单侧平衡舌侧集中牙合在全口义齿修复中的疗效观察

目的比较单侧平衡舌侧集中牙合全口义齿与半解剖平衡牙合全口义齿的临床效果。方法选择20例牙槽嵴条件较差的无牙颌患者,随机分成A、B两组,两组患者随机接受单侧平衡舌侧集中牙合和半解剖平衡牙合全口义齿修复,每位患者制作2副义齿,A组患者先戴单侧平衡舌侧集中牙合义齿,6个月后再戴半解剖平衡牙合全口义齿;B组戴牙顺序相反,观察义齿初戴时义齿的调改次数,在佩戴1、3、6个月时通过吸光光度法测定咀嚼效率,同时填写满意度调查问卷进行主观评价分析。结果单侧平衡舌侧集中牙合全口义齿初戴时义齿的牙槽嵴压痛的调改次数明显少于半解剖牙合全口义齿,差别具有统计学意义(P<0.05),吸光光度法测定咀嚼效率单侧平衡舌侧集中牙合明显高于半解剖式平衡牙合全口义齿(P<0.05),在问卷调查分析表明:固位、稳定及咀嚼功能方面的评分单侧平衡舌侧集中牙合明显高于半解剖平衡牙合全口义齿,差异有显著性(P<0.05)。在美观度、语音功能、舒适度方面单侧平衡舌侧集中牙合全口义齿与半解剖平衡牙合全口义齿比较无显著性差异(P>0.05)。结论牙槽嵴吸收严重的无牙颌患者,单侧平衡舌侧集中牙合全口义齿能够取得较好的...     

线性（牙合）与解剖式（牙合）全口义齿满意度的比较

目的：比较线性（牙合）全口义齿与解剖式（牙合）全口义齿满意度。方法：选择15例牙槽嵴吸收严重的无牙颌患者,为每例患者制作传统的解剖式（牙合）和线性（牙合）2副全口义齿,3个月后更换使用。每副义齿于戴用1个月、3个月时用满意度问卷调查患者。结果：2种（牙合）型全口义齿使用3个月时,线性（牙合）全口义齿的固位稳定和舒适程度满意度明显高于解剖式全口义齿（P〈0.01）;线性（牙合）全口义齿使用3个月比使用1个月在固位稳定、咀嚼功能和舒适程度方面有显著提高（P〈0.01）。观察期间,线性（牙合）全口义齿初戴后因疼痛调改的次数明显少于解剖式（牙合）全口义齿。结论：对牙槽嵴吸收严重的无牙颌患者,应用线性（牙合）全口义齿可以提高其义齿的固位稳定和舒适程度。     

线性《牙合》与解剖式袷全口义齿满意度的比较

目的:比较线性<牙合>全口义齿与解剖式骀全口义齿满意度.方法:选择15例牙槽嵴吸收严重的无牙颌患者,为每例患者制作传统的解剖式骀和线性<牙合>2副全口义齿,3个月后更换使用.每副义齿于戴用1个月、3个月时用满意度问卷调查患者.结果:2种骀型全口义齿使用3个月时,线性<牙合>全口义齿的固位稳定和舒适程度满意度明显高于解剖式<牙合>全口义齿(P<0.01);线性<牙合>全口义齿使用3个月比使用1个月在固位稳定、咀嚼功能和舒适程度方面有显著提高(P<0.01).观察期间,线性牙台全口义齿初戴后因疼痛调改的次数明显少于解剖式<牙合>全口义齿.结论:对牙槽嵴吸收严重的无牙颌患者,应用线性<牙合>全口义齿可以提高其义齿的固位稳定和舒适程度.     

骨转换标志物对于牙槽嵴重度吸收患者咀嚼效能与两种改良牙合型全口义齿戴用的影响

目的 对骨转换标志物正常和升高的牙槽嵴重度吸收的无牙颌患者,分析两种改良牙合型（长正中牙合型、舌向集中牙合型）全口义齿的戴用与咀嚼效能的关系,以期为临床全口义齿修复中牙合型的选择提供参考。 方法 选取85例（男45例,女40例）牙槽嵴重度吸收的无牙颌患者,采用随机数字表法随机选用两种改良牙合型全口义齿（长正中牙合型全口义齿、舌向集中牙合型全口义齿）治疗方案。电化学发光免疫法测量血清中骨转换标志物——Ⅰ型前胶原N端前肽（P1NP）和Ⅰ型胶原交联C 末端肽（CTX）的水平,分为骨转换标志物正常组及升高组。义齿戴用3个月后,吸光度法测定咀嚼效能,多因素方差分析不同骨转换标志物测量值的患者不同类型改良牙合型全口义齿的戴用与咀嚼效能的关系。 结果 骨转换标志物（P1NP和CTX）正常组的患者,不同类型改良牙合型（长正中牙合型、舌向集中牙合型）全口义齿的戴用与其咀嚼效能的关系无统计学差异。而骨转换标志物（P1NP和CTX）升高组患者,不同类型改良牙合型全口义齿的戴用与其咀嚼效能的差异有统计学意义（P<0.01）,与戴用舌向集中牙合型全口义齿的患者相比,戴用长正中牙合型全口义齿的患者具有更高的咀嚼效能。 结论 骨转换标志物较高的患者,选用长正中牙合型全口义齿会得到相对更高的咀嚼效能。骨转换标志物有望成为牙槽嵴重度吸收的无牙颌患者选择戴用不同改良牙合型全口义齿时的参考指标。     

