正畸联合固定义齿修复治疗成人内倾型深覆牙合伴重度磨耗疗效观察

Clinical Observation of Orthodontic Combined Fixed Denture in the Treatment of Adult Introversion Deep Overbite with Severe Wear

目的:探讨正畸联合不同咬合重建修复治疗成人内倾型深覆牙合伴重度磨耗的效果。方法:回顾性分析2021年12月-2022年12月沧州市人民医院收治的40例内倾型深覆牙合伴牙齿重度磨耗患者的临床资料,其中21例采用正畸联合固定义齿修复(A组),19例采用正畸联合牙合垫式可摘取局部义齿修复(B组)。对比两组的深覆牙合矫治效果,以及治疗前后的咀嚼效率、颞下颌关节功能变化、口腔功能及美学效果等。结果:治疗后1年,两组上前牙内收、下颌Spee氏曲线降低水平接近(P>0.05)。两组治疗后的咀嚼效率及咬合力显著提升,且A组咀嚼效率及咬合力水平更高(P<0.05)。与治疗前比较,两组治疗后的颞下颌关节功能各指标评分均下降(P<0.05),而两组对照显示各指标评分差异无统计学意义(P>0.05)。治疗后,两组的颞下颌前关节间隙较治疗前缩小,上关节间隙及后关节间隙均较治疗前增加(P<0.05),而两组的颞下颌前、上、后关节间隙接近(P>0.05)。A组治疗后的口腔功能(舒适度)及美学效果(美观度)均明显优于B组(P<0.05)。结论:正畸联合咬合重建修复能在矫正前牙深覆牙合的同时有效改善颞下颌关节功能和关节间隙,但固定义齿修复对咀嚼效率及咬合力的提升效果更好,且美观满意度及舒适度更高。

Objective To explore the effect of orthodontic combined with different occlusal reconstructions on the treatment of adult introverted deep overbite with severe wear.Methods Clinical data of 40 patients with introverted deep overbite and severe tooth admitted wear were retrospectively selected from December 2021 to December 2022 from Cangzhou People’s Hospital as the research subjects.21 cases among patients were treated with orthodontic combined fixed denture restoration(group A),and 19 cases were treated with orthodontic combined removable partial denture restoration(group B).The effectiveness of deep overbite correction,the changes in chewing function,temporomandibular joint function,oral function,and aesthetic effects before and after treatment were compared between two groups.Results The reduction levels of upper anterior tooth adduction and lower Spee's curve in the two groups after 1 year of treatment were similar(P>0.05).The chewing efficiency and bite force of group A and group B were significantly improved after treatment,and the comparison between groups showed that chewing efficiency and bite force of group A were higher(P<0.05).The temporomandibular joint function scores of the two groups after treatment were significantly reduced(P<0.05),and scores of the two groups were similar(P>0.05).The anterior temporomandibular joint space after treatment of the two groups decreased,and the upper and posterior joint spaces increased compared with before treatment(P<0.05).The temporomandibular anterior,superior,and posterior joint spaces of two groups were similar(P>0.05).The oral function(comfort)and aesthetic effect(aesthetics)after treatment of group A were clearly better than those of group B(P<0.05).Conclusion Orthodontic combined occlusal reconstruction can correct the deep overbite of the anterior teeth,while effectively improve the temporomandibular joint function and joint space.However,fixed denture repair has better effects on the improvement of masticatory function and bite force quotient.It has higher aesthetic satisfaction and comfort.