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。     

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。     

全口义齿修复中确定咬合垂直距离的方法

垂直距离的确定是牙合重建的重要内容,本文通过对无牙颌患者新总义齿修复后新旧总义齿不同咬合垂直距离时颞颌关节X线片的对比分析,以期为临床提供一个比较客观准确的确定垂直距离的方法.作者现分析报告如下：     

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。     

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.     

下颌球帽覆盖义齿与全口义齿戴用2~3年咬合特征研究

目的研究下颌球帽附着体固位覆盖义齿（COD）及全口义齿（CD）修复后2~3年咬合接触特征及差异。 方法采用T-ScanⅡ咬合分析仪对戴用2~3年CD及COD修复患者（各12例）进行体内咬合分布特征及 力升高时间的测定。记录患者义齿左右侧咬合面积不对称指数、咬合力中心（X,Y）值、咬合力前后向分布比率及 力升高时间。 结果（1）CD组、COD组左右侧咬合面积不对称指数、咬合力中心X值,差异无统计学意义（P > 0.05）;（2）COD组咬合中心前移,差异有统计学意义（P < 0.05）;（3） 力升高时间CD组0.28 s,COD组延长为0.59 s,差异有统计学意义（P < 0.05）。 结论正中咬合时,CD戴用2~3年咬合分布、 力升高时间近似正常 ,COD咬合中心向基牙区偏移, 力升高时间延长。     

激光扫描在头面部软组织三维重建和测量中的应用

近年来,随着科学和计算机技术的发展,人们对头面部软组织的研究已经由二维发展到三维,用于三维重建的技术也越来越多,包括直接测量法、莫尔云纹法、形态分析法、激光扫描法、结构光测量法、立体摄影测量技术、光栅投影测量法和电子计算机断层扫描技术等。其中,激光扫描是目前比较先进的技术之一。尽管受很多因素的影响,但笔者相信随着技术的不断改进和完善,激光扫描在头面部软组织三维重建中将得到更加广泛的应用。本文将从激光扫描技术的原理、技术构成、特点及其在头面部软组织三维重建方面的应用等内容进行综述。     

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。     

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。     

两校口腔医生制作全口义齿时使用面弓情况的调查

目的：调查全口义齿制作过程中面弓应用情况及其意义.方法：问卷调查两所口腔医学院修复科36名医生.结果：91.67%的医生认为其90%以上的患者对疗效满意：所有医生均不常用面弓,61.11%从未用过面弓.38.89%认为不用面弓影响义齿质量,19.44%认为面弓无价值.77.78%认为用简单[牙合]架修复的质量低于用全可调试[牙合]架.所有医生都认为颌位关系重要.戴牙时75%的医生调[牙合].结论：制作全口义齿并非必须使用面弓,调[牙合]等是弥补义齿微小误差的重要步骤.     

舌侧集中全口义齿咀嚼效率的研究

目的比较舌侧集中全口义齿与解剖式双侧平衡全口义齿的咀嚼效能。方法选择48例无牙颌患者,随机分成2组,分别为其制作舌侧集中型全口义齿与解剖式双侧平衡型全口义齿。3个月后采用吸光度法检测其咀嚼效率进行对比分析,并采用问卷调查对患者的总体满意度进行调查。结果与解剖式双侧平衡型全口义齿比较,舌侧集中型全口义齿在修复牙槽嵴吸收为Ⅰ、Ⅱ度的无牙颌患者咀嚼效率及患者满意度略低,但差异无统计学意义;在修复牙槽嵴吸收为Ⅲ、Ⅳ度的无牙颌患者咀嚼效率略高,但差异无统计学意义;患者满意度明显高于传统型,有统计学意义。结论对牙槽嵴吸收严重的无牙颌患者,应用舌侧集中全口义齿可以取得较好的治疗效果。     

Occlusal designs on masticatory ability and patient satisfaction with complete denture: A systematic review

Objectives

To systematically review clinical outcomes of different occlusal designs of complete dentures.

Methods

Using a various key words, an electronic search of clinical trials published in English and Chinese literature was performed from four databases: Medline/PubMed, EMBASE, Cochrane Library, and CBM. Furthermore, a manual searching of the relevant journals and the bibliographies of reviews was performed. General satisfaction, masticatory ability, retention, and stability were major criteria for the evaluation of the outcomes. Studies met these criteria were selected for a full-text reading. The whole processes were performed by two reviewers independently.

Results

This systematic review started with 1030 articles, which were finally narrowed down to seven, according to the inclusion criteria. The following occlusal designs were included and analyzed: anatomic occlusion, balanced occlusion, canine guidance occlusion, lingualized occlusion, monoplane occlusion, and bilateral-balanced and canine-guided design. Three of the seven studies showed that lingualized occlusion had ratings of higher patients’ satisfaction than other occlusion designs. On the other hand, the canine-guided occlusion dentures demonstrated equal or better clinical performances than bilateral-balanced dentures. Because of the heterogeneity and bias of the studies, it was not possible to analyze the data statistically.

Conclusions

Lingualized occlusion and canine-guided occlusion can be successfully applied in the fabrication of complete dentures. Canine guided occlusion has also been shown to be satisfactory. More well-controlled randomized trials are needed regarding canine-guided occlusion and the relationship between alveolar ridge resorption, different occlusal schemes and patient satisfaction. The conventional prosthodontic wisdom that complete dentures require a balanced occlusal design is not supported by the included literature.

