重度磨损双侧后牙游离缺失可摘牙合重建前后髁状突位置的分析

ANALYSIS OF CONDYLAR POSITION BEFORE AND AFTER REMOVABLE OCCLUSAL RECONSTRUCTION FOR SEVERELY WORN DENTITION WITH BILATERALLY DISTO-EXTENSIVE LOSS OF TEETH

目的探讨可摘牙合重建对重度牙合磨损伴双侧后牙游离缺失患者的髁状突移位的调位作用。方法根据治疗前及传统可摘义齿和可摘牙合重建义齿戴用后双侧颞颌关节侧位体层摄片上关节间隙线性测量值，对４２侧髁状突位置进行评判分析。结果治疗前髁状突后移位和上移位分别为８５．７％（３６／４２）和５４．８％（２３／４２），可摘义齿戴用和可摘牙合重建治疗后髁状突调整居中心分别为２６．２％（１１／４２）和７８．６％（３３／４２），左右侧关节对称性亦以可摘牙合重建治疗为佳。结论高覆盖可摘牙合重建治疗可达完全调整髁状突移位作用。

Objective To determine the repositioning effect on displaced condyles by removable occlusal reconstruction of removable overlay denture (ROD) prosthesis for patients with severely occlusal wear.Methods Tomographic X-rays of bilateral temporomandibular joint at intercuspal position were taken before and after RODs or traditional removable dentures (RDs) were inserted.The condylar positions were idenified according to the values of dimensional measurement of TMJ space on X-ray films.Results Before treatment,the frequencies of posterior and upper condylar displacement were 85.7% (36/42) and 54.8% (23/42) respectively.The displaced condyles were adjusted to the centric position in 26.2% (11/42) of the cases by wearing RDs,while in 78.6% (33/42) by wearing RODs.The correction of condylar asymmetry by RODs was also better than by RDs.Conclusions ROD occlusal reconstruction is more effective than RD prosthesis for repositioning the displaced condyles.