咬合接触的研究进展

咬合接触是颅颌系统各部位相互关系的重要表现形式 ,仅观察牙齿是否有接触远不能满足基础研究和临床诊治的需求 ,必须从面积、数目、位置、大小以及分布、时相、性质等诸方面系统研究。     

正常He肌接触位,下颌后退接触位咬合接触的计算机图像分析

目的研究正常肌接触位及下颌后退接触位咬合接触的基本规律。方法采集35名正常肌接触位及下颌后退接触位的硅橡胶记录,进行计算机图像分析。结果肌接触位33人前牙无接触,单颌后牙区接触数为16．6±7．2,所有受试者均为双侧接触。肌接触位咬合接触均在牙尖交错位重复出现。接触频率超过50％的部位位于上颌磨牙颊尖和舌尖的远中斜面,下颌磨牙颊尖和舌尖的近中斜面。下颌后退接触位所有受试者均为双侧接触,有接触的牙齿数目单颌单侧2．7士0．8,接触点数目单颌8．0±2．3,前牙无接触,接触数目及比率从第二磨牙到第一前磨牙依次减少。接触频率超过40％以上的斜面上颌为前磨牙舌尖、磨牙远中舌尖及第二磨牙近舌尖的近中颊斜面,下颌为前磨牙及第二磨牙颊尖的远中舌斜面。结论以硅橡胶为记录材料准确采集到肌接触位及下颌后退接触位记录,经计算机图像分析,得出其咬合接触的基本特征。     

TMD患者咬合板治疗后接触变化的研究

目的:比较咬合板治疗颞下颌关节紊乱病(TMD)前后异常因素的变化情况,探讨咬合板治疗TMD的机理。方法:选取34名用咬合板治疗的TMD患者,记录其戴用咬合板后2个月时的咬合特征及临床症状,并与治疗前进行比较。结果:TMD患者治疗后的力中心距中线距离减小,闭合时间与侧方分离时间明显较治疗前缩短,早接触出现率较治疗前降低,但前伸分离时间、非工作侧干扰及前伸干扰的出现率与治疗前相比无显著性差异。结论:咬合板对于纠正力中心位置、减小早接触的发生率、缩短闭合时间及侧方分离时间具有明显的作用,能够使TMD患者的关系向着更加协调、稳定的方向发展,是其有效治疗TMD的重要机理。     

正常接触位、下颌后退接触位咬合接触的计算机图像分析

目的 :研究正常牙合肌接触位及下颌后退接触位咬合接触的基本规律。方法 :采集 35名正常牙合肌接触位及下颌后退接触位的硅橡胶牙合记录 ,进行计算机图像分析。结果 :肌接触位 33人前牙无接触 ,单颌后牙区接触数为 16 .6± 7.2 ,所有受试者均为双侧接触。肌接触位咬合接触均在牙尖交错位重复出现。接触频率超过 5 0 %的部位位于上颌磨牙颊尖和舌尖的远中斜面 ,下颌磨牙颊尖和舌尖的近中斜面。下颌后退接触位所有受试者均为双侧接触 ,有接触的牙齿数目单颌单侧 2 .7± 0 .8,接触点数目单颌 8.0± 2 .3,前牙无接触 ,接触数目及比率从第二磨牙到第一前磨牙依次减少。接触频率超过 40 %以上的斜面上颌为前磨牙舌尖、磨牙远中舌尖及第二磨牙近舌尖的近中颊斜面 ,下颌为前磨牙及第二磨牙颊尖的远中舌斜面。结论 :以硅橡胶为记录材料准确采集到肌接触位及下颌后退接触位牙合记录 ,经计算机图像分析 ,得出其咬合接触的基本特征。     

成年人功能正常咬合音的初步研究

本文对50名成年功能正常者在三种头位下叩齿的咬合音分别作了初步研究,结果表明 (1)咬合音在头直立位与头前倾位之间无显著性差异,而在头直立与头后仰位以及头前倾与头后仰位之间有显著性差异;(2)在三种头位下,左右咬合音均无显著性差异;(3)在三种头位中,影响咬合音的主要因素都是持续时间、最大波峰到达时间、最大波幅以及高频率4个指标。而在头后仰叩齿时,影响咬合音的主要因素还包括低频率这一指标。     

