舌侧集中牙合与解剖式双侧平衡牙合应用于全口义齿修复的系统评价

背景：牙合型是制作全口义齿成功的关键，临床上如何选择合适的牙合型一直是困扰修复科医师的问题。 目的：系统评价舌侧集中牙合和解剖式双侧平衡牙合应用于全口义齿修复的临床效果。 方法：用关键词“complete denture” ，“edentulous”，“occlusion” ，“balanced”，“lingualized,” “anatomic”，计算机检索Cochrane图书馆临床对照试验库、Pubmed/Medline数据库、EMBASE数据库、万方数据库、CNKI中国知网数据库及中国生物医学文献库，语言设置为中文和英文，年限设置均从创刊到2013年10月，检索相关文献，此外用手工检索11种口腔医学杂志和相关文献的参考文献。由两位评价员独立进行文献筛选、资料提取和质量评价，共检索出628篇文献。 结果与结论：按照纳入和排除标准，纳入5篇文献。其中1篇文献研究证明舌侧集中牙合在患者固位力满意度上高于双侧平衡牙合(P < 0.05)。其中1篇研究证明舌侧集中牙合在患者对“进食有问题”、“需要避免特殊食物”的评比分数上低于完全双侧平衡牙合(P < 0.05)，在“不舒适假牙”的评比分数上高于完全双侧平衡牙合(P < 0.05)。其中1篇文献证明舌侧集中牙合应用于重度牙槽骨吸收患者具有更好的咀嚼效率和能较好保护牙槽骨(P < 0.05)。其他2篇文献研究中舌侧集中牙合与双侧平衡牙合在患者总体满意度等研究的比较结果上差异无显著性意义。结果证实，舌侧集中牙合具有与解剖式双侧平衡牙合相似的患者满意度、咀嚼效率、美观和发音，对严重牙槽骨吸收患者有更好的咀嚼效率和保护牙槽骨的作用。中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程全文链接：

Clinical effects of lingualized occlusion and bilateral balanced occlusion for complete denture: a systematic review

BACKGROUND:Occlusal scheme is the key of a successful complete denture, and how to choose a suitable occlusal scheme is a long-term problem for prosthodontists. OBJECTIVE:To systematically review the clinical effects of two occlusal schemes for complete denture. METHODS:An electronic search of Cochrane Library, Medline/PubMed, EMBASE, CNKI, Wanfang and CBM databases were performed for clinical trials published before October 2013 using the key words of “complete denture”, “edentulous”, “occlusion”,”balanced”, “lingualized”, “anatomic” in Chinese and English. A manual searching of 11 relevant journals concerning oral medicine and reference lists of selected articles were conducted. Two reviewers independently extracted the data and assessed the quality of the included literature. Totally, 628 papers were retrieved. RESULTS AND CONCLUSION:Only five articles met the inclusion and exclusion criteria. Of these five articles, one study showed lingualized occlusion dentures were more satisfactory than bilateral balanced occlusion dentures in denture retention (P < 0.05); one study showed the lingualized occlusion exhibited lower scores  for uncomfortable eating and avoiding particular foods (P < 0.05), but higher scores for uncomfortable dentures than the bilateral balanced occlusion (P < 0.05); one study showed the lingualized occlusion dentures have better masticatory efficiency and better protective role in alveolar bone than the bilateral balanced occlusion dentures (P < 0.05); another two studies showed no significant differences in the overall satisfaction between lingualized occlusion and bilateral balanced occlusion dentures. These findings indicate that the lingualized occlusion is similar to bilateral balanced occlusion in the satisfaction of patients, masticatory efficiency, appearance and speech, but the lingualized occlusion dentures are better for severe alveolar bone resorption patients in terms of masticatory efficiency and better protection of alveolar bone.