舌侧集中牙合与解剖式双侧平衡牙合全口义齿修复低平牙槽嵴无牙颌患者咀嚼效率及咬合力比较研究

Study on the masticatory efficiency and the occlusal force in different types of complete denture

目的评价舌侧集中牙合与解剖式双侧平衡牙合全口义齿修复低平牙槽嵴无牙颌患者的咀嚼效率及咬合力。方法选择2012年6月至2013年4月到中国医科大学口腔医学院修复科就诊的牙槽嵴吸收较严重的无牙颌患者20例作为研究对象,采用闭口式印模法在同一垂直距离和正中关系咬合记录下为同一患者制作舌侧集中牙合与解剖式双侧平衡牙合2种不同牙合型全口义齿,每例患者随机先后接受2副义齿盲戴使用。每副义齿分别在戴用1周、3个月时采用吸光度法测量咀嚼效率以及用Tee-Tester咬合压力测试仪测量2种牙合型的最大咬合力,并在每副义齿使用3个月时进行问卷调查。结果舌侧集中牙合全口义齿的咀嚼效率略高于解剖式双侧平衡牙合,但差异无统计学意义(P>0.05);其咬合力小于解剖式双侧平衡牙合,差异有统计学意义(P<0.05)。在主观满意度调查问卷中,患者对舌侧集中牙合全口义齿的舒适性、稳定性、咀嚼能力等评价更高。结论与解剖式双侧平衡牙合全口义齿相比,舌侧集中牙合全口义齿修复低平牙槽嵴无牙颌患者具有更高的稳定性;其具有与解剖式双侧平衡牙合相当的咀嚼效能,且咬合力小于解剖式双侧平衡牙合,从而延缓了牙槽嵴的吸收。

Objective To compare the difference in the masticatory efficiency and the occlusal force in two different types of complete denture for edentulous patients with low alveolar ridge：the lingualized occlusion and the anatomic bilateral balanced occlusion. Methods Totally 20 patients with the residual resorption of the edentulous were collected from Department of Prosthodontics,School of Stomatology,China Medical University. Two different types of complete dentures （the lingualized occlusion and the anatomic bilateral balanced occlusion）were made for each patient in the same vertical distance and centric relation occlusion record using closed-type impression techniques. Each patient randomly received both the two types of complete dentures. Each pair of dentures was measured the masticatory efficiency by light absorption method and the maximal bite force was measured by Tee-Tester occlusion pressure measurement after 1 week and 3 months,respectively. All patients received questionnaire survey after using for 3 months in each pair of dentures. Results The masticatory efficiency of the lingualized occlusion was slightly higher than the anatomic bilateral balanced occlusion,but there was no statistically significant difference. The occlusal force of the lingualized occlusion was less than the anatomic bilateral balanced occlusion and there was statistically significant difference. In the questionnaire,the patients gave a high evaluation on the complete denture of lingualized occlusion. Conclusion Compared with the complete denture of anatomic bilateral balanced occlusion,the complete denture of lingualized occlusion has higher stability,with the same masticatory efficiency and less occlusion pressure,which protects the alveolar ridge and delays the absorption of alveolar ridge.