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北京大学学报（医学版） ›› 2026, Vol. 58 ›› Issue (1): 133-138. doi: 10.19723/j.issn.1671-167X.2026.01.017

• 论著 • 上一篇    下一篇

牙列缺失种植覆盖义齿集中𬌗型的临床研究

刁畅1, 王时敏2, 李曼2, 潘韶霞1, 刘洋1,*()   

  1. 1. 北京大学口腔医学院·口腔医院修复科, 北京 100081
    2. 北京大学口腔医学院·口腔医院义齿加工中心, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 北京 100081
  • 收稿日期:2025-10-10 出版日期:2026-02-18 发布日期:2025-11-28
  • 通讯作者: 刘洋
  • 基金资助:
    国家自然科学基金(81600846); 北京大学口腔医院临床新技术新疗法项目(PKUSSNCT-23B08); 北京大学口腔医学院教育教学研究课题(2022-PT-02)

A clinical study on the centralized occlusal scheme for implant-supported overdentures in edentulous patients

Chang DIAO1, Shimin WANG2, Man LI2, Shaoxia PAN1, Yang LIU1,*()   

  1. 1. Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
    2. Denture Processing Center, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2025-10-10 Online:2026-02-18 Published:2025-11-28
  • Contact: Yang LIU
  • Supported by:
    the National Natural Science Foundation of China(81600846); the Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-23B08); the Education Research Project of Peking University School and Hospital of Stomatology(2022-PT-02)

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摘要：

目的: 针对种植覆盖义齿存在的支持中心与咬合负荷中心不匹配的问题, 尝试一种新型集中𬌗型设计, 充分利用下颌前部种植体和上颌骨尖牙支柱区的支持能力, 在尖牙区增加正中咬合接触, 评估新𬌗型的临床应用可行性。方法: 为5位无牙颌患者下颌前部植入2颗种植体, 制作传统𬌗型与新型集中𬌗型的下颌种植覆盖义齿和上颌总义齿。新𬌗型上颌尖牙参考前磨牙改形, 在保留其唇面轮廓与𬌗平衡基础上, 增加舌面窝形成正中咬合接触。通过双色胶姆糖法测定咀嚼效率, 数字化"虚拟咬合纸法"计算咬合接触面积, 同时对比患者主观满意度评分, 并结合三维有限元应力分析, 比较两种𬌗型的临床应用效果差异。结果: 与传统𬌗型相比, 集中𬌗型的咬合接触面积和咀嚼效率提升幅度分别为21.22% (17.48%, 26.01%) 和21.87% (17.51%, 24.18%), 咀嚼效率恢复至完整牙列的55.13% (43.73%, 59.09%)。患者主观评价显示, 集中𬌗型在总体满意度、发音、美观性等方面与传统𬌗型类似; 有限元分析显示, 集中𬌗型义齿将义齿承托区扩大到上颌尖牙区。结论: 本研究提出的新型集中𬌗型能够通过利用下颌前部种植体和上颌骨尖牙支柱的支持能力, 在维持义齿稳定、平衡、美观、发音和患者满意度等的同时, 提升咬合接触面积和咀嚼效率, 为种植覆盖义齿的𬌗型改进提供了新思路与初步的循证依据。

关键词: 种植覆盖义齿, ??型, 咀嚼效率

Abstract:

Objective: To address the mismatch between the support center and the occlusal load center in implant-supported overdentures, this study proposed a novel centralized occlusal scheme. This design aimed to utilize the supportive capacity of the anterior mandibular implants and the maxillary canine pillars by establishing occlusal contacts in the canine region. A preliminary evaluation of the clinical feasibility of this new occlusal scheme was conducted. Methods: In this study, five completely edentulous patients received two implants in the mandible. Each participant was provided with two complete prosthetic sets: mandibular implant-supported overdentures and corresponding complete maxillary dentures featuring either a conventional bilateral balanced occlusion or the novel centralized occlusal scheme, delivered in a randomized crossover sequence. For the new scheme, the maxillary canines were reshaped referencing the premolars, while preserving their labial contour and occlusal balance, the lingual fossa was modified to establish centric occlusal contacts. A comprehensive evaluation was conducted using standardized methods: chewing efficiency was measured using the two-color chewing gum method, occlusal contact area was calculated digitally using virtual articulating paper method, and patient satisfaction was assessed using validated questionnaires, and stress distribution patterns were examined through detailed three-dimensional finite element analysis. Results: Compared with the conventional occlusal scheme, the centralized occlusal scheme achieved M (P25, P75) improvements of 21.22% (17.48%, 26.01%) in occlusal contact area and 21.87% (17.51%, 24.18%) in masticatory efficiency, with the latter reaching 55.13% (43.73%, 59.09%) of the level observed in complete natural dentitions. Patient subjective evaluations indicated that the centralized scheme was comparable to the conventional scheme in terms of overall satisfaction, speech, and aesthetics. Finite element analysis revealed that the centralized scheme expanded the denture support area to the maxillary canine region. Conclusion: The proposed novel centralized occlusal scheme can enhance occlusal contact area and chewing efficiency by utilizing the support capacity of the anterior mandibular implants and the maxillary canine pillars, while maintaining denture stability, balance, aesthetics, and patient satisfaction. This study provides a new approach and preliminary evidence for improving the occlusal design of implant-supported overdentures.

Key words: Implant overdenture, Occlusal scheme, Masticatory efficiency

中图分类号: 

  • R783.6

图1

集中𬌗型全口义齿的咬合接触分析"

图2

集中𬌗型与传统𬌗型的咬合接触面积及咀嚼效率比较分析"

图3

集中𬌗型与传统𬌗型的三维有限元应力比较分析"

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ISSN 1671-167X
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