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北京大学学报（医学版） ›› 2019, Vol. 51 ›› Issue (6): 1119-1123. doi: 10.19723/j.issn.1671-167X.2019.06.025

• 论著 • 上一篇    下一篇

后牙种植冠桥修复后局部咬合变化的定量分析

罗强1,丁茜2,张磊2,△(),谢秋菲2   

  1. 1. 中国人民解放军总医院口腔医学中心,北京　100853
    2. 北京大学口腔医学院·口腔医院,修复科　国家口腔疾病临床医学研究中心　口腔数字化医疗技术和材料国家工程实验室　口腔数字医学北京市重点实验室, 北京　100081
  • 收稿日期:2017-10-23 出版日期:2019-12-18 发布日期:2019-12-19
  • 通讯作者: 张磊 E-mail:drzhanglei@yeah.net
  • 基金资助:
    国家自然科学基金(81671026);首都卫生发展科研专项基金(2014-4-4105)

Quantitative analysis of occlusal changes in posterior partial fixed implant supported prostheses

Qiang LUO1,Qian DING2,Lei ZHANG2,△(),Qiu-fei XIE2   

  1. 1. Institute of Stomatology, General Hospital of Chinese PLA, Beijing 100853, China
    2. Department of Prosthodontics, Peking University School and Hospital 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:2017-10-23 Online:2019-12-18 Published:2019-12-19
  • Contact: Lei ZHANG E-mail:drzhanglei@yeah.net
  • Supported by:
    Supported by the National Natural Science Foundation of China(81671026);the Capital Health Development Research Special(2014-4-4105)

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摘要：

目的 定量分析后牙种植冠桥修复后局部咬合力与咬合接触的变化规律,为种植修复体的精确咬合设计、调整和维护提供参考。方法 按照一定的纳入和排除标准收集后牙区缺牙并行种植单冠或固定桥修复的患者,分别于修复后2周、3个月、6个月、12个月复查,采用咬合纸和T-Scan Ⅲ ?(Tekscan,South Boston,USA)电子咬合分析系统检查全牙列咬合接触情况,分别记录每个时间点对照牙、近中邻牙和种植修复体的咬合接触时间和咬合力百分比,分析局部咬合接触和咬合力随时间的变化。结果 共收集33例患者(男性16人,女性17人,年龄24~72岁)、37颗种植修复体,修复体戴用3~12个月(平均8.3个月)。2周到3个月,种植修复体达到咬合接触的时间显著缩短(P<0.05,Wilcoxon检验),种植修复体的咬合力百分比显著增大(P<0.05,Wilcoxon检验);3~6个月、6~12个月期间,咬合力百分比和咬合接触时间变化均不明显。2周时,种植修复体咬合力显著低于对照牙(P<0.01),而戴用3个月后种植修复体咬合力与对照牙差异已无统计学意义,6个月、12个月时差异均无统计学意义。结论 轻咬合接触和咬合接触时间延迟的后牙种植修复体,在修复后3个月咬合接触强度会明显增加,临床上种植修复后3个月复查时应重点关注咬合情况。

关键词: 牙修复体, 牙牙合, 牙种植, 调牙合

Abstract:

Objective: To analyze changes in occlusal force distribution and occlusal contact in poste-rior partial fixed implant-supported prostheses over time, and to provide reference for the precise occlusion design, adjustment and maintenance of implant prostheses.Methods: According to certain inclusion and exclusion criteria, patients were recruited from partially edentulous patients who had received implant-supported single crown or fixed bridge in the posterior region. The patients were collected since the implant prostheses settling and scheduled for the routine examination of implant prostheses and the occlusal examinations of complete dentition after 2 weeks, 3, 6, and 12 months. Occlusal examinations were taken with the articulating papers and T-Scan Ⅲ ? (Tekscan, South Boston, USA), which could check and measure the occlusal contact condition of complete dentition. The occlusion time and relative occlusal forces of implant prostheses, mesial adjacent teeth and control teeth were recorded at the same time.Results: Thirty-seven posterior partial fixed implant prostheses in 33 patients (17 women and 16 men, aged 24-70 years) were followed up for 3-12 months (average 8.3 months). At baseline, the relative occlusal forces of implant prostheses were significantly lower than those of the corresponding control teeth (P<0.001). However, after 3 months, the relative occlusal forces of implant prostheses had significantly increased (P<0.05), while control teeth decreased significantly (P<0.05), resulting in no statistical significance between them. The implant prostheses occlusion time ratio also increased significantly from 2 weeks to 3 months (P<0.05). There was no significant difference from the third month to the sixth month, or from the sixth month to the twelfth month (P>0.05).Conclusion: Light contact and time-delayed occlusion of posterior implant prostheses changes significantly in the first three months after settling implant prostheses. These changes mainly include the advance of the time point of the implant prosthesis to start the occlusion contact, and the increase of the occlusal force of the implant prosthesis. The occlusion of posterior implant prostheses should be carefully monitored at end of the third month follow-up clinically.

