咬合板治疗磨牙症的磨牙信息监测研究

目的　应用自行研制的磨牙症监测仪客观评价稳定型咬合板与尖牙高型咬合板治疗磨牙症的临床效果。方法　将 2 0名磨牙症患者随机分为两组 ,在受试条件基本一致的情况下 ,于低于息止颌位 0 5mm的高度分别制作稳定型咬合板与尖牙高型咬合板。应用自行研制的磨牙症监测仪监测每名患者治疗前后的磨牙时间与磨牙次数。结果　尖牙高型咬合板组患者磨牙时间与磨牙次数明显减少 ,治疗前后差异有极显著性 ;稳定型咬合板组患者治疗前后的监测数据差异无显著性。结论　磨牙症监测仪能自动测量和记录戴咬合板的磨牙症患者的磨牙数据 ,有一定的临床应用价值 ;尖牙高型咬合板治疗磨牙症的临床效果明显优于稳定型咬合板。     

磨牙症患者（牙合）接触特征的研究

目的 :研究磨牙症患者牙合接触的特征 ,探索牙合因素与磨牙症的关系。方法 :用T -scanII型咬合分析仪对 2 3名磨牙症患者与 13名对照者分别进行正中牙合位、前伸及侧方运动的咬合检查 ,测量闭合接触时间、前伸与侧方牙合分离时间 ,观察平衡侧牙合干扰出现的情况。结果 :磨牙症患者的闭合时间小于对照组 ;侧方牙合分离时间比对照组长 ;与对照组相比多数磨牙症患者出现平衡侧牙合干扰。结论 :平衡侧牙合干扰可能是与磨牙症有密切关系的重要的牙合因素     

青年磨牙症伴深覆患者使用前牙平面导板治疗前后的咬合分析

目的 通过对青年磨牙症伴深覆<牙合>的患者使用前牙平面导板,利用咬合力计进行治疗前后咬合指标的测量分析,为治疗磨牙症提供理论支持.方法 选取青年磨牙症伴深覆<牙合>且近期没有正畸治疗计划者8例,在戴用前牙平面导板治疗前以及治疗后1个月和3个月时分别用咬合力计对其进行咬合指标的测量.结果 治疗后1个月和3个月时患者的磨牙症评分、双侧<牙合>力比值、早接触、左右侧胎干扰以及后退<牙合>干扰均有显著变化,前伸胎干扰及深覆<牙合>的变化无统计学意义.结论 青年磨牙症伴深覆<牙合>患者使用前牙平面导板治疗有效.咬合因素与磨牙症有十分密切的关系.     

尖牙高菶型咬合板治疗磨牙症的远期疗效观察

采用自行设计的尖牙高型咬合板治疗磨牙症 ,对 6 8例患者进行 6年以上随访观察。结果 30人治愈 (4 4.1% )、2 2人显效 (32 .4% )、16人有效 (2 3.5 % )。成年患者的颌位及咬合关系无改变。认为尖牙高型咬合板是治疗磨牙症的有较好疗效的方法。     

尖牙高(牙合)型咬合板治疗磨牙症的远期疗效观察

采用自行设计的尖牙高 型咬合板治疗磨牙症,对68例患者进行6年以上随访观察.结果30人治愈(44.1%)、22人显效(32.4%)、16人有效(23.5%).成年患者的颌位及咬合关系无改变.认为尖牙高 型咬合板是治疗磨牙症的有较好疗效的方法.     

尖牙高He型咬合板治疗磨牙症的远期疗效观察

采用自行设计的尖牙高Ｈｅ型咬合板治疗磨牙症，对６８例患者进行６年以上随访观察。结果３０人治愈（４４．１％）、２２人显效（３２．４％）、１６人有效（２３．５％）。成年患者的颌位及咬合关系无改变。认为尖牙高Ｈｅ型咬合板是治疗磨牙症的有效疗效的方法。     

