚼效率明显高于平面(牙合)型全口义齿（P ＜0．05）。结论：对于刃状、低平、凹陷状牙槽嵴条件的无牙(牙合)患者,长正中(牙合)全口义齿能恢复良好的咀嚼效能。