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。     

长正中[牙合]与解剖[牙合]全口义齿患者满意度比较研究

目的研究患者对长正中[牙合]全口义齿与解剖[牙合]全口义齿的满意度。方法选择16例牙槽嵴重度吸收的无牙颌患者,每例患者制作传统解剖[牙合]全口义齿和长正中[牙合]全口义齿,每例患者均先戴用解剖[牙合]全口义齿3个月后改戴用长正中[牙合]全口义齿3个月,每副义齿使用1个月、3个月时进行满意度问卷调查。结果使用3个月时,长正中[牙合]全口义齿固位稳定（t=2.261,P=0.028）和舒适程度（t=2.686,P=0.006）的满意度高于解剖[牙合]全口义齿,差异有统计学意义。与1个月时相比,长正中[牙合]全口义齿使用3个月在固位稳定（t=9.896,P=0.006）、咀嚼功能（t=7.980,P=0.012）和舒适程度（t=6.898,P=0.023）方面的满意度有显著提高。长正中[牙合]全口义齿初戴后因疼痛调改的次数少于解剖[牙合]全口义齿（T=45.5,P=0.008）。结论牙槽嵴吸收严重的无牙颌患者对长正中[牙合]全口义齿固位、稳定和舒适程度的满意度高于解剖全口义齿。     

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目的 评价舌侧集中（牙合）与解剖式双侧平衡（牙合）全口义齿修复低平牙槽嵴无牙颌患者的咀嚼效率及咬合力。方法 选择2012年6月至2013年4月到中国医科大学口腔医学院修复科就诊的牙槽嵴吸收较严重的无牙颌患者20例作为研究对象,采用闭口式印模法在同一垂直距离和正中关系咬合记录下为同一患者制作舌侧集中（牙合）与解剖式双侧平衡（牙合）2种不同（牙合）型全口义齿,每例患者随机先后接受2副义齿盲戴使用。每副义齿分别在戴用1周、3个月时采用吸光度法测量咀嚼效率以及用Tee-Tester咬合压力测试仪测量2种（牙合）型的最大咬合力,并在每副义齿使用3个月时进行问卷调查。结果 舌侧集中（牙合）全口义齿的咀嚼效率略高于解剖式双侧平衡（牙合）,但差异无统计学意义（P 〉 0.05）;其咬合力小于解剖式双侧平衡牙合,差异有统计学意义（P 〈 0.05）。在主观满意度调查问卷中,患者对舌侧集中（牙合）全口义齿的舒适性、稳定性、咀嚼能力等评价更高。结论 与解剖式双侧平衡（牙合）全口义齿相比,舌侧集中牙合全口义齿修复低平牙槽嵴无牙颌患者具有更高的稳定性;其具有与解剖式双侧平衡（牙合）相当的咀嚼效能,且咬合力小于解剖式双侧平衡（牙合）,从而延缓了牙槽嵴的吸收。     

舌向集中咀嚼效能的评价

目的:比较舌向集中全口义齿与半解剖式全口义齿的咀嚼效能。方法:搜集2009—2010年就诊的刃状及低平或凹形牙槽嵴患者60例,随机分为2组,分别用舌向集中型与半解剖式型人工牙制作全口义齿,采用固定咀嚼时间与咀嚼次数,分别检测舌向集中与半解剖式全口义齿患者戴义齿1、2、3、6个月的咀嚼效率,比较两者的咀嚼效率。采用SAS6.12软件包对数据进行统计学分析。结果:咀嚼时间固定或咀嚼次数固定时,舌向集中与半解剖式全口义齿咀嚼效率无显著差异(P>0.05)。结论:针对刃状、低平及凹陷状牙槽嵴条件的无牙患者,应用舌向集中全口义齿也能恢复良好的咀嚼效能。     