正常牙尖交错位咬合接触的计算机图像分析

目的 :研究正常牙合牙尖交错位咬合接触的基本规律。方法 :采集 35名正常牙合受试者牙尖交错位硅橡胶牙合记录 ,计算机图像分析系统定量测量。结果 :75 .0 %的前牙有 80 μm牙合间距离 ,仅 3.3%的前牙接触。后牙区牙合接触数为 71.4± 7.4,磨牙区占 70 %以上 ,以第一磨牙最多。牙合接触人群左右两侧无明显差异 ,其中仅 4人一侧牙合接触数目超过总数 6 0 %。 86 .1%的后牙牙合接触为稳定型 ,9.6 %为不稳定型 ,4.3%没有接触 (均为前磨牙 )。结论 :前牙不接触 ,有利于前牙免受移位性冲击     

咬合接触的定量研究技术

咬合接触是[牙合]学研究的重要内容。随着研究手段的进步，咬合接触的研究发生了从定性观察到定量研究的发展。本文就咬合接触的基本概况和计算机图像分析系统、T-Scan咬合分析仪以及Dental Prescale系统等定量研究技术及其临床应用状况作一综述。     

深覆牙尖交错位咬合接触的计算机图像分析

目的 :研究深覆牙合患者牙尖交错位咬合接触的异常表现。方法 :采集 2 4名深覆牙合患者牙尖交错位的硅橡胶牙合记录 ,进行计算机图像分析。结果 :深覆牙合单颌咬合接触数目为 2 2 .1± 9.4,明显低于正常牙合。前牙区75 .0 %的人有咬合接触 ,接触数目及频率明显增加。后牙区接触数目明显减少 ,咬合接触类型与正常牙合有明显差异 ,不稳定的接触增多。结论 :深覆牙合咬合接触与正常牙合明显差异 ,牙合的稳定性不良。深覆牙合易致颅颌功能紊乱可能与其异常的咬合接触有密切联系。     

牙齿楔状缺损与侧方工作侧咬合接触关系的调查

目的　研究牙颈部楔状缺损与牙齿咬合接触的关系。方法　选取 12 3名中年机关干部。用 0 .0 2mm厚的超薄咬合纸 ,临床检查侧方运动工作侧上颌尖牙、第一、二前磨牙、第一磨牙颊尖各斜面上及咀嚼循环各个时期中的牙齿咬合接触情况 ;评估接触程度。结果　患楔状缺损牙齿咬合接触程度明显高于未患楔状缺损牙。上颌尖牙和前磨牙楔状缺损患牙在远中 (上第一磨牙的近、远中 )斜面上咬合接触程度高于未患牙 ,患牙在咀嚼侧方运动循环的中、末 (上第一磨牙在初、中或末 )期咬合接触程度增加。结论　牙颈部楔状缺损的发生与牙齿的咬合接触程度加重有关。     

侧方咬合运动中接触型及其分布特征

目的观察侧方咬合运动中接触点的分布特征,并对尖牙尖对尖颌位时的侧方型进行分类。方法利用T-ScanII咬合分析系统记录85名个别正常者侧方咬合运动过程中的接触信息,并进行统计分析。结果尖牙尖对尖颌位时的接触形式有六类:尖牙保护(44.1%)、组牙功能(20.6%)、工作侧多组前牙接触(2.9%)、仅工作侧第一前磨牙接触(8.8%)、工作侧前后牙同时存在接触(20.0%)、工作侧非工作侧同时存在接触(3.5%)。结论自然牙列侧方接触形式除尖牙保护与组牙功能外还存在其它一些型。     

正常(牙合)者咬合功能的研究

目的研究正常[牙合]者的咬合功能状况。方法用T-scan Ⅱ型系统4．02版记录26名正常[牙合]青少年在牙尖交错位（ICP）的[牙合]力总值（TOF）、[牙合]力不对称指数（AOF）、[牙合]力中心点位置（COF）、[牙合]力中心点最大位移（MMCOF）、[牙合]干扰指数（0II）、[牙合]接触点数（NOC）、[牙合]接触面积不对称指数（AOA）。分析[牙合]力及咬合接触点的分布规律。结果①正常[牙合]者三次咬合记录的左右侧[牙合]力百分比及COF无显著性差异。②正常[牙合]者AOF、MMCOF、OⅡ均较小，男性[牙合]力总值大于女性（P〈0．05）。③正常[牙合]者NOC主要分布在磨牙区，前牙几乎无接触，咬合接触点与[牙合]力成正相关。结论①T-scan Ⅱ系统传感器薄膜具有良好的重复性。②正常[牙合]者具有平衡稳定的咬合。     

