Craddock H L, Youngson C C
Lecturer in Restorative Dentistry, Division of Restorative Dentistry, Leeds Dental Institute, The Worsley Building, Clarendon Way, Leeds LS2 9LU.
Br Dent J. 2004 Mar 27;196(6):341-8; discussion 337. doi: 10.1038/sj.bdj.4811082.
To determine the incidence and extent of overeruption in unopposed posterior teeth; to determine the incidence of occlusal interferences associated with unopposed posterior teeth; and to detect an association between the extent of overeruption and the presence of occlusal interference.
The study was a single centre clinical retrospective analysis. Setting The setting was in the Combined Care Clinic of Leeds Dental Institute. The patients were undergoing routine restorative care by final year undergraduate dental students during 2000.
All patients over18 years of age with one or more unopposed posterior tooth, were invited to participate. A sample group of 120 subjects were recruited. A clinical occlusal examination was carried out and the presence of initial retruded contact position (RCP) contacts and excursive interferences were recorded. Study models were made and digitally scanned.
Measurements of overeruption from the curve of Spee were made from the images obtained, by a single observer. Reliability of the measurements was assessed by means of a Bland Altman Plot. The presence and site of RCP contacts and excursive interferences were recorded by a single observer. Reliability of the measurements was assessed by means of Kappa scores. The association between overeruption and the presence of occlusal interference was examined using Spearmans Correlation Coefficient.
A total of 120 subjects were recruited, with a total of 155 unopposed sites. Eighty-one of the sites belonged to male subjects, 74 to female subjects. The mean age of the group was 50.9 years, Standard deviation 13.9 Eighty-three per cent of sites displayed overeruption (95% CI 78-90), ranging from under 0.5 mm to 5.4 mm. The reliability of the observations was found to be good. A total of 51.6% (95% CI 44-60) of unopposed teeth were involved in RCP contacts or excursive interferences. Thirty-two sites were involved in more than one contact or interference. The intra-examiner agreement was found to be good, using Kappa. The findings of the Spearman's correlation, show that if an association exists between overeruption and occlusal interference, it is weak, and of no statistical significance.
Eighty-three per cent of unopposed teeth are likely to overerupt, and the extent of the overeruption may be marked. The incidence and extent of overeruption is of clinical significance, not only in terms of treatment planning to prevent undesirable vertical movement, but also in the restoration of the edentulous space. The reliability of observations made in the study was found to be good, justifying the methodology. Fifty-one point six per cent of unopposed teeth are likely to be involved in RCP contacts or excursive interferences. The incidence is of clinical significance when planning the restoration of unopposed teeth, or the associated edentulous space. Only a weak statistical association was demonstrated between the degree of overeruption and the presence of occlusal interferences.
确定无对颌后牙的过长萌出发生率及程度；确定与无对颌后牙相关的咬合干扰发生率；并检测过长萌出程度与咬合干扰存在之间的关联。
本研究为单中心临床回顾性分析。地点：研究地点为利兹牙科研究所综合护理诊所。患者于2000年由牙科本科最后一年的学生进行常规修复治疗。
邀请所有年龄超过18岁且有一颗或多颗无对颌后牙的患者参与。招募了120名受试者组成样本组。进行了临床咬合检查，并记录了初始后退接触位（RCP）接触和前伸干扰的存在情况。制作了研究模型并进行数字化扫描。
由一名观察者根据获得的图像测量Spee曲线的过长萌出情况。通过Bland Altman图评估测量的可靠性。由一名观察者记录RCP接触和前伸干扰的存在情况及部位。通过Kappa评分评估测量的可靠性。使用Spearman相关系数检验过长萌出与咬合干扰存在之间的关联。
共招募了１２０名受试者，共有１５５个无对颌部位。其中81个部位属于男性受试者，74个属于女性受试者。该组的平均年龄为50.9岁，标准差为13.9。83%的部位出现过长萌出（95%可信区间78 - 90），范围从不足0.5毫米到5.4毫米。观察的可靠性良好。共有51.6%（95%可信区间44 - 60）的无对颌牙参与了RCP接触或前伸干扰。32个部位涉及不止一处接触或干扰。使用Kappa检验发现检查者内一致性良好。Spearman相关性的结果表明，即使过长萌出与咬合干扰之间存在关联，也是微弱的，且无统计学意义。
83%的无对颌牙可能会过长萌出，且过长萌出的程度可能较为明显。过长萌出的发生率及程度具有临床意义，不仅在制定预防不良垂直移动的治疗计划方面，而且在无牙间隙的修复方面。本研究中观察的可靠性良好，证明了该方法的合理性。51.6%的无对颌牙可能会参与RCP接触或前伸干扰。在计划无对颌牙或相关无牙间隙的修复时，该发生率具有临床意义。过长萌出程度与咬合干扰的存在之间仅显示出微弱的统计学关联。