天然恒牙列的动态咬合接触形式

目的：在既往研究中．从未停止过关于修复和正畸治疗中进行咬合重建时．应该建立何种形式的咬合接触的讨论。对天然恒牙列的动态咬合的流行病学调查将有助于走出这种持续讨论的困境。本研究的目的就是要通过调查研究．总结年青群体和老年群体天然牙列的特征性动态咬合接触形式,并且分析动态咬合接触形式与性别和年龄之间的相关性。材料和方法：本研究共调查了834人。所有的调查对象都具有天然牙列．并且没有修复体存在。调查对象的年龄范围是20--63岁。在调查对象进行牙诱导的侧方和前伸运动过程中,检查天然牙的动态咬合接触形式。结果：结果发现存在以下的动态咬合接触形式：双侧和单侧的尖牙保护[牙合],组牙功能[牙合]．平衡[牙合]以及“其他[牙合]型”。男性和女性之间不同类型的动态咬合接触形式的出现概率相同。但是．一些咬合接触形式的出现率与年龄有相关性。随着年龄的增加．双侧和单侧尖牙保护耠的出现率出现下降趋势,而组牙功能[牙合]的出现率上升。平衡[牙合]以及“其他[牙合]型”的出现率很低．并且没有呈现与年龄相关的变化趋势。结论：双侧尖牙保护[牙合]和组牙功能[牙合]是年青患者的特征性咬合接触形式．而老年患者中组牙功能[牙合]的接触形式更加普遍。当年青患者接受修复和正畸手段的咬合重建时．尖牙保护[牙合]是一种最适合的咬合接触形式,而对于老年患者来说．组牙功能[牙合]则更加适合。需要进一步的研究来探讨[牙合]型和牙周炎、磨牙症或者颞下颌关节紊乱病之间的关系。     

TMD患者咬合板治疗后(牙合)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(牙合)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(牙合)力中心距中线距离减小,闭合时间与侧方(牙合)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(牙合)分离时间、非工作侧(牙合)干扰及前伸(牙合)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(牙合)力中心位置、减小早接触的发生率、缩短闭合时间及侧方(牙合)分离时间具有明显的作用,能够使TMD患者的(牙合)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.     

2种(牙合)垫治疗磨牙症的疗效比较

目的:比较组牙功能性(牙合)垫和尖牙保护性(牙合)垫治疗磨牙症的疗效.方法:制作组牙功能性(牙合)垫和尖牙保护性(牙合)垫,夜间戴用导板,定期复查,观察疗效,采用SPSS10.0软件包对数据进行x2检验.结果:组牙功能性(牙合)垫对夜磨牙症的总治愈率为79.16%;尖牙保护性(牙合)垫治疗磨牙症的总治愈率为83.33%.结论:组牙功能性(牙合)垫和尖牙保护性(牙合)垫对磨牙症的疗效相同.     

侧咬合(牙合)型及牙齿接触关系的观察

目的:研究侧咬合型(牙合)及牙接触关系,为临床应用提供(牙合)基础.材料方法:活体观察146名青年人侧咬合(牙合)型及牙齿接触关系.结果:侧咬合时,(牙合)型分组牙功能(牙合)最多(45.21%),尖牙保护次之(34.25%),混合型最少(20.54%);组牙功能(牙合)时,上下牙接触关系分为七种类型,其中以(牙合)最多(31.06%).结论:青年人侧咬合时以组牙功能(牙合)最多,尖牙保护(牙合)次之,混合型最少;组牙功能(牙合)时,上下颌牙齿接触关系分为七种类型.     

Salivary flow rates during relaxing, clenching, and chewing-like movement with maxillary occlusal splints.

The purpose of this study was to test the hypothesis that the application of occlusal splints increases the diurnal salivary flow rate both in bruxism patients and in normal subjects. Salivary flow rates in 16 adult volunteers (8 bruxism patients and 8 sex- and age-matched control subjects) were measured with the spitting method. There was no significant difference in the salivary flow rate with or without splints between the control and bruxism groups. In all subjects, the salivary flow rates with splints were significantly higher than those without splints during relaxing, clenching, and chewing-like movement. The salivary flow rate during the chewing-like movement was significantly higher than that during relaxing and clenching, irrespective of splint application. The results suggest that maxillary occlusal splints might stimulate salivary secretion, particularly during chewing-like movement, in both bruxism patients and normal subjects.     