骨转换标志物对于牙槽嵴重度吸收患者咀嚼效能与两种改良■型全口义齿戴用的影响

目的对骨转换标志物正常和升高的牙槽嵴重度吸收的无牙颌患者,分析两种改良■型(长正中■型、舌向集中■型)全口义齿的戴用与咀嚼效能的关系,以期为临床全口义齿修复中■型的选择提供参考。方法选取85例(男45例,女40例)牙槽嵴重度吸收的无牙颌患者,采用随机数字表法随机选用两种改良■型全口义齿(长正中■型全口义齿、舌向集中■型全口义齿)治疗方案。电化学发光免疫法测量血清中骨转换标志物——Ⅰ型前胶原N端前肽(P1NP)和Ⅰ型胶原交联C-末端肽(CTX)的水平,分为骨转换标志物正常组及升高组。义齿戴用3个月后,吸光度法测定咀嚼效能,多因素方差分析不同骨转换标志物测量值的患者不同类型改良■型全口义齿的戴用与咀嚼效能的关系。结果骨转换标志物(P1NP和CTX)正常组的患者,不同类型改良■型(长正中■型、舌向集中■型)全口义齿的戴用与其咀嚼效能的关系无统计学差异。而骨转换标志物(P1NP和CTX)升高组患者,不同类型改良■型全口义齿的戴用与其咀嚼效能的差异有统计学意义(P<0.01),与戴用舌向集中■型全口义齿的患者相比,戴用长正中■型全口义齿的患者具有更高的咀嚼效能。结论骨转换标志物较高的患者,选用长正中■型全口义齿会得到相对更高的咀嚼效能。骨转换标志物有望成为牙槽嵴重度吸收的无牙颌患者选择戴用不同改良■型全口义齿时的参考指标。     

舌向集中(牙合)义齿满意度调查

目的 临床观察患者对舌向集中(牙合)全口义齿的满意度.方法 选择Ⅲ类和Ⅳ类牙槽嵴患者10例,每例患者制作舌向集中(牙合)和解剖式(牙合)2副全口义齿,分别戴用1个月后进行满意度调查,对患者分别戴用2种义齿的满意度得分进行t检验,比较二者的临床修复效果.结果 患者对解剖式(牙合)的外观、语音、咀嚼、固位、舒适满意度得分为(8.01±1.13)分、(6.72±0.60)分、(5.55±0.60)分、(5.55±0.67)分、(5.83±0.56)分,对舌向集中(牙合)的外观、语音、咀嚼、固位、舒适满意度得分为(7.97±1.17)分、(6.79±0.56)分、(6.88±0.57)分、(6.74±0.62)分、(6.76±0.50)分,患者对2种(牙合)型义齿外观(t=0.446,P=0.666)、语音(t =0.829,P =0.428)的满意度差异没有统计学意义;面对舌向集中(牙合)义齿咀嚼(t=13.147,P=0.000)、固位(t=12.551,P=0.000)、舒适(t=7.984,P=0.010)的满意度均较解剖式(牙合)义齿高,二者差异均具有统计学意义.结论 牙槽嵴条件差的无牙颌患者配戴舌向集中(牙合)全口义齿能够提高其对咀嚼、固位、舒适的满意度.     

Clinical protocol for occlusal adjustment: Rationale and application

Background: Occlusal adjustment can optimize the result of orthodontics, orthognathic surgery, and comprehensive restoration, and resolve adverse forces to the dentition that affect the entire masticatory system. Mounted diagnostic casts and computerized occlusal analysis offer complementary advantages for evaluating occlusal problems. Predictable occlusal adjustment is facilitated by precise, measured documentation of occlusal force by computerized occlusal analysis.

Clinical presentation: A conservative, structural correction of a pronounced, chronic occlusal problem by additive and subtractive occlusal adjustment was performed after a previous failed occlusal adjustment. The patient’s chief concerns were significant anterior teeth fremitus in maximum intercuspation and “pain in the teeth and a poor bite” after 30+ adjustments over 2.5 years.

Clinical Relevance: Confirmation of specific criteria for a therapeutic occlusion resolved the anterior teeth fremitus and uneven bite. Traumatic occlusal contact on posterior teeth may elicit protective mandibular repositioning affecting anterior teeth relationships and should be considered during comprehensive diagnosis.     

复合(牙合)切垫的改进及其临床应用效果观察

目的:本文观察用改进的复合(牙合)切垫对老年人作可摘式(牙合)重建的临床效果.方法:评定疗效标准,分别观察牙列重度磨耗组及牙体治疗后重度牙周病组各20例,随诊2～5年的临床效果.结果;磨耗组优15例(75%),良5例(25%).牙周病组优良18例(90%).结论:复合(牙合)切垫在技术上弥补了一般金属及塑胶(牙合)垫的不足,改进后操作更为方便,舒适美观,是用作老年可摘式(牙合)重建的一种较好方法.     

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??Occlusal analysis and occlusal management are important in periodontal therapy. In order to provide reference for the clinicians??we made a literature review to summarize the development and changes of the connection between occlusal trauma and periodontitis??the methods of occlusal examination and occlusal management of occlusal trauma??timing??method selection??effect evaluation and long-term follow-up??in periodontal treatment.     