Masticatory performance and areas of occlusal contact and near contact in subjects with normal occlusion and malocclusion

This preliminary study evaluated relationships between masticatory performance and areas of interocclusal distance contact (<50 microm) and near contact (50-350 microm) of the buccal segments during maximum intercuspation. The sample included subjects with normal occlusion (n = 18) and Class I (n = 14), Class II (n = 13), and Class III (n = 6) malocclusions. Chewing performance was evaluated on the basis of the breakdown of CutterSil (Heraeus Kulze, South Bend, Ind); chewing ability was assessed by the number of chews necessary to swallow jerky and almonds. Impressions of the buccal segments, taken with Blu Mousse (Parkell Bio-Materials, Farmingdale, NY) impression material, were scanned and enlarged, and each subject's first molars and premolars were manually traced bilaterally to estimate the platform area. The areas of contact and near contact (ACNC) that measured between 0 and 350 microm thick were estimated optically on the basis of the amount of light transmitted through the impression. The results showed no significant differences in platform area between the right and left sides or between the malocclusion groups. ACNC were negatively related to median particle size and broadness of particle distribution. There were no correlations between ACNC and the number of chews necessary to swallow jerky or almonds. Subjects with normal occlusion had significantly larger ACNC than those with Class I, Class II, and Class III malocclusions, in descending order. Subjects with Class III malocclusions had the smallest areas of near contact (<350 microm). We concluded that ACNC are similar on the right and left sides; that subjects with larger ACNC are better able to break down foods; and that subjects with malocclusions have smaller ACNC than those with normal occlusions.     

(牙合)贴面的研究进展

(牙合)贴面即采用粘接技术,在少磨牙或不磨牙的情况下,用超薄的修复材料直接粘接覆盖于牙齿的咬(牙合)面,以恢复牙体的正常形态和咬合功能的一种修复方法。因其微创的牙体预备,所以已成为牙列重度磨耗的修复新途径。本文就(牙合)贴面的发展、应用和相关材料进行综述。     

[牙合]平面的研究进展

平面是影响口颌系统功能的重要因素之一。对患者进行口颌功能修复或重建时,确定适宜的平面是重要的一步。本文结合国内外学者的研究状况,对平面的定位及其影响因素、平面与口颌系统的关系以及平面与颈椎的关系等进行综述。     

正常(牙合)牙尖交错位咬合平衡的定量研究

目的　对正常（牙合）牙尖交错位（ICP）最大（牙合）力咬合进行定量研究，初步探讨ICP咬合平衡的生理范围。方法　应用T－Scan　Ⅱ系统记录123名正常骀者ICP最大（牙合）力的咬合情况，测量并计算力的中心点（COF）、（牙合）力百分比值、胎接触点数目。结果　正常胎者ICP最大（牙合）力时力的中心点相对位置、（牙合）力百分比差值以及不对称系数均服从正态分布，95％参考值范围分别为：－6．60～6．68mm，－15．50％～12．10％，0．65～1．39；98．4％的正常（牙合）者ICP最大（牙合）力咬合时力的中心点分布于后牙区。结论　正常（牙合）者最大（牙合）力时ICP咬合是稳定、平衡的咬合。     

正常(牙合)青年(牙合)平面与咀嚼运动轨迹的相关性分析

Objective To investigate the characteristics of and relationship between occlusal plane and masticatory path in young adults with individual normal occlusion, and to provide clinical implications on both morphological and functional reference of occlusal plane location Methods Forty-three young adults with individual normal occlusion were included. Lateral projections of cephalometric radiographs were taken. The parameters of anatomical landmarks were analyzed. The BioEGN mandibular kinesiography analyzer was used to record the path of incisal edge of mandibular central incisor movement during mastication. The Pearson's linear correlation analysis was performed to analyze the relationship of inclination of occlusal plane and data mentioned above with SPSS13. 0 software. Results The inclination of occlusal plane (the angle between occlusal plane and Camper's line OP-CP) was (2. 1 ± 3. 8) ° in youth with normal occlusion. Means of maximal distances of 3-dimensional masticatory mandibular movement paths were as follow; the vertical length was ( 20. 22 ± 4. 28) mm, the anterior-posterior width was ( 11.42 ± 2. 45) mm, and the lateral width was (8. 62 ± 1. 52) mm. The inclination of occlusal plane was negatively correlated to the lateral width of masticatory path in frontal plane (r = -0. 39, P <0. 05). Occlusal plane was approximately vertical to the opening and closing path in the vicinity of intercuspal position during mastication. The inclination of occlusal plane was positively related to occlusal plane-closing angles in the upper segments of closing path during mastication(P<0. 05). Masticatory axis angle was (66. 50 ±7. 98)° with no significant correlation to the inclination of occlusal plane (P >0. 05).Conclusions These results suggest that the sagittal inclination of occlusal plane can influence 3-dimensional morphology of masticatory path. The inclination of occlusal plane has a guiding effect on masticatory movement in the upper segments of closing path.     

