下颌偏斜患者髁突正中关系位与最大牙尖交错位三维位置不调的比较分析
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Comparative analysis of three dimensional position discrepancy of centric relation-maximum intercuspation in patients with mandibular deviation
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    摘要:

    目的:分析下颌偏斜患者髁突正中关系(centric relation,CR)位与最大牙尖交错(maximum intercuspation,MI)位不调的三维特征,探讨其对牙颌面畸形正畸治疗的影响。方法:随机选取下颌偏斜患者34例为试验组,非偏斜患者50例为对照组,再将试验组按有无颞下颌关节紊乱症分为2组。分别获取所有研究对象CR位、MI位时的咬合记录,记录CR位的干扰牙位,采用髁突移位测量仪测量CR位与MI位时髁突位置,比较干扰及CR-MI不调的比例、CR-MI在三维方向的偏移量并进行统计分析。结果:(1)干扰发生的比例在试验组、对照组分别为94.12%、72%,差异具有统计学意义( χ2=6.421,P=0.010)。2组的干扰均大多位于后牙区,分别占91.18%和68%;(2)CR-MI不调的比例在试验组为79.41%,对照组为12%,差异有统计学意义( χ2=38.59,P=0.000);(3)经统计学分析,试验组中下颌偏斜侧与非偏斜侧CR-MI不调的比例( χ2=0.167,P=0.687)、CR-MI垂直向偏移量(t=0.283,P=0.779)、CR-MI矢状向偏移量(t=-0.743,P=0.463)均无明显差异(P >0.05);有颞下颌关节紊乱症组与无症状组比较,其下颌偏斜量、CR-MI的偏移量等均无明显差异(P >0.05)。结论:下颌偏斜患者更易出现咬合干扰及CR-MI不调,故进行正畸治疗前有必要分析下颌偏斜患者CR-MI的一致性,在理想的颌位上确定正畸治疗方案。

    Abstract:

    Objective:To analyze the three dimensional characteristics of condylar position between centric relation(CR) and maximum intercuspation(MI) in patients with mandibular deviation and to discuss its influence on orthodontic treatments of dental maxillofa-cial deformities. Methods:Thirty-four patients with mandibular deviation were taken as experimental group and fifty patients with non-deviation as control group. Experimental group was then divided into two groups according to the existence of temporomandibular joint disorder(TMD). CR/MI occlusions and occlusal interferences of CR position were recorded respectively. Condylar positions of CR and MI were measured respectively by measures condyle displacement(MCD) and the proportion of occlusal interferences and CR-MI discrepancy,as well as the offset in condylar position between CR and MI in three dimensional direction were compared. Results:(1)Percentages of occlusion interferences in experimental and control group were 94.12% and 72% respectively with statistical differences(χ2=6.421,P=0.010) and the occlusion interferences of both groups were located at the posterior teeth,accounting for 91.18% and 68% respectively;(2)Percentages of CR-MI discrepancy in experimental and control group were 79.41% and 12.00% respectively( χ2=38.59,P=0.000);(3)In the experimental group,there was no significant difference in the percentage of CR-MI discrepancy( χ2=0.167,P=0.687) and the amount of displacement of CR-MI in vertical(t=0.283,P=0.779) or sagittal(t=-0.743,P=0.463) plane between deviated and non-deviated side(P >0.05). There was no significant difference in the amount of displacement of mandible and CR-MI discrepancy in three dimensional direction between TMD group and non-TMD group(P >0.05). Conclusions:Patients with mandibular deviation show a higher tendency to suffer occlusal interferences and CR-MI discrepancy,so it is necessary to analyze the consistency of CR-MI in patients with mandibular deviation and to make a treatment plan in the ideal position of jaw.

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董艳玲,陈 军,邓 锋,王 睿.下颌偏斜患者髁突正中关系位与最大牙尖交错位三维位置不调的比较分析[J].重庆医科大学学报,2014,38(4):561-565

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  • 在线发布日期: 2014-09-24
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