van 't Spijker Arie, Kreulen Cees M, Creugers Nico H J
Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Clin Oral Implants Res. 2007 Jun;18 Suppl 3:117-26. doi: 10.1111/j.1600-0501.2007.01458.x.
Attrition and occlusal factors and masticatory function or dysfunction are thought to be related. This study aims to systematically review the literature on this topic with the emphasis to find evidence for occlusion-based treatment protocols for attrition.
Literature was searched using PubMed (1980 to 2/2006) and the Cochrane Library of Clinical Trials with the keywords 'tooth' and 'wear'. Five steps were followed. Exclusion was based on the following: (1) reviews, case-reports, studies on non-human tooth material, and studies not published in English and (2) historical or forensic studies. Included were (3) in vivo studies. Next, studies on (4) occlusal factors, function or dysfunction [temporomandibular disorders (TMD), bruxism], or intervention, and (5) attrition were included. Two investigators independently assessed the abstracts; measure of agreement was calculated using Cohen's kappa; disagreement was resolved by discussion. Full-text articles were obtained and correlation between outcomes on occlusal factors, (dys)function, treatment, and attrition were retrieved. References in the papers included in the final analysis were cross-matched with the original list of references to add references that met the inclusion criteria.
The search procedure revealed 1289 references on tooth wear. The numbers of included studies after each step were (1) 345 (kappa=0.8), (2) 287 (kappa=0.87), (3) 174 (kappa=0.99), (4) 81 (kappa=0.71), and (5) 27 (kappa=0.68). Hand searches through the reference lists revealed six additional papers to be included. Analysis of the 33 included papers failed to find sound evidence for recommending a certain occlusion-based treatment protocol above another in the management of attrition.
Some studies reported correlations between attrition and anterior spatial relationships. No studies were found suggesting that absent posterior support necessarily leads to increased attrition, though one study found that fewer number of teeth resulted in higher tooth wear index (on the remaining teeth). Attrition seems to be co-existent with self-reported bruxism. Reports on attrition and TMD signs and symptoms provide little understanding of the relationship between the two.
磨耗与咬合因素以及咀嚼功能或功能障碍被认为是相关的。本研究旨在系统回顾关于该主题的文献，重点是寻找基于咬合的磨耗治疗方案的证据。
使用PubMed（1980年至2006年2月）和Cochrane临床试验图书馆，以“牙齿”和“磨损”为关键词进行文献检索。遵循五个步骤。排除标准如下：（1）综述、病例报告、关于非人类牙齿材料的研究以及非英文发表的研究，以及（2）历史或法医研究。纳入的研究包括：（3）体内研究。接下来，纳入关于（4）咬合因素、功能或功能障碍[颞下颌关节紊乱病（TMD）、磨牙症]或干预措施，以及（5）磨耗的研究。两名研究者独立评估摘要；使用Cohen's kappa计算一致性测量值；通过讨论解决分歧。获取全文文章，并检索咬合因素、（功能）障碍、治疗与磨耗之间结果的相关性。对最终分析中纳入论文的参考文献与原始参考文献列表进行交叉核对，以添加符合纳入标准的参考文献。
检索过程共发现1289篇关于牙齿磨损的参考文献。每一步之后纳入研究的数量分别为：（1）345篇（kappa = 0.8），（2）287篇（kappa = 0.87），（3）174篇（kappa = 0.99），（4）81篇（kappa = 0.71），以及（5）27篇（kappa = 0.68）。通过参考文献列表的手工检索又发现6篇论文可纳入。对33篇纳入论文的分析未能找到充分证据来推荐一种基于咬合的治疗方案优于另一种用于磨耗的管理。
一些研究报告了磨耗与前牙空间关系之间的相关性。未发现有研究表明后牙支持缺失必然导致磨耗增加，不过有一项研究发现牙齿数量减少会导致更高的牙齿磨损指数（在剩余牙齿上）。磨耗似乎与自我报告的磨牙症并存。关于磨耗与TMD体征和症状的报告对两者之间的关系了解甚少。
