T-ScanⅢ系统对不同义齿修复KennedyⅡ类牙列缺损的咬合力分析

Analysis occlusion of different prosthesis for Kennedy Ⅱ patients with T-ScanⅢ system

目的:观察KennedyⅡ类(肯氏Ⅱ类)牙列缺损运用不同修复方法后咬合力大小和分布情况及与天然牙列咬合力分布的差异。方法:选择实验组为肯氏Ⅱ类牙列缺损患者,按不同修复方法分为支架组12例、种植组12例和精密附着体组12例,对照组为正常牙列者12例。应用T-ScanⅢ咬合力分析仪测定患者修复后当日、半年和1年的咬合力大小及分布情况并比较其差异。结果:3个时间段中,在总咬合力和左右向位移方面,正常组分别是1082.83±63.23N和4.20±0.96mm,种植组分别是1070.17±61.85N和4.25±1.20mm,二者差异无统计学意义(P>0.01),而正常组与支架组的612.33±70.89N和-9.19±1.41mm差异有统计学意义(P<0.01),在修复后1年时正常组与附着体组的895.42±71.45N和5.41±1.53mm差异有统计学意义(P<0.05)。在前后向位移方面,正常组的36.44±1.72mm与种植组的30.35±2.93mm和支架组的22.44±2.96mm间差异均有统计学意义(P<0.01),附着体组在修复后半年的36.10±2.37mm和1年时的35.99±2.16mm与正常组差异无统计学意义(P>0.05)。结论:种植义齿在恢复牙列咬合力和控制义齿左右向中心方面优于附着体和活动义齿,较接近天然牙列咬合力分布。而附着体义齿能较好地协调义齿的前后向位移,使咬合力中心在前后向达到均衡。

Objective： To observe the occlusal force distribution after three prostheses for restoration of Kennedy Ⅱ patients and compare their difference from the natural tooth.Methods： Kennedy Ⅱ patients were selected for experimental group,who were assigned to three groups according to different treatments,framework group（12 cases）,implant group（12 cases）,precision attachments group（12 cases）.The subjects in control group were volunteers with normal dentition（12 cases）.T-ScanⅢ system was used to test the occlusal force distribution of restored teeth in the same day of treatment,six months and one year after restoration.Results： In the three-time-point analysis,there was no difference in general occlusion force and horizontal displacement center of force between control group（1082.83±63.23N and 4.20±0.96mm）and implant group（1070.17±61.85N and 4.25±1.20mm）（P 0.01）,however,there was significant difference between control group and framework group（612.33±70.89N and-9.19±1.41mm）（P 0.01）.There was difference in general occlusion force and horizontal displacement center of force between control group and precision attachments group（895.42±71.45N and 5.41±1.53mm） at one year after restoration（P 0.05）.There was significant difference in anterior-posterior direction displacement between control group（36.44±1.72mm）and implant group（30.35±2.93mm） or framework group（22.44±2.96mm）（P 0.01） There was no significant difference in anterior-posterior direction displacement between control group and precision attachments group in six months（36.10±2.37mm）and one year（35.99±2.16mm） after restoration（P 0.05）.Conclusion： Precision attachments could obtain occlusion balance in displacement of anterior-posterior direction.Implant dentures would achieve a comparable occlusal force with natural tooth and easily control the horizontal displacement of center of force.