牙齿重度磨耗伴牙列缺损咬合重建固定义齿修复的临床研究

Clinical study of fixed denture in severe tooth wear with defect of dentition occlusal reconstruction

目的探讨采用固定义齿对牙齿重度磨耗伴牙列缺损咬合重建的效果。方法入选2012年8月至2013年8月接收的50例牙齿重度磨耗伴牙列缺损患者,根据咬合重建的方式不同将50例患者分为两组,采用固定义齿修复设为A组(22例),采用牙合垫式可摘局部义齿修复设为B组(28例),比较两组疗前疗后咀嚼效率变化,观察两组修复后主观感觉及效果、颞下颌关节功能的改善。结果修复后,两组咀嚼效率均明显改善,而A组咀嚼效率明显高于B组(P<0.05);A组在美观满意度、咀嚼有力、舒适度上均优于B组(P<0.05),牙齿敏感率明显低于B组(P<0.05),食物嵌塞发生率稍高于B组(P>0.05);治疗后,两组颞下颌关节功能均明显改善,但组间比较无显著差异(P>0.05)。结论在掌握适应证的情况下,采用固定义齿对齿严重磨耗牙伴牙缺损进行咬合重建更具美观性、舒适性,且不易发生基牙继发龋,可显著改善牙齿咀嚼效能,恢复牙列完整,改善颞下颌关节病症状,值得推广。

Objective To investigate the effect of fixed partial denture in the occlusal reconstruction for patients with severe tooth wear accompanied with defect of dentition. Methods 50 patients with severe tooth wear and tooth defect treated in our hospital from August 2012 to August 2013 were divided into two groups： the patients with the use of fixed partial denture was set as group A（ 22 cases）,patients treated with occlusal pad removable partial denture was set as group B（ 28 cases）. The change of chewing efficiency of the two groups after treatment was compared,and the subjective feeling and effect,improvement of temporomandibular joint function of the two groups were observed. Results After repair,two groups of masticatory efficiency were significantly improved,and masticatory efficiency of group A was significantly higher than that in group B（ P〈0. 05）. Aesthetic satisfaction,chewing powerful and comfort in group A were better than group B（ P〈0. 05）. Tooth sensitivity rate was significantly lower than that of group B（ P〈0. 05）. Food impaction occurrence rate was slightly higher than that in group B（ P〉0.05）. After treatment,temporomandibular joint function in two groups were significantly improved,but had no significant difference（ P〉0. 05）.Conclusion In the case of mastering the indications,using the fixed denture to carry out the occlusal reconstruction of severe tooth wear with tooth defect is more attractive,comfortable,and is not easy to have dental caries,can significantly improve the teeth chewing efficiency,restore dentition integrity and improve temporomandibular joint disease.