后牙种植单冠咬合接触时间及[牙合]力变化的临床研究

Clinical research on posterior single-implant occlusal contact time and force changes

目的研究后牙种植单冠采用预留间隙咬合设计后1年内种植修复体咬合延迟时间和[牙合]力百分比以及患者主观感受评分的变化,为临床种植修复体的咬合设计和调[牙合]提供依据。方法前瞻性选择2019年1至12月于首都医科大学口腔医学院修复科进行后牙种植单冠修复的患者,使用T-scanⅢ咬合分析仪分别记录修复后0.5、3、6、12个月时种植单冠与天然牙的咬合初接触时间以及牙尖交错位时种植单冠与对照牙(对侧同名天然牙)的[牙合]力百分比,同期记录患者对咀嚼功能的主观评分。分析咬合延迟时间(种植单冠与对照牙咬合初接触时间的差值)、[牙合]力百分比和患者主观感受随时间的变化。通过单因素重复测量方差分析比较各时间点差异,以双侧P<0.01为差异有统计学意义。结果共收集患者48例,男性23例,女性25例,年龄(36.8±8.4)岁(23~50岁)。修复后0.5、3、6、12个月种植单冠[牙合]力百分比分别为(7.7±4.8)%、(10.6±5.9)%、(12.3±6.2)%、(13.2±6.7)%,各时间点差异均有统计学意义(P<0.01),其中修复后0.5至3个月期间变化最明显;修复后0.5个月种植单冠[牙合]力百分比显著小于对照牙[(14.3±6.5)%](P<0.01)。修复后0.5、3、6、12个月种植修复体咬合延迟时间分别为0.15(0.08,0.20)、0.11(0.06,0.16)、0.07(0.03,0.13)和0.06(0.03,0.10)s,各时间点差异均有统计学意义(P<0.01)。患者对咀嚼功能的主观评分显示,修复后3个月至12个月各时间点评分均比前一个时间点显著升高(P<0.01)。结论后牙种植单冠[牙合]力百分比在修复后3个月内变化最明显。临床种植修复后3个月内应重点复查咬合情况并酌情调[牙合]。

Objective To investigate the changes of occlusal delay time,percentage of occlusal force and patients′subjective satisfaction of masticatory function for single implant crown in one year after the application of space reserved occlusion design.To provide data support and suggestions for clinical occlusion design.Methods Patients who had received single posterior dental implant restoration in Department of Prosthodontics,Capital Medical University School of Stomatology from January 2019 to December 2019 were selected.At 0.5,3,6 and 12 months after restoration,the T-scanⅢocclusal analyzer was used to detect and record the initial occlusal contact time of the natural tooth and implanted single crown,the occlusal force percentage of single implant prosthesis and corresponding tooth on the contralateral side(control teeth)on the contralateral side(control teeth)were also recorded.Subjective satisfaction with the masticatory function of the implants was recorded using visual analogue scale(VAS).The changes of occlusal delay time(the difference of the initial occlusal time between implant restoration and the natural teeth),percentage of occlusal force and patients'subjective feeling with time were analyzed.All data were analyzed by repeated measurement analysis of variance,bilatteral P<0.01 was considered statistically significant.Results A total of 48 patients aged(36.8±8.4)years(23 males,25 females,aged 23-50 years)were recruited.The occlusal delay time at 0.5 months was 0.15(0.08,0.20)s,at 3 months was 0.11(0.06,0.16)s,at 6 months was 0.07(0.03,0.13)s and at 12 months was 0.06(0.03,0.10)s.The occlusal delay time was shortened at every two time points,and the occlusal force percentage of the implant crown increased significantly.The percentage of occlusal force of implant prosthesis at 0.5 months was(7.7±4.8)%,at 3 months was(10.6±5.9)%,at 6 months was(12.3±6.2)%and at 12 months was(13.2±6.7)%.The most significant change was during the period of 0.5-3 months.At 0.5 months,the occlusal force of implant prosthesis was significantly lower than that of control teeth(14.3±6.5)%(P<0.01).The VAS score at 0.5 months was(7.06±1.64)and was(8.71±0.74)at 12 months.The score was increased and the difference was statistically significant from 3 month to 12 month(P<0.01).Conclusions The change of occlusal force percentage of single posterior dental implant is most obvious within 3 months after restoration.The occlusal condition should be reexamined and adjust occlusal after 3 months of implant restoration as appropriate.