不同咬合重建方式对牙齿重度磨耗伴牙列缺损患者咀嚼效能及美观满意度的影响

Effects of Different Occlusal Reconstruction Methods on Chewing Efficiency and Aesthetic Satisfaction of Patients with Severe Tooth Abrasion and Dentition Defect

目的:探究不同咬合重建方式治疗牙齿重度磨耗伴牙列缺损的效果。方法:选取笔者医院2016年1月-2019年1月牙齿重度磨耗伴牙列缺损的84例患者为研究对象,按照随机数字表法分为两组,每组42例。牙合垫式义齿组采用牙合垫式可摘局部义齿修复治疗,固定义齿组采取固定义齿修复治疗。比较两组治疗前、治疗1个月后、治疗1年后咀嚼效能、颞下颌关节功能[下颌关节紊乱指数(CMI)、颞下颌关节功能障碍指数(DI)、肌肉压痛指数(PI)]、关节间隙(前、上、后间隙),统计两组美观满意度、舒适度及不良事件发生率。结果:治疗1个月、1年后,两组咀嚼效能均高于治疗前,且固定义齿组高于牙合垫式义齿组(P<0.05);两组治疗1个月、1年后CMI、DI、PI均低于治疗前,前间隙小于治疗前,上间隙、后间隙大于治疗前(P<0.05),但组间比较差异无统计学意义(P>0.05);固定义齿组美观满意度、舒适度评分高于牙合垫式义齿组,固定义齿组基牙继发龋、食物嵌塞发生率低于牙合垫式义齿组,差异均有统计学意义(均P<0.05)。结论:牙合垫式可摘局部义齿修复、固定义齿修复均能显著改善颞下颌关节功能及关节间隙,但固定义齿修复在提高咀嚼效能方面效果更佳,且基牙继发龋、食物嵌塞发生率低,美观满意度、舒适度高,为牙齿重度磨耗伴牙列缺损患者进行咬合重建的有效方式。

Objective To explore the effect of different occlusal reconstruction methods in the treatment of severe tooth abrasion with dentition defects.Methods A total of 84 patients with severe dental attrition and dentition defects in author hospital from January 2016 to January 2019 were selected as the research objects.They were divided into 2 groups according to the random number table method,with 42 cases in each group.The occlusion cushion removable partial denture was repaired by the occlusion cushion denture group,and fixed denture group took solid denture repair treatment.The chewing performance,temporomandibular joint function[mandibular joint disorder index (CMI),temporomandibular joint dysfunction index (DI),muscle pres-sure pain index (PI)],joint space (anterior,superior and posterior space) before treatment,after 1 month of treatment,and after 1 year of treatment in the two groups were compared.The aesthetic satisfaction,comfort,and incidence of adverse events of the two groups were counted.Results After 1 month and 1 year of treatment,the chewing efficiency of the two groups was higher than before treatment,moreover,the fixed denture group was higher than the occlusion cushion denture group (P<0.05);after 1 month and 1 year of treatment,CMI,DI and PI of the two groups were lower than before treatment,the anterior gap was less than before treatment,and the upper gap and posterior gap were greater than before treatment (P<0.05),there was no statistically significant difference between the groups(P>0.05),the aesthetic satisfaction and comfort score of the fixed-definition tooth group were higher than that of the occlusion cushion denture group,the incidence of secondary caries and food impaction on the abutment of the fixed tooth group was lower than that of the occlusal cushion denture group (P<0.05).Conclusion Occlusion cushion removable partial denture repair,and fixed denture repair can significantly improve the function and joint space of the temporomandibular joint.However,the fixed tooth restoration has a better effect in improving chewing efficiency,moreover,the incidence of secondary caries in abutment teeth is low,aesthetic satisfaction and comfort are high,which is an effective way to perform occlusal reconstruction for patients with severe tooth wear and dentition defects.