Key words: Dental prosthesis, Dental occlusion, Dental implantation, Occlusal adjustment

中图分类号: 

  • R783.3

图1

T-scan咬合检查操作(A),数字化咬合记录与咬合纸检查记录进行匹配校准(B)"

图2

从咬合开始到牙列咬合平衡稳定的时间序列"

表1

种植修复体和对照天然牙的咬合力百分比不同时间的对比"

Time points Implant
prostheses/%,
median (min, max)		 Control
natural teeth/%,
median (min, max)		 P
2 weeks (n=37) 7 (1, 18) 14 (3, 28) <0.001
3 months (n=27) 9 (1, 25) 11 (5, 24) 0.247
6 months (n=25) 9 (2, 25) 13 (3, 23) 0.156
12 months (n=14) 10 (3, 20) 14 (5, 28) 0.140

图3

种植修复体、近中邻牙、对照牙的咬合力百分比随时间纵向变化"

表2

种植修复体的咬合力百分比与种植修复体咬合时间比值的相关性"

Time points Implant prostheses relative occlusal force/%,
median (min, max)		 Implant occlusion time ratio,
median (min, max)		 R P
2 weeks (n=37) 7 (1, 18) 0.44 (0.08, 1.00) 0.447 0.006
3 months (n=27) 9 (1, 25) 0.64 (0.11, 1.00) 0.714 <0.001
6 months (n=25) 9 (2, 25) 0.70 (0.19, 0.96) 0.497 0.011
12 months (n=14) 10 (3, 20) 0.83 (0.22, 0.93) 0.113 0.700

图4

种植修复体咬合时间比的纵向变化"

[1] Zembic A, Kim S, Zwahlen M , et al. Systematic review of the survival rate and incidence of biologic, technical, and esthetic complications of single implant abutments supporting fixed prostheses[J]. Int J Oral Maxillofac Implants, 2014,29(Suppl):99-116.
[2] Velzen FJ, Ofec R, Schulten EA , et al. 10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: a prospective cohort study in 177 fully and partially edentulous patients[J]. Clin Oral Implants Res, 2015,26(10):1121-1128.
[3] Jung RE, Zembic A, Pjetursson BE , et al. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years[J]. Clin Oral Implants Res, 2012,23(Suppl 6):2-21.
[4] Lee JH, Lee JB, Park JI , et al. Mechanical complication rates and optimal horizontal distance of the most distally positioned implant-supported single crowns in the posterior region: a study with a mean follow-up of 3 years[J]. J Prosthodont, 2015,24(7):517-524.
[5] Anner R, Grossmann Y, Anner Y , et al. Smoking, diabetes mellitus, periodontitis, and supportive periodontal treatment as factors associated with dental implant survival: a long-term retrospective evaluation of patients followed for up to 10 years[J]. Implant Dent, 2010,19(1):57-64.
[6] Kim Y, Oh TJ, Misch CE , et al. Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale[J]. Clin Oral Implants Res, 2005,16(1):26-35.
[7] Goodacre CJ, Bernal G, Rungcharassaeng K , et al. Clinical complications with implants and implant prostheses[J]. J Prosthet Dent, 2003,90(2):121-132.
[8] Yuan JC, Sukotjo C . Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts[J]. J Periodontal Implant Sci, 2013,43(2):51-57.
[9] Bocklage R . Biomechanical aspects of monoblock implant bridges for the edentulous maxilla and mandible: concepts of occlusion and articulation[J]. Implant Dent, 2004,13(1):49-53.
[10] Kerstein RB . Nonsimultaneous tooth contact in combined implant and natural tooth occlusal schemes[J]. Pract Proced Aesthet Dent, 2001,13(9):751-755.
[11] Stevens CJ . Computerized occlusal implant management with the T-Scan II System: a case report[J]. Dent Today, 2006,25(2):88-91.
[12] Lewis MB, Klineberg I . Prosthodontic considerations designed to optimize outcomes for single-tooth implants. A review of the literature[J]. Aust Dent J, 2011,56(2):181-192.
[13] Roberts SD, Kapadia H, Greenlee G , et al. Midfacial and dental changes associated with nasal positive airway pressure in children with obstructive sleep apnea and craniofacial conditions[J]. J Clin Sleep Med, 2016,12(4):469-475.
[14] D’Incau E, Couture C, Maureille B . Human tooth wear in the past and the present: tribological mechanisms, scoring systems, dental and skeletal compensations[J]. Arch Oral Biol, 2012,57(3):214-229.
[15] Mundhe K, Jain V, Pruthi G , et al. Clinical study to evaluate the wear of natural enamel antagonist to zirconia and metal ceramic crowns[J]. J Prosthet Dent, 2015,114(3):358-365.
[16] Palaniappan S, Elsen L, Lijnen I , et al. Nanohybrid and microfilled hybrid versus conventional hybrid composite restorations: 5-year clinical wear performance[J]. Clinl Oral Investig, 2012,16(1):181-190.
[17] Heij DG, Opdebeeck H, van Steenberghe D, et al. Facial deve-lopment, continuous tooth eruption, and mesial drift as compromising factors for implant placement[J]. Int J Oral Maxillofac Implants, 2006,21(6):867-878.
[18] Schulte W . Implants and the periodontium[J]. Int Dent J, 1995,45(1):16-26.
[19] Kerstein RB, Radke J . Clinician accuracy when subjectively interpreting articulating paper markings[J]. Cranio, 2014,32(1):13-23.
[20] Koos B, Godt A, Schille C , et al. Precision of an instrumentation-based method of analyzing occlusion and its resulting distribution of forces in the dental arch[J]. J Orofac Orthop, 2010,71(6):403-410.
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ISSN 1671-167X
CN 11-4691/R
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