软性垫和硬性垫治疗夜磨牙或紧咬牙的临床效果观察

目的：观察硬性垫和软性垫治疗夜磨牙或紧咬牙的临床效果。方法对58例夜磨牙或紧咬牙患者随机采用硬性垫或软性垫进行治疗,28例使用硬性垫,30例使用软性垫。患者每天佩戴垫8h以上,睡眠时佩戴,佩戴垫后1个月、2个月、3个月、6个月复诊,问诊并记录肌肉酸痛症状,以及夜磨牙或紧咬牙习惯与佩戴前是否有变化。对佩戴垫6个月时的治疗有效率用SPSS 17.0软件行卡方检验。结果治疗6个月时软性垫和硬性垫的治疗有效率分别为93.33%、82.14%,差异无统计学意义（c2=1.709,P=0.191）。结论硬性垫和软性垫的临床治疗效果均较好,软性垫因制作简便、佩戴舒适,更易被患者接受。     

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目的    探讨可摘式局部义齿咬合重建修复对脑血流的影响。方法    选择2008年1月至2010年1月在山西医科大学口腔医院修复科就诊的需进行咬合重建修复的患者20例,在咬合重建前后分别应用经颅多普勒超声诊断仪探测患者大脑中动脉（MCA）的收缩期峰流速、舒张期末峰流速及平均峰流速,并进行比较分析。结果    20例患者进行咬合重建后,咀嚼前与咀嚼后MCA的收缩期峰流速、收缩期末峰流速及平均峰流速均比咬合重建前增加,且差异有统计学意义（P < 0.05）。结论    咬合重建修复可提高患者MCA的血流速度,增加相应脑区的供血量。     

Computerized analysis of occlusal contacts in bruxism patients treated with occlusal splint therapy

PURPOSE

Occlusal splints are commonly used to prevent tooth wear caused by bruxism. However, the effects of splints on occlusion are still unclear. Although it is rarely alluded in literature, splints can provoke severe occlusal alterations and other complications. This study was aimed to identify differences in the responses of individuals with bruxism and healthy individuals to a full-arch maxillary stabilization splint in terms of occlusal changes.

MATERIALS AND METHODS

Occlusal contacts in 20 (5 male, 15 female) bruxism patients and 20 (5 male, 15 female) controls with normal occlusion were evaluated before and after occlusal splint therapy. T-Scan III, a computerized occlusal analysis system, was used to simultaneously measure occlusion and disclusion times as well as left-right and anterior-posterior contact distributions before splint therapy and 3 months after therapy. Wilcoxon and Mann-Whitney U tests were used for statistical analyses (α=.05).

RESULTS

No differences were found in the posterior contact of bruxism patients before and after stabilization splint treatment. However, differences in posterior contact were observed between bruxists and normal individuals prior to treatment, and this difference disappeared following treatment.

CONCLUSION

The results of this study showed the use of a stabilization splint may not have an effect on occlusion. However, the area of posterior occlusal contact among bruxists was found to be greater than that of normal individuals. According to this study, the clinical use of splints may be harmless.     

颞下颌关节紊乱病咬合板治疗前后脑血流变化的初步探讨

目的：通过咬合板治疗前后咀嚼运动时脑血流变化的测定，探讨咬合板在治疗颞下颌关节紊乱病（TMD）时脑血流的变化。方法：使用德国DML系列multidopX1经颅多普勒超声诊断仪测定脑血流的改变。对大脑中动脉的收缩期峰流速，舒张期末峰流速与平均峰流速进行对比分析。结果：病例组和对照组在行使咀嚼运动后，大脑中动脉的血流明显增加。未戴咬合板和戴咬合板的TMD患者咀嚼运动后，脑血流速无明显改变。结论：咀嚼运动可以促进脑部血液循环，咬合板对大脑中动脉血流速影响不大。     

Rehabilitation with dental prosthesis can increase cerebral regional blood volume

Treatment with denture for edentulous people is highly important for maintaining quality of life. However, its effect on the brain is unknown. In this experimental study, we hypothesized that dental prosthesis can recover not only the physical condition of mastication system but also the regional brain activity. We evaluated functional brain imaging of edentulous subjects fixed by dental implant prosthesis with clenching tasks by multi-channel near-infrared optical topography. Results revealed a significantly (P<0.001; paired t-test) increased cerebral regional blood volume during maximum voluntary clenching task by implant-retained prosthesis. There were no statistically significant differences between patients with and without prosthesis in the latency to the maximum regional blood volume after the task. Conclusively, clenching can be effective for increasing cerebral blood volume; accordingly maintenance of normal chewing might prevent the brain from degenerating.     

