【作者】 刘宁；

【导师】 孙晓菊；

【作者基本信息】 大连医科大学 ， 口腔医学， 2014， 硕士

【摘要】 目的：本实验应用数字咬合力分析仪对牙周炎伴牙合创伤患者和牙周健康者进行动态咬合力分析，通过对比牙合接触时间（occlusion time，OT），为牙合创伤的诊断提供参考指标；通过对早接触点和牙合干扰点的检测，为牙合创伤的精确调牙合治疗提供新的辅助检查方法，使调牙合更加精准和有效。方法：1.病例选择与分组收集中重度牙周炎伴牙合创伤患者42例，根据指导调牙合的方法不同随机分成A（分析仪组）、B（咬合纸组）两组；收集20例牙周健康的志愿者作设为C组（对照组），不进行治疗。2.实验设备和器材（1）艾动咬合力分析仪及TeeTester咬合分析软件v3.1版本（江苏畅微电子科技有限公司）。（2）100微米咬合纸（德国宝诗）。（3）超声波龈上洁治器。（4）龈下刮治器与根面平整器械。（5）williams牙周探针。（6）高速涡轮手机（日本NSK）。3.实验步骤患者初诊时均记录年龄、性别等一般资料，为每一位入选患者进行全口牙齿检查，记录分析仪组（A组）和咬合纸组（B组）患者的以下牙周检查指标：出血指数（bleeding Index，BI）、探诊深度(probing depth，PD)、附着丧失（attachmentloss、AL）、功能性动度(Functional mobility,FM)，并拍摄全口曲面断层片。测试并对比A、B、C三组的牙合接触时间（occlusion time，OT）。对A、B两组进行牙周局部治疗（包括龈上洁治和龈下刮治），六周后检查治疗效果并进行统计分析。之后进行调牙合治疗，在指导调牙合时A组使用咬合纸配合咬合力分析仪检查咬合，B组仅使用咬合纸检查咬合，治疗后四周对比A、B两组的治疗效果，测试并对比A、B、C三组的OT值。4.数据处理使用SPSS13.0软件包对数据进行统计分析，计量资料以x±s表示。A、B、C三组的年龄、性别、OT值的组间比较采用方差分析，A、B两组的AL、PD、BI、FM的组间比较和治疗前后自身比较均采用配对t检验。结果：1.牙周治疗前，测试仪组（A）、咬合纸组（B）、对照组（C）的性别、年龄组间比较均无显著差异(P>0.05)；A、B两组的AL、PD、BI、FM组间均无显著差异(P>0.05)；A组与B组OT无显著差异(P>0.05)，均大于C组，差异有统计学意义(P<0.05)。2.牙周局部治疗六周后，A组与B组的OT值与治疗前自身相比下降，两组治疗后均大于C组，差异有统计学意义(P<0.05)； A、B两组的PD、BI、FM治疗后与治疗前自身相比均下降，差异有统计学意义(P<0.05)，两组间比较无显著差异(P>0.05)。3.调牙合治疗四周后，A、B两组的PD、BI、OT、FM与调牙合治疗前相比均下降，差异有统计学意(P<0.05)；PD、FM、OT值组间比较结果A组均小于B组，差异有统计学意义(P<0.05)； A组与C组的OT值无显著差异(P>0.05)，B组OT值高于C组，差异有统计学意义(P<0.05)。结论：1.咬合力定量分析对中重度牙周炎的牙合创伤具有临床诊断意义。2.应用咬合力分析仪检查能够为中重度牙周炎伴牙合创伤患者的临床诊断提供量化参考指标，提高调牙合治疗效果。更多还原

【Abstract】 Objective: In this experiment, the Computerized Occlusal Analysis System wereused to analyze the occlusion of periodontitis with occlusal trauma patients andperiodontally healthy subjects. Compared with the Occlusion Time,provide a referenceindex for the diagnosis of occlusal trauma;Through the detection of premature contactsand occlusal interference point to occlusal trauma, and provide a new auxiliaryexamination method of occlusal adjustment in occlusal trauma,which can make makeocclusal adjustment more accurate and effective.Methods: To select42cases of patients with moderately severe periodontitis withocclusal trauma, male21, female21, which were randomly divided into groupA, andgroup B,and each group of21people, aged35to74years old, while collecting20periodontally healthy volunteers served as group C (control group), male10and female10,aged35to74years old.Compared periodontitis with occlusal trauma groups and the control group in theOT, and then gave the periodontitis with occlusal trauma groups periodontal therapy(including supragingival scaling and subgingival scaling), after6weeks, OT, functionalmobility (FM) and periodontal clinical index were compared,to see the improve ofocclusal trauma and inflammation;later on，gave the periodontitis with occlusal traumagroups occlusal therapy,later on periodontitis with occlusal trauma group of occlusaltherapy, group A on the basis of using traditional methods with the ComputerizedOcclusal Analysis System, group B only using the methods without Computerized Occlusal System. To compare therapeutic effect,one month after treatment, comparedtwo groups of OT,FM and clinical periodontal examination index again.The experimental groups were in accordance with the "periodontology" FourthEdition periodontal examination and grading standards, a detailed record of eachselected patients with full mouth teeth, and shoot panoramic X-ray panoramicradiographs, check and record the following periodontal examination index of fulldentition: bleeding index (BI),probing depth (PD), attachment loss (AL), functionalmobility (FM); and use the Occlusal Analysis System recording occlusion time (OT).SPSS13.0software package was used for statistical analysis of data, measurementdata were expressed as x±s, compared with the measurement data were analyzed bypaired t test or variance.Results: No difference in A, B, C groups of gender, age (P>0.05); there was nodifference in group A and group B of AL, PD, BI (P>0.05); there was no significantdifference in group A and group B of OT, FM (P>0.05), but were higher than those ofOT in group C, the difference was statistically significant (P<0.05).A month after periodontal treatment, groups A and B of OT compared with beforetreatment were decreased, The difference was statistically significant (P<0.05),but stillhigher than the control group, the difference was statistically significant (P<0.05);compared with before treatment, groups A and B of AL, PD, BI, FM were decreased,the difference was statistically significant (P<0.05)A month after occlusal adjustment, groups A and B of AL, PD, BI have decreasedcompared with before treatment (P<0.05), and group A was than those in group B, thedifference was statisticallysignificant (P<0.05); after treatment,both group A and groupB of OT decreased (P<0.05), the group A was higher than C, But the difference was notstatistically significant (P>0.05); group B was higher than group C, the difference wasstatisticallysignificant (P<0.05); groupA and group B of FM decreased after treatment,And the groupA was lower than that of group B, The difference wasstatisticallysignificant (P<0.05).Conclusion: Occlusion time quantitative analysis has significance in clinical diagnosis of moderate to severe periodontitis with occlusal traumaClinical application of Computerized Occlusal Analysis System examination canmoderate to severe periodontitis with occlusal trauma patients to provide quantitativereference index,and which can improve the effect of occlusal adjustment.更多还原