开张式双垫与塑料垫治疗磨牙症的对比研究

目的：比较开张式双垫在治疗磨牙症中与塑料垫的临床疗效。方法：分别用自制的开张式双垫与塑料垫对48位磨牙症患者进行治疗,随访9个月。分别统计治疗结束1个月和9个时的停止磨牙列数和平均减少的磨牙时间。结果：戴用1个月停止磨牙数比为6∶12,戴用9个月停止磨牙数比为10∶21。其差异具有显著性（P〈0.01）。结论：开张式双垫治疗磨牙症优于塑料垫。     

牙周治疗中的咬合分析

在牙周治疗中,咬合分析和咬合治疗是不可忽视的一个环节。文章通过文献回顾,阐述了咬合创伤与牙周炎之间联系的发展变化,总结了牙周治疗中咬合检查的方法,对牙周治疗中咬合创伤的治疗时机、方法选择、效果评价及长期随访等进行了归纳,以期对临床医生提供参考。     

A Method for Occlusal Reshaping

A method for occlusal reshaping is described using a step-by-step analysis starting from the articulation of models to the completion of the clinical procedures. Several newly introduced definitions are provided to help the reader understand the procedures. This article is divided into three parts: (1) the preliminary procedures, (2) the occlusal reshaping of the study casts, and (3) the clinical occlusal reshaping. The advantages of this particular method include establishment of anterior guidance before initiating posterior reshaping procedures, maintenance of maximum cusp height and fossae depth, the placement of forces along the mid vertical axis of the teeth, and the establishment of simultaneous even contact of the posterior teeth, while providing the desirable anterior guidance.     

Occlusal pressure, contact area, force and the correlation with the morphology of the jaw-closing muscles in patients with skeletal mandibular asymmetry

Summary  The purpose of this study was to investigate the difference in the occlusal force between deviated and non-deviated sides of the mandible in adult patients with skeletal mandibular asymmetry, and then also compare the findings to those obtained from controls. The absolute and balance data of the occlusal pressure, occlusal contact area and occlusal force of 23 patients and the controls were examined. Correlations between the occlusal force and the morphology of the jaw-closing muscles were also analysed. The occlusal pressure of patients was not smaller than controls, however, the occlusal contact area and occlusal force in patients were significantly lower than those in the controls. There was no significant difference in the balance of the occlusal contact area and the occlusal force between the right and left sides in the controls, while the balance was shifted to the deviated side in the patients. Interestingly, the balance of the occlusal pressure was very similar between the patients and the controls. Most parameters of the morphology of the jaw-closing muscles did not show a linear correlation with either the occlusal pressure or force. In conclusion, the occlusal contact area and occlusal force in patients were significantly lower than those in the controls, and also the balance was shifted to the deviated side in patients with skeletal mandibular asymmetry. It is assumed that the morphology and orientation of jaw-closing muscles may have not linear but complex correlation to the weaker and unbalanced occlusal force in patients.     

Reliable and Repeatable Centric Relation Adjustment of the Maxillary Occlusal Device

This technique article describes a quantifiable, repeatable, and reliable method for occlusal device adjustment in centric relation using a leaf gauge. In addition, specific suggestions for occlusal device design are provided to enhance patient comfort with the prosthesis in place.     

Influence of different narrative instructions to record the occlusal contact with silicone registration materials

This study examined the influence of narrative instructions on the occlusal contact area, occlusal contact point and masticatory muscle activities in normal subjects. Twelve healthy men and 12 healthy women with no more than one missing tooth per quadrant participated. Surface EMG was recorded from the masseter and temporal muscle. As a control measurement, intercuspal position was maintained to produce a habitual clenching record (NCR) while the occlusal contact area and occlusal contact point was recorded by means of silicone material. Subsequently, the occlusal contact area was recorded with the narrative instruction for minimum clenching record (MCR), light clenching record (LCR) and strong clenching record (HCR). While the EMG activity (%MVC) increased modestly from MCR to LCR (from 9·3 ± 2·0% to 11·5 ± 1·5%), the occlusal contact area increased rapidly (from 17·2 ± 11·3 mm² to 26·8 ± 15·6 mm²) (P < 0·05). Both EMG activity and occlusal contact area increased gradually from LCR to NCR (to 17·7 ± 2·0% and to 31·4 ± 14·2 mm², respectively). Finally, EMG activity still increased from NCR to HCR (to 44·5 ± 3·7%) (P < 0·05), but the occlusal contact area remained stable (to 36·8 ± 16·6 mm²). Occlusal contact points at left posterior, right posterior, anterior and total area were not significantly different between each task. This study showed that narrative instructions while recording the bite can result in largely stable occlusal contact area. An adequate narrative instruction may therefore contribute to taking a stable occlusal recording in natural dentition.