夜磨牙症患者咬合因素的初步研究

A Preliminary Study of Occlusal Factors in Patients With Bruxism

目的探讨夜磨牙症与咬合因素的关系。方法选取18名夜磨牙症患者,记录患者在正中咬合及左、右侧方咬合三种咬合状态下最大的咬合接触面积和最大咬合力度数值,并进行左右侧对比;记下3种咬合状态下的前牙、前磨牙和磨牙区最大的咬合接触面积和最大的咬合力度数值及所占百分比;记录3种咬合状态下闭颌时间和开颌时间,并与系统设置的正常值进行比较。结果正中咬合时,在达到咬合接触面积最大的时点和咬合力度数值最大的时点,右边咬合力度值大于左边,差异有统计学意义(P<0.05);左边侧方咬合时,在达到咬合接触面积最大的时点和咬合力度数值最大的时点,右边咬合力度数值与左边咬合力度数值相比差异无统计学意义(P>0.05),右边侧方咬合时,在咬合接触面积最大的时点,右边咬合力度数值与左边咬合力度数值相比差异无统计学意义(P>0.05),而在咬合力度数值最大的时点,右边咬合力度值大于左边咬合力度值,差异有统计学意义(P=0.000)。夜磨牙症患者闭颌时间、开颌时间异常,Teetester系统设定的默认正常值为OT<0.25 s,DT<0.4 s,这是根据大量流行病学数据的基础上设定的。本研究大多数夜磨牙患者的OT、DT均异常,均不在系统设定的正常范围内,其中OT最大值可达4.68 s,DT最大值可达8.31 s,进一步证实夜磨牙患者存在咬合早接触。结论夜磨牙症的发生与侧方咬合干扰及咬合早接触有关,夜磨牙症咬合力的分布存在不均匀现象。

Objective The objective of this study is to observe the occlusal characteristics of the median occlusion,left lateral occlusion and right lateral occlusion of the patients with sleep bruxism,analyze the occlusal state of the patients with bruxism and explore the relationship between the occlusal factors and the sleep bruxism by using the Ai dynamic system Teetester.Methods Eighteen volunteers were randomly recruited to conduct polysomnography to confirm the diagnosis of sleep bruxism.Then,the Teetester examination of the Ai dynamic system was performed.The patients were trained to perform median occlusion,left lateral occlusion,and right lateral occlusion.The maximum occlusal contact area and the maximum occlusion force value were recorded in the three occlusal states,and compare the left and right sides;The maximum occlusal contact area,maximum occlusal force value and their percentages in the anterior,premolar and molar areas under three occlusal states were recored;The occlusion time(OT)and disocclusion time(DT)were recorded in three occlusal states and compared with the normal values set by the system.Results In the median occlusion and the right lateral occlusion,at the time of the maximum occlusal contact area and the maximum occlusal strength,the right occlusal strength is greater than the left side,and the difference is statistically significant(P<0.05).In the left lateral occlusion,at the time of the maximum occlusal contact area and the maximum occlusal strength,the right occlusion strength was not statistically different from the left(P>0.05);In the right lateral occlusion,at the time of the maximum occlusal contact area,the right occlusion strength was not statistically different from the left(P>0.05),at the time of the maximum occlusal strength the right occlusal strength is greater than the left side,and the difference is statistically significant(P<0.05).The occlusal force of the anterior,premolar and molar areas is higher when the patients with sleep bruxism.The occlusion time and disocclusion time of patients with sleep bruxism showed abnormal.The default normal value set by the Teetester system is OT<0.25 s,DT<0.4 s,which is based on a large number of epidemiological data.In this study,most of the patients with night bruxism had abnormal OT and DT,which were not within the normal range set by the system.The maximum value of OT and DT could reach 4.68s and 8.31s,which further confirmed the existence of early occlusal contact in the patients with night bruxism.Conclusion Sleep bruxism is related to lateral occlusal interference and early occlusal contact and the occlusal force distribution of patients with sleep bruxism is uneven.