Clinical significance

A suitable occlusal scheme would be a critical factor for a successful complete denture. However, there is no conclusive evidence to support which occlusal design is more appropriate for fabricating a successful complete denture. In occlusal design of conventional complete denture, lingualized occlusion can provide better clinical outcomes than other occlusal designs; meanwhile, canine-guided occlusion also can be used in clinic practice.     

上颌半口义齿金属基托的计算机辅助设计

目的 :在自行重建无牙颌三维数据模型的基础上设计上颌半口义齿金属基托数字模型。方法 :采用数控铣床及新型层析数据采集系统 ,通过对标准无牙颌模型的层切 ,二维轮廓数据获取及计算 ,重建无牙颌模型 ,在此数据基础上 ,通过SURFACER软件 ,设计上颌半口义齿金属基托。结果 :获得无牙颌三维数据及上颌金属基托的数据文件。结论 :通过新型层析系统可以实现对无牙颌三维建模 ;在此基础上设计的三维数字基托可为进一步激光立体成形制作奠定基础。     

上颌总义齿(牙合)力与基托应力相关性的比较研究

目的 探讨无牙颌患者上颌总义齿(牙合)力与基托应力的相关性,为预防上颌总义齿基托折断提供理论参考.方法 选取10例戴用6 ～ 12个月使用良好且配合良好的总义齿患者,使用应变仪及(牙合)力仪同步测定上颌总义齿基托的应力及第一磨牙的(牙合)力.结果 上颌总义齿腭侧基托的应变值与(牙合)力之间具有相关性或高度相关性.基托前部和后部的应变值大于基托中部的应变值.结论 (牙合)力是影响上颌总义齿基托折断的重要因素之一.提示在进行上颌总义齿设计时要考虑减轻(牙合)力,并加强基托前部的强度.     

Evaluation of functional suitable digital complete denture system based on 3D printing technology

PURPOSETo improve the clinical effects of complete denture use and simplify its clinical application, a digital complete denture restoration workflow (Functional Suitable Digital Complete Denture System, FSD) was proposed and preliminary clinical evaluation was done.MATERIALS AND METHODSForty edentulous patients were enrolled, of which half were treated by a prosthodontic chief physician, and the others were treated by a postgraduate student. Based on the primary impression and jaw relation obtained at the first visit, diagnostic denture was designed and printed to create a definitive impression, jaw relation, and esthetic confirmation at the second visit. A redesigned complete denture was printed as a mold to fabricate final denture that was delivered at the third visit. To evaluate accuracy of impression made by diagnostic denture, the final denture was used as a tray to make impression, and 3D comparison was used to analyze their difference. To evaluate the clinical effect of FSD, visual analogue scores (VAS) were determined by both dentists and patients.RESULTSTwo visits were reduced before denture delivery. The RMS values of 3D comparison between the impression made via diagnostic dentures and the final dentures were 0.165 ± 0.033 mm in the upper jaw and 0.139 ± 0.031 mm in the lower jaw. VAS ratings were between 8.5 and 9.6 in the chief physician group, while 7.7 and 9.5 in the student group; there was no statistical difference between the two groups.CONCLUSIONFSD can simplify the complete denture restoration process and reduce the number of visits. The accuracy of impressions made by diagnostic dentures was acceptable in clinic. The VASs of both dentists and patients were satisfied.     

全口义齿在(牙合)架上前伸运动的计算机三维模拟

目的：探索建立能将三维模拟全口义齿在（牙合）架上进行前伸运动的算法模块。方法：应用激光三维扫描和重建技术，建立全口义齿人工牙列模型，采用Matlab6．5数学计算分析软件，并结合空间解析几何原理，对全口义齿在（牙合）架上的前伸运动进行数学建模和运动模拟。结果：建立了用于模拟全口义齿在（牙合）架上三维前伸运动的算法模块．并在实际病例进行验证。结论：该方法的设计思想可行，为定量研究义齿动态咬合情况奠定了基础。     

全口义齿在架上前伸运动的计算机三维模拟

目的:探索建立能将三维模拟全口义齿在架上进行前伸运动的算法模块。方法:应用激光三维扫描和重建技术,建立全口义齿人工牙列模型,采用Matlab6.5数学计算分析软件,并结合空间解析几何原理,对全口义齿在牙合架上的前伸运动进行数学建模和运动模拟。结果:建立了用于模拟全口义齿在牙合架上三维前伸运动的算法模块,并在实际病例进行验证。结论:该方法的设计思想可行,为定量研究义齿动态咬合情况奠定了基础。     

舌侧集中[牙合]与三次印模法在全口义齿制作中的临床效果评价

目的:评价制作全口义齿时采用3次印模法配合舌侧集中[牙合]的临床效果。方法:纳入80例低平牙槽嵴患者,随机分为40例实验组(三次印模法)和40例对照组(二次印模法),所有患者均接受舌侧集中[牙合]治疗。在不同时间点,分别对义齿咀嚼效率、患者满意度、义齿基托密合性的指标进行统计分析。结果:实验组在义齿稳定性、咀嚼效率优于对照组(P<0.05),而在美观、发音方面2组间无明显统计学差异(P>0.05)。结论:3次印模法配合舌侧集中[牙合]在修复低平牙槽嵴患者中具有更好的修复效果。