后牙咬合支持状态对老年牙齿磨耗咬合重建修复效果的影响

The effect of occlusal support status of posterior teeth on occlusal reconstruction in the elderly

目的:研究后牙咬合支持状态对老年牙齿重度磨耗咬合重建修复效果的影响。方法:纳入2017年1月~2020年3月我院收治的112例老年牙齿重度磨耗患者为对象,均接受咬合重建修复。按照随机数表法将患者分为两组,各56例,其中观察组后牙咬合支持完全,对照组后牙咬合支持不全。比较两组修复前、过渡及永久修复1个月时双侧嚼肌(masseter muscle,MM)、颞肌前束(temporal anterior muscle,TA)、颞肌后束(temporal posterior,TP)的咀嚼周期、活动期与间歇期比值、肌电积分值变化情况。结果:咀嚼周期:两组修复后MM、TA、TP呈降低趋势(P<0.05),观察组过渡修复1个月MM、TA、TP显著高于对照组,永久修复1个月显著低于对照组(P<0.05)。咀嚼运动活动期与间歇期比值:两组修复后MM、TA、TP呈降低趋势(P<0.05),观察组修复前、过渡修复1个月及永久修复1个月后MM、TA、TP显著低于对照组(P<0.05)。咀嚼运动肌电积分值:两组过渡修复1个月时MM、TA、TP降低,而永久修复1个月时增高,但均低于修复前(P<0.05),观察组修复前、过渡修复1个月MM、TA、TP高于对照组,而永久修复1个月MM、TA低于对照组,TP高于对照组(P<0.05)。结论:后牙咬合支持状态对老年牙齿磨耗咬合重建修复效果具有重要影响。

Objective:To study the effect of occlusal support state of posterior teeth on occlusal reconstruction and repair of elderly teeth with severe wear and tear.Methods:Totally 112 elderly patients with severe tooth abrasion admitted to our hospital from January 2017 to March 2020 were included as the subjects,and all of them received occlusal reconstruction and repair.The patients were divided into two groups,56 patients in each group,of which the observation group had complete occlusal support of the posterior teeth,and the control group had incomplete occlusal support of the posterior teeth.The masticatory cycle,the ratio of active to intermittent period and the changes of EMG integral value of bilateral masseter muscle(MM),temporal anterior muscle(TA)and temporal posterior muscle(TP)before repair,1 month after transitional repair and 1 month after permanent repair were compared between the two groups.Results:Masticatory cycle that MM,TA and TP decreased in the two groups after restoration(P<0.05).The MM,TA and TP of the observation group after one month of transitional repair were significantly higher,and those of the permanent repair one month were significantly lower than those of the control group(P<0.05).The ratio of active period and intermittent period of masticatory movement,MM,TA and TP decreased in the two groups after repair(P<0.05),while MM,TA and TP in the observation group before repair,1 month after transitional repair and 1 month after permanent repair were significantly lower than those in the control group(P<0.05).EMG integral value of masticatory movement that MM,TA and TP decreased at 1 month of interim repair,and increased at 1 month of permanent repair,but that were lower than before repair(P<0.05).MM,TA and TP in observation group were higher than those in control group before repair and 1 month after transitional repair,while MM,TA in observation group were lower at 1 month after permanent repair,and TP was higher(P<0.05).Conclusion:The occlusal support status of the posterior teeth has an important influence on the restoration effect of the occlusal reconstruction in the elderly.