【作者】 王蓉；

【导师】 马跃； 徐欣；

【作者基本信息】 山东大学 ， 口腔颌面外科， 2011， 硕士

【摘要】 目的：本研究旨在观察种植义齿修复患者,在不同的调(?)方式下咬合及咀嚼肌的变化及其变化的相关联系,从而为种植修复的调(?)供临床依据和指导。方法：在来我院种植中心选择种植修复的单侧后牙游离缺失患者中,筛选出符合实验条件的患者20例,缺牙区均植入Ankylos种植体共56颗,将患者随机分为A、B两组,采用不同的调(?)方法进行调(?)。A组为常规咬合组,B组为延时咬合组。分别在种植固定义齿初戴、种植固定义齿修复3个月、修复后6个月,对其咬合情况及咀嚼肌肌电进行测量分析,从而得到反应咬合平衡的指标：咬合力中心(COF)偏移指数、磨牙咬合力不对称指数(AMOF),和反应咀嚼肌平衡的指标：下颌姿势位时咬肌及颞肌前束的电位、ICP位时紧咬时咬肌及颞肌前束的平均肌电幅值、咀嚼肌总体不对称指数Astot、咬肌不对称指数ASMM、颞肌不对称指数ASTA。比较两组间各指标间的变化差异及每组在种植固定义齿初戴、种植固定义齿修复3个月、修复后6个月各指标的变化差异。结果：1)常规咬合组A与延时咬合组B相比,在种植固定义齿初戴与种植固定义齿修复3个月,咬合平衡各指标的改变相比有统计学差异(P<0.05),咀嚼肌平衡指标的改变相比有统计学差异(P<0.05)。2)常规咬合组A与延时咬合组B相比,在种植固定义齿修复3个月与修复后6个月,咬合平衡各指标的改变相比无显著统计学差异(P>0.05),咀嚼肌平衡指标的改变相比有统计学差异(P<0.05)。3)常规咬合组A,在种植固定义齿初戴、种植固定义齿修复3个月、修复后6个月咬合平衡指标无显著统计学差异(P>0.05),咀嚼肌平衡指标有明显改变有统计学差异(P<0.05)。延时咬合组B在种植固定义齿初戴、种植固定义齿修复3个月、修复后6个月咬合平衡指标和咀嚼肌平衡指标均有明显改变有统计学差异(P<0.05)。结论：后牙游离缺失种植修复患者,采用咬合面降低调(?)法,能达到接近自身对侧天然牙相似的咬合指标及咀嚼肌肌电指标。咬合面降低调(?)法,可以使咀嚼肌和(?)在一定时间内相互作用相互适应从而形成更接近对侧天然牙的状况。更多还原

【Abstract】 Objective:Study and compare different occlusion adjustment techniques in patients with dental implant restoration and observing adjustment effects on occlusion, muscles of mastication, and its clinical applications.Method:Using our dental implantation center’s initial clinical application forms to select 20 appropriate patients that with 56Ankylos implants, each with a single edentulous posterior dentition with no distal dentition. These selected patients were further divided into two groups. Group "A" used the original occlusion adjustment technique and group "B" used the occlusal plane reduction technique. Implant body manufactured by Ankylos was implanted in the edentulous space in each patient and restored with fix prosthodontics single unit crown. Occlusion was adjusted in each restoration accordingly. Electromyograms were conducted to determine adjustment technique’s effect on occlusion and muscles of mastication three months and six months after initial restoration and adjustment.From the experiments, the following data were collected and measurements for balanced occlusal measuring standards are obtained:Central occlusion force (COF), Asymmetry index of molar occlusal force (AMOF). Balanced muscles of mastication measuring standards also obtained are:measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position. Average electromyogram measurements of the anterior bundle of the Temporalis muscle at the intercuspal position (ICP). Astot, Masseter Muscle Asymmetry Index, and Anterior Temporalis Asymmetry index (ASTA). Data were collected and each measurement and index was compared from each experimental group 3 months and 6 months after initial occlusion adjustment.Results:(1)3 months after occlusion adjustment the original occlusion adjustment technique side of group "A" compared with used the occlusal plane reduction technique of group "B" were statistically differents (P<0.05) in balanced occlusal measuring standards and balanced muscles of mastication measuring standards.(2)After 3-6 months occlusion adjustment the original occlusion adjustment technique side of group "A" compared with used the occlusal plane reduction technique of group "B" was statistically differents (P<0.05) in balanced muscles of mastication measuring standards,but was no statistically differents in balanced occlusal measuring standards (P>0.05)(3)After 6 months restoration the original occlusion adjustment technique side of group "A" was statistically differents (P<0.05) in balanced muscles of mastication measuring standards,but was no statistically differents in balanced occlusal measuring standards (P>0.05). the occlusal plane reduction technique of group "B" was statistically differents (P<0.05) in balanced occlusal measuring standards and balanced muscles of mastication measuring standards.Conclusion:Using occlusion plane reduction adjustment technique, it is possible to obtain occlusion index and muscles of mastication’s electromyogram index similar to the opposite side’s natural dentition in patients with single unit fix prosthodontics crown with single posterior edentulous dentition without distal dentitions. Using occlusal plane reduction technique can facilitate and improve interactions between muscles of mastication to approach a near normal condition similar to the natural dentition on the opposite side.更多还原