正常(牙合)青年(牙合)平面与咀嚼运动轨迹的相关性分析

目的 分析个别正常(牙合)青年(牙合)平面与咀嚼运动轨迹特征的相关性,以期为临床定位(牙合)平面提供参考.方法 收集43名个别正常(牙合)青年志愿者,拍摄头颅侧位X线片,测量耠平面倾斜度(OP-CP);记录下颌中切牙切点的左右侧咀嚼运动轨迹,测量矢状面垂直向最大位移(V)、矢状面水平向前后最大位移之和(P+A)、冠状面水平向左右侧方位移之和(L+R)以及(牙合)平面与咀嚼运动轨迹的夹角,对(牙合)平面倾斜度(OP-CP)与V、(P+A)、(L+R)以及(牙合)平面与咀嚼运动轨迹的夹角进行Pearson线性相关分析.结果 OP-CP为(2.1±3.8)°.V为(20.22±4.28)mm,(P+A)为(11.42±2.45)mm,(L+R)为(8.62±1.52)mm.OP-CP与(L+R)呈负相关,相关系数r为-0.39(P<0.05).矢状面(牙合)平面与牙尖交错位及其附近的咀嚼运动开闭口轨迹近似垂直;OP-CP与咀嚼运动轨迹(牙合)期阶段2.0 mm、(牙合)外期上段的(牙合)平面-闭口轨迹角呈正相关(P<0.05);咀嚼轴角平均为(66.50±7.98)°,与OP-CP不相关(P>0.05).结论 矢状面(牙合)平面倾斜度与咀嚼运动轨迹有一定相关性.(牙合)平面对咀嚼运动(牙合)期闭合轨迹的影响较明显.     

正常(牙合)青年(牙合)平面与咀嚼运动轨迹的相关性分析

Objective To investigate the characteristics of and relationship between occlusal plane and masticatory path in young adults with individual normal occlusion, and to provide clinical implications on both morphological and functional reference of occlusal plane location Methods Forty-three young adults with individual normal occlusion were included. Lateral projections of cephalometric radiographs were taken. The parameters of anatomical landmarks were analyzed. The BioEGN mandibular kinesiography analyzer was used to record the path of incisal edge of mandibular central incisor movement during mastication. The Pearson's linear correlation analysis was performed to analyze the relationship of inclination of occlusal plane and data mentioned above with SPSS13. 0 software. Results The inclination of occlusal plane (the angle between occlusal plane and Camper's line OP-CP) was (2. 1 ± 3. 8) ° in youth with normal occlusion. Means of maximal distances of 3-dimensional masticatory mandibular movement paths were as follow; the vertical length was ( 20. 22 ± 4. 28) mm, the anterior-posterior width was ( 11.42 ± 2. 45) mm, and the lateral width was (8. 62 ± 1. 52) mm. The inclination of occlusal plane was negatively correlated to the lateral width of masticatory path in frontal plane (r = -0. 39, P <0. 05). Occlusal plane was approximately vertical to the opening and closing path in the vicinity of intercuspal position during mastication. The inclination of occlusal plane was positively related to occlusal plane-closing angles in the upper segments of closing path during mastication(P<0. 05). Masticatory axis angle was (66. 50 ±7. 98)° with no significant correlation to the inclination of occlusal plane (P >0. 05).Conclusions These results suggest that the sagittal inclination of occlusal plane can influence 3-dimensional morphology of masticatory path. The inclination of occlusal plane has a guiding effect on masticatory movement in the upper segments of closing path.