Adaption of the condyle position of patients with extensive tooth wear during occlusal rehabilitation

目的 探讨牙齿重度磨耗患者咬合重建中髁突位置的调整过程及垂直距离的改变与髁突位置变化之间的关系.方法 选择27例牙齿重度磨耗患者进行咬合重建修复.分别于修复前、过渡修复1个月及永久修复1个月后拍摄颞下颌关节许勒位X线片,并测量颞下颌关节上、前、后间隙.结果 重度磨耗患者修复前关节上、前、后间隙分别为(3.24±0.16)、(2.06±0.11)、(1.89±0.13)mm;过渡修复后分别为(3.61±0.15)、(1.94±0.10)、(2.52±0.11)mm;永久修复后分别为(3.49±0.19)、(1.93±0.10)、(2.40±0.13)mm.过渡修复及永久修复后关节后间隙与修复前的差异均有统计学意义(P<0.01);过渡修复后关节上间隙与修复前的差异有统计学意义(P<0.05).过渡修复后及永久修复后垂直距离改变量与关节上、前、后间隙的变化量均无明显相关性(P>0.05).结论 对牙齿重度磨耗的患者进行咬合重建修复,建立合适的颌位关系后,髁突在关节窝内的位置也发生相应调整.To evaluate the adoption of the condyle position of patients with extensive tooth wear during occlusal rehabilitation, and the correlation between increased vertical dimensions and the changes of joint spaces.Twenty-seven patients (five from Beifang hospital, others from Peking University School and Hospital of Stomatology) with extensive tooth wear were selected and received occlusal rehabilitation treatment. The radiographs of standard Schüllers position were taken before treatment (stage 1), 1 month following delivery of temporary restoration (stage 2), and 1 month following delivery of permanent restoration (stage 3).The superior, anterior and posterior joint spaces were (3.24 ± 0.16), (2.06 ± 0.11), (1.89 ± 0.13) mm at stage 1; (3.61 ± 0.15), (1.94 ± 0.10), (2.52 ± 0.11) mm at stage 2; (3.49 ± 0.19), (1.93 ± 0.10), (2.40 ± 0.13) mm at stage 3. The posterior joint spaces at stage 2 and stage 3 were significantly larger than that at stage 1(P < 0.01). The superior spaces at stage 2 were significantly larger than that at stage 1 (P < 0.05). No correlations between the increased vertical dimensions and the changes of joint spaces were found in the three stages (P > 0.05).The condyle positions in the patients with extensive tooth wear changed after occlusal rehabilitation.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)05297-2994