青少年错[牙合]患者正畸治疗后动态[牙合]接触

A preliminary study on the occlusal contact changes during retention in adolescent patients

目的 探讨经正畸治疗后获得正常牙列形态的青少年错[牙合]患者矫治结束后12个月内动态[牙合]接触的变化规律,以期为正畸矫治结束前的精细调整提供参考.方法 选择20例正畸矫治后戴用标准霍利保持器的青少年患者,并将20例患者分为[牙合]干扰组与无[牙合]干扰组,其中[牙合]干扰组患者11例,无[牙合]干扰组9例,使用T-ScanⅡ咬合分析系统分别于矫治结束即刻（T1）和矫治结束12个月（T2）时检查患者的动态[牙合]接触,对比分析两个时间点总体与分组情况下患者动态[牙合]接触特征.结果 20例患者的总体情况：T1至T2的前伸、左侧方和右侧方[牙合]分离时间明显减少,从（1.07±0.87）、（0.91±0.47）、（0.76±0.43）s分别降至（0.43±0.25）、（0.67±0.41）、（0.50±0.27）s,两时间点差异均有统计学意义（P＜0.05）.其中4例存在[牙合]干扰的患者[牙合]干扰消失.1例出现[牙合]干扰侧咀嚼肌不适症状.无[牙合]干扰组T1至T2的前伸、左侧方和右侧方[牙合]分离时间明显减少,从（1.25±1.11）、（0.84±0.15）、（0.52±0.49）s降至（0.35±0.15）、（0.36±0.15）、（0.33±0.11）s,两时间点差异均有统计学意义（P＜0.05）,[牙合]干扰组T1与T2的前伸、左侧方和右侧方[牙合]分离时间的差异无统计学意义（P＞0.05）.结论 戴用标准霍利保持器12个月后患者的动态[牙合]接触总体改善,但[牙合]干扰的存在影响了咬合的自行改善进程,矫治器拆除前对动态抬[牙合]接触的评估与精细调整仍是必要的.

Objective To evaluate the changes of the occlusal contact characteristics in adolescent patients during 12 months after active orthodontic treatment Methods Twenty adolescent patients with Hawley retainers after active orthodontic treatment were divided into none occlusal interference group and occlusal interference group. The occlusion of the patients was examined with T-Scan Ⅱ system directly after the appliance removal（Tl） and after an average retention period of 12 months（T2）. The changes of occlusal contact characteristics were observed. Results The disclusion time during protrusion, left and right lateral movements reduced significantly. The average disclusion time decreased [ from （1.07 ±0.87） , （0. 91 ± 0.47）, （0.76±0.43） s to （0.43 ±0. 25）, （0.67±0.41）, （0.50±0.27） s] significantly （P〈 0.05）. The occlusal interference disappeared in 4 patients and 1 patient with occlusal interference showed masticatory muscle symptom. The dynamic occlusion [ from （1. 25 ±1.11）, （0.84±0.15）, （0.52± 0.49） sto （0.35 ±0.15）, （0.36±0.15）, （0.33±0.11） s ] improved significantly （P 〈 0. 05） in none occlusal interference group after retention and no statistical differences were found in the occlusal interference group（P〉0. 05）. Conclusions The overall dynamic occlusion improved after retention in patients with retainers. The presence of occlusal interference affected the self-improvement process and increased the chance of the disorders of stomatognathic system, such as mandibular abnormal movements. Therefore, functional occlusion evaluation and final detailing were needed before appliance removal.