三种改良人工牙修复全口义齿的稳定性及应力支撑

背景：改良牙合型是重度吸收牙槽嵴全口义齿修复的一种良好选择，其中线性牙合、舌向集中牙合及长正中牙合具有代表性。 目的：概述线性牙合、舌向集中牙合及长正中牙合3种改良牙合型的特点及其在全口义齿修复中的应用。 方法：计算机检索中国知识资源总库(中国期刊网)1985年1月至2011年11月、PubMed 数据库1965年1月至2011年11月与线性牙合型、舌向集中牙合型、长正中牙合型3种改良牙合型在全口义齿应用相关的文章。 结果与结论：线性牙合为单颌刃状牙一维接触，能尽可能减小侧向牙合力消除牙合干扰。舌向集中牙合比平面牙合美观，对于重度吸收牙槽嵴患者较解剖牙合型更稳定。长正中牙合型能满足患者长正中量的自然要求，以及无牙颌患者正中关系位至肌力闭合道终点位置之间无障碍的义齿设计要求。3种改良牙合型均能减小侧向牙合力，将牙合力集中于剩余牙槽嵴，有助于提高义齿稳定性和软硬组织的支持作用。

Application of three modified occlusal schemes in complete denture: Stability and stress support

BACKGROUND:The modified scheme of occlusion is a good treatment for complete denture with severely resorbed alveolar ridges. Linear occlual scheme, linualized occlusal scheme and long-centric occlusal scheme are the typical types in modified occlusal schemes. OBJECTIVE:To review the characters and applications of these three types of modified occlusal schemes in complete denture. METHODS:CNKI (1985-01/2011-11) and PubMed (1965-01/2011-11) were retrieved for articles addressing linear occlual scheme, linualized occlusal scheme and long-centric occlusal scheme used in complete denture. RESULTS AND CONCLUSION:Linear occlusal scheme have been modified into bladed teeth so as to achieve linear occlusal contacts, and potentially damaging lateral forces are minimized as a result. The lingualized occlusal scheme provides better aesthetics than the monoplane occlusion scheme, and better stability than bilateral occlusion scheme of anatomic teeth, in the case of resorbed residual ridges. The long-centric occlusal scheme can meet the physiological requirement for the long centric of edentulous patients and achieve a free slide from the centric relation position to the muscular contact position of the mandible. The vertical forces provided by these three modified occlusal schemes can be centered upon the residual ridges. The application of vertical forces is considered advantageous for denture stability and maintenance of supporting hard and soft tissues.