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[单侧短缩牙弓与可摘局部义齿修复治疗中咀嚼中枢的临床与生理评估]

[A clinical and physiological evaluation of masticatory center in unilateral shortened arch and RPD treatment].

作者信息

Toda S

机构信息

Department of Maxillofacial Rehabilitation, Faculty of Dentistry, Tokyo Medical and Dental University.

出版信息

Kokubyo Gakkai Zasshi. 1999 Jun;66(2):170-88. doi: 10.5357/koubyou.66.170.

DOI:10.5357/koubyou.66.170
PMID:10429408
Abstract

The purpose of this study was to elucidate the relation between distribution of occlusal contacts in unilateral shortened arch and prosthodontic treatment, those occlusal loads, coordinates of the points and amounts, in relation to masticatory musculature activities by EMG and Prescale. Occlusal contacts and loads were measured by extra-thin-layer of pressure indicator (Prescale Fuji Film Co.), with an exclusive analyzing computer system. Masticatory muscular EMG and occlusal contacts were recorded with Prescale at i.p. clenching. Ten bilateral shortened arch-cases were used as control and fifteen unilateral shortened dental arches were studied in periodically at pre- and post-RPD treatments. These data were analyzed and evaluated in those of the control group. These results were as follows: 1) The location of the occlusal load center in dentate mouth was about median line of the maxillar first molar region, but in unilateral shortened arch the load center was biased about one premolar breadth anteriorly and inclined toward remaining dentate side. 2) The center of supporting area of unilateral shortened arch edentation was biased toward the remaining side and slightly to incisal arch. 3) After wearing eligible designed RPD for over one year, in the unilateral edentate arch, the location of the load center was improved at the dentate arch, presuming physiological and functional recovery, and also activated masticatory musculatures. 4) The prosthodontic restoration for unilateral edentate cases (unilateral shortened arch) was quite effective in clinical and physiological stand points.

摘要

本研究的目的是阐明单侧短缩牙弓中咬合接触分布与修复治疗之间的关系,以及这些咬合负荷、点的坐标和量与通过肌电图(EMG)和压力感应片(Prescale)测量的咀嚼肌活动之间的关系。咬合接触和负荷通过压力指示片(Prescale富士胶片公司)的超薄层,使用专用分析计算机系统进行测量。在最大紧咬时,用压力感应片记录咀嚼肌肌电图和咬合接触。选取10例双侧短缩牙弓病例作为对照,对15例单侧短缩牙弓病例在可摘局部义齿(RPD)治疗前后进行定期研究。将这些数据与对照组的数据进行分析和评估。结果如下:1)有牙颌时咬合负荷中心的位置约在上颌第一磨牙区的中线处,但在单侧短缩牙弓中,负荷中心向前偏移约一个前磨牙宽度,并向剩余有牙侧倾斜。2)单侧短缩牙弓无牙区支撑面积的中心偏向剩余侧且略向切牙弓方向。3)佩戴设计合适的RPD一年以上后,在单侧无牙牙弓中,负荷中心的位置在有牙牙弓处得到改善,推测生理和功能得以恢复,同时咀嚼肌也被激活。4)单侧无牙病例(单侧短缩牙弓)的修复治疗在临床和生理方面都相当有效。

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