不同咬合接触对单颗后牙种植修复咬合平衡的影响

Effect of different occlusal contacts on occlusal balance of single posterior dental implants

目的 :研究不同咬合接触方式对咬合平衡指数的影响,为改进种植修复咬合平衡提供依据。方法 :选择2018年12月—2019年12月上海市普陀区眼病牙病防治所行单颗后牙种植修复的患者24例,均采用标准化种植流程,按照修复体与对颌牙将被调整到的咬合接触紧密程度不同,随机分为A、B 2组,分别使用12μm和20μm咬合纸进行调整,使咬合纸在修复体和对颌牙咬紧时恰好可以有阻力抽出。应用T-scan咬合力分析仪分别测定修复前及修复当天、3个月、6个月、12个月和18个月牙尖交错位时咬合力分布情况,换算成咬合平衡指数。采用SPSS 21.0软件包对数据进行统计学分析。结果:2组在修复前咬合平衡指数分别为(-0.389+0.066)和(-0.368+0.055),修复当天分别为(-0.249+0.069)和(-0.283+0.056),差异无统计学意义(P>0.05);修复3个月时分别为(-0.052+0.022)和(-0.169+0.063),6个月时分别为(-0.025+0.015)和(-0.088+0.045),12个月时分别为(-0.010+0.008)和(-0.029+0.016),18个月时分别为(-0.000+0.000)和(-0.006+0.008),2组咬合平衡指数均呈逐渐增加至0的趋势,A组绝对值远小于B组,但A组的上升幅度远大于B组,差异有统计学意义(P<0.05)。结论:单颗后牙种植修复能逐渐恢复咬合平衡,选用12μm咬合纸调整修复体与对颌牙咬合接触紧密程度,能更早获得咬合平衡。

PURPOSE: To investigate the effect of different occlusal contacts on occlusal balance index of single posterior dental implants, and to provide evidence for clinical improvement of occlusal balance of implant prostheses.METHODS: Twenty-four patients with single posterior teeth implants were selected from December 2018 to December2019 in Dental and Ophthalmic Clinic of Putuo District. According to the occlusal contact degree between different prostheses and opposite teeth, all implants were randomly divided into two groups: a 12 μm occlusal paper was used to adjust the occlusal degree in group A, while a 20 μm occlusal paper was used in group B. The occlusal paper could be extracted from between the prosthesis and the opposite teeth when clenched. The occlusal force was measured at the intercuspal position(ICP), with T-scan Ⅲ system before and on the day of restoration as well as 3, 6, 12 and 18 months after restoration, and their occlusal balance index were calculated. The data were analyzed with SPSS 21.0 software package. RESULTS: The occlusal balance index of the two groups was(-0.389+0.066) and(-0.368+0.055) before the day of restoration respectively, while(-0.249+0.069) and(-0.283+0.056) respectively on the restoration day. There was no significant difference between group A and group B during these two periods. The occlusal balance index of these two groups was(-0.052+0.022) and(-0.169+0.063) respectively 3 months after restoration,(-0.025+0.015) and(-0.088+0.045) respectively 6 months after restoration,(-0.010+0.008) and(-0.029+0.016) respectively 12 months after restoration as well as(-0.000+0.000) and(-0.006+0.008) respectively 18 months after restoration. The absolute value of occlusal balance index in group A was much less than that in group B at the 3 rd, 6 th, 12 th months after restoration. On the contrary, the increase extent of group A was much larger than that of group B. There was significant difference between the two groups(P<0.05). At 18 month after restoration, the occlusal balance index of the two groups were all close to "0".CONCLUSIONS: Occlusal balance will be obtained gradually after the restoration of a single posterior tooth implant and earlier when a 12 μm occlusal paper was used to adjust the occlusal degree.