牙齿病理性磨损充填治疗的临床效果研究

目的观察尚未出现牙髓症状的牙齿病理性磨损充填治疗的临床效果。方法选择牙列完整、后牙骀面有病理性磨损且具有充填空间的患者10例，患牙48颗，均无牙髓症状。使用后牙树脂充填后，比较治疗前、治疗后3个月和1年时，患者主观感觉和咀嚼功能（咬合力、咀嚼效率和咬肌肌电活动）的变化，观察树脂充填的临床效果（美国公共健康部评价系统）。结果患牙经充填治疗后患者临床症状消失，咬合力增加（P〈0．05），咀嚼效率明显提高（P〈0．01），治疗前后下颌息止位、大力咬合时、咀嚼运动时，颞肌前束和咬肌的活动强度、活动对称性及用力方式差异均无统计学意义（P〉0．05）；治疗后3个月和1年时复查，48颗后牙树脂充填体各项指标A级率为100％。结论对后牙骀面尚未出现牙髓症状的病理性磨损用树脂进行充填是一种有效的治疗方法，可以解除患者的临床症状，减缓磨损的发展，增加咀嚼效率及患牙咬合力。

Clinical effect of the restoration for pathological tooth wear

OBJECTIVE: To investigate the effect of the restoration for pathological tooth wear. METHODS: A total of 48 pathological weared premolars and molars with restorable space in occlusal surface in 10 patients were restored by composite resins. The patients' masticatory function (biting force, masticatory efficiency, the surface electromyographic (EMG) activity of masseter muscles and anterior temporalis) were compared before and after the treatment. At the same time, the restorations were evaluated according to the modified the United States Public Health Service (USPHS) criterion. RESULTS: After the treatment, patients' clinical syndrome disappeared, the biting force was improved (P < 0.05) and the masticatory efficiency was increased significantly (P < 0.01). EMG activity, the asymmetry index and the action index of the tested muscles during different status had no significant change (P > 0.05). The composite resin restorations of the 48 teeth were all evaluated as A after three month and one year. CONCLUSIONS: Restoring the pathological weared posterior teeth with composite resins is an effective treatment to relieve the patients' syndrome, improve their masticatory efficiency and biting force.