下颌尖牙高[牙合]型[牙合]板配合直丝弓矫治器治疗前牙深覆[牙合]深覆盖临床观察

目的：总结下颌尖牙高[牙合]型[牙合]板配合直丝弓矫治器治疗前牙深覆[牙合]深覆盖的临床疗效。方法：选择Angle Ⅰ类错[牙合]上颌前牙有散在间隙伴深覆[牙合]深覆盖病例15例,男7例,女8例。年龄18～22岁。均采用国产直丝弓托槽,先行上颌牙固定矫治。同时下颌配戴尖牙高[牙合]型[牙合]板打开咬合,矫治前拍摄头颅侧位定位片,待咬合打开,后牙有接触时再拍摄头颅侧位定位片,选择头影测量指标22项,对测量结果进行T检验。结果：MP—SN,S-Ar—Go,Y—axis在戴尖牙高[牙合]型[牙合]板治疗前后均有显著性差异,N—Me,ANS—Me也有显著性差异,下颌平面角增大,下颌有后旋趋势,有利于改善低角型面形。U6-PP,L6-PP增大,有显著性差异,上下后牙均有升高,有利于打开咬合,解除深覆[牙合]。U1-PP增大有显著性差异,提示上前牙伸长,L1-Mp有减小的趋势,没有显著性差异,下前牙有压低的可能。U1-SN,UI—NA,U1-PP有非常显著差异,上颌前牙明显内收,深覆盖明显改善。结论：下颌尖牙高[牙合]型[牙合]板配合直丝弓矫治器是-种治疗前牙深覆[牙合]深覆盖的有效方法。     

Effects of jaw clenching while wearing an occlusal splint on awareness of tiredness,bite force,and EEG power spectrum

PurposeTreatment with an occlusal splint is used for temporomandibular disorders, bruxism, and occlusal disturbance to relieve orofacial symptoms such as myofascial pain and jaw movement restriction. However, the effects of various types of occlusal splints have not been elucidated. We investigated the effects of jaw clenching with soft and hard occlusal splints on the awareness of tiredness, bite force, and EEG activity.MethodsSix healthy adults were used as subjects, with a visual analogue scale utilized to evaluate the awareness of each patient's tiredness both preceding the session and following the clenching trials. In addition, a Dental Prescale was used to measure bite force and an EEG recording was conducted while performing jaw clenching. The jaw clenching task comprised 1 min of maximal voluntary clenching under 3 kinds of clenching conditions: with natural dentition, and with soft and hard occlusal splints, which were each repeated 5 times.ResultsJaw clenching with natural dentition and a hard occlusal splint did not cause a significant awareness of tiredness following repetitive jaw clenching, and there was not a significant alteration of EEG spectrum values with those conditions. In contrast, jaw clenching with a soft occlusal splint caused a significant increase in awareness of tiredness, as well as significant decreases in bite force and EEG alpha 2 power spectrum values.ConclusionsJaw clenching with a soft resilient occlusal splint causes an awareness of tiredness, which might be accompanied by declines in bite force and EEG spectrum values.     

全口义齿垂直距离恢复过低对脑血流的影响

目的研究全口义齿垂直距离恢复过低对脑血流的影响。方法选取10例无牙颌患者,应用经颅多普勒超声诊断仪,探测全口义齿垂直距离恢复过低患者（降低5 mm）在咀嚼前、咀嚼10 min和咀嚼20 min时大脑中动脉的平均峰流速度、收缩期峰流速度和舒张期末峰流速度。试验采取自身前、后对照,应用SPSS18.0软件包对数据进行独立样本t检验和方差分析。结果试验组在咀嚼前、咀嚼10 min和咀嚼20 min时的血流速度无显著变化,而对照组血流速度显著升高。试验组在咀嚼10 min后血流速度显著性低于对照组,咀嚼20 min后血流速度无显著变化。结论全口义齿垂直距离恢复过低患者在咀嚼运动时脑血流无显著增加。