【作者】 王彦；

【导师】 康宏；

【作者基本信息】 兰州大学 ， 口腔修复学（专业学位）， 2015， 硕士

【摘要】 在现代医学中,磨牙症是一种常见的疾病,它对口颌系统乃至全身系统都有很大的危害¨。迄今为止,病因和发病机制仍无明确结论,一般认为是多种因素协同致病,且无特异性的诊断和治疗方法。本研究借助模型分析和艾动牙齿咬合力测试仪,通过分析磨牙症患者的牙合型和咬合接触特点,从静态和动态角度观察磨牙症患者的咬合状况,进一步探索咬合因素在磨牙症病因学中的作用。实验分为以下二部分：第一部分磨牙症患者的牙合型分析目的：利用模型分析,从静态角度观察和分析磨牙症患者和正常健康学生的牙合型特征,探索咬合因素在磨牙症病因学中的作用。材料和方法：病例组是2013年10月-2014年10月经兰州大学口腔医院临床确诊的12名磨牙症患者,对照组是本校医学院6名无磨牙的正常健康学生。所有受试者取模型观察,分析比较前牙覆牙合、覆盖、拥挤度、Spee曲度、尖牙和磨牙关系的差异。结果：1、两组的覆牙合有差别,病例组的覆牙合比对照组大(P<0.05)。而两组覆盖的差别不显著(P>0.05)。2、两组的拥挤度有差别,病例组的拥挤度比对照组大(P<0.05)。3、两组Spee曲度有差别,病例组Spee曲度比对照组大(P<0.05)。4、两组的尖牙关系有差别(P<0.05)。病例组左右侧尖牙非中性关系(包括近中尖牙关系和远中尖牙关系)的人数多于对照组。5、两组的磨牙关系有差别(P<0.05)。病例组左右侧非安氏Ⅰ类磨牙关系的人数多于对照组。结论：磨牙症患者和正常健康学生的前牙覆牙合、拥挤度、Spee曲度、磨牙关系和尖牙关系有显著差异。从目前的数据分析来看,尚不能说明错牙合畸形与磨牙症之间的因果关系。第二部分磨牙症患者的咬合接触特点分析目的：利用艾动牙齿咬合力测试仪(I-Motion Teetester)动态地观察并分析磨牙症(bruxism)患者的咬合接触特点,进一步探索咬合因素和磨牙症的关系。方法：选择实验一的受试者。采用Teetester分析牙尖交错位下咬合力为25%、50%、75%、100%时左右侧牙弓牙合力(%)、各牙位牙合力(%)、总牙合力(kg)、总咬合面积(mm2)、牙合接触时间(occlusion time, OT)和牙合力中心(center of force, COF)分布情况。结果：1、病例组左右侧牙弓牙合力有差别,右侧大于左侧(P<0.05)；对照组左右侧牙弓牙合力无差别(P>0.05)。2、病例组13牙合力比23大,差别显著(P<0.05)；其余左右侧同名牙牙合力无差别(P>0.05)。对照组左右侧同名牙牙合力差别不显著(P>0.05)。3、病例组和对照组的总牙合力和总咬合面积差别不显著(P>0.05)；两组的OT时间有差别,病例组大于对照组(P<0.05)。4、两组COF定性分析结果有差别,病例组COF在灰圈内的人数比对照组少(P<0.05)。5、两组COF偏移距离有差别,病例组COF的偏移距离比对照组大(P<0.05)。结论：磨牙症可能存在左右侧牙弓牙合力分布不平衡、COF分布异常和OT时间长的现象。更多还原

【Abstract】 In modern medicine, bruxism is a common disease, it has great harm to the Stomatognathic System, even all-around health. It is considered as a complex, multifactorial disorder, and at present no specific diagnosis and treatment method has been used clinically. In this study, we observed and analyzed the characteristics of occlusal contact of bruxers statically and dynamically by model analysis and I-Motion teetester, exploring the role of occlusal factors in bruxism. The following experiment was divided into two parts:Part one:The analysis of occlusal pattern on BruxersObjective:The study statically observed and analyzed the characteristics of occlusal contact in bruxers and healthy students by model analysis, exploring the role of occlusal factors in bruxism. Method:12 bruxers were selected as the testing group, which were from Department of Prosthedontics, Stomatology Hospital of Lanzhou University from October 2013 to October 2014, and 6 healthy students without bruxism from Lanzhou University were selected as the control group. All subjects were maked models, analyzing and comparing anterior overbite, overjet, crowding, curve of Spee, canine and molar relationships. Result:1.Overbite showed the significant difference between the testing group and the control group. Overbite in the testing group was larger than the latter(P<0.05). But Overjet showed no significant difference between two groups(P>0.05).2.Crowding showed the significant difference between the two groups, and Crowding in the testing group was larger than the latter(P<0.05).3.Curve of Spee showed the significant difference between the testing group and the control group, and it in the testing group was larger than the latter(P<0.05).4.Cannie relationships showed the significant difference between the testing group and the control group, and persons of non-neutroclusion in the testing group was more than the latter(P<0.05).5.Molar relationships showed the significant difference between the testing group and the control group, and persons of non-Angle Class Ⅰ malocclusion in the testing group was more than the latter(P<0.05). Conclusion: There are significant differences in anterior overbite, crowding, Curve of Spee, canine and molar relationships between the bruxers and the healthy students. Malocclusion is related to bruxism.Part two:The characteristic analysis on occlusal contacts of BruxersObjective:The study dynamically observed and analyzed the characteristics of occlusal contact in bruxers by I-Motion teetester occlusal analyzer, exploring the relationship between occlusal factors and bruxism. Method:All subjects were from part one. By using I-Motion teetester, the study selected four time points in intercuspal position, just as 25%,50%,75%,100% of bite force and analyzed the bite force percentage in the left and right sections, the bite force percentage on individual teeth, total bite force(kg), total occlusal areas(mm2), occlusal time (OT) and the distribution of center of force (COF). Result:1. The bite force percentage in the left and right sections showed the significant difference in the testing group, and the right one was larger than the left(P<0.05). No significant difference was in the control group(P>0.05).2.The bite force percentage on 13 was larger than 23 in the testing group(P<0.05), the bite force percentage on the other individual teeth showed no significant difference(P<0.05). The bite force percentage on individual teeth in the control group showed no significant difference (P>0.05).3. Total bite force and total occlusal areas showed no significant difference in the two groups(P>0.05). Occlusion time showed the significant difference in the two groups. OT in the testing group was longer than one in the control group(P<0.05).4.The qualitative analysis showed the significant difference in the two groups. Persons of COF in gray circle in the testing group were less than the one in the control group.5. The offset distance showed the significant difference in the two groups. It was larger in the testing group than the one in the control group(P<0.05). Conclusion:Bruxism may be related to bite force imbalance in the left and right sections, abnormal COF distribution and long OT.更多还原