Strajnić Ljiljana, Sinobad Darinka Stanisić
Klinika za stomatologiju Vojvodine, Medicinski fakultet, Novi Sad.
Med Pregl. 2012 May-Jun;65(5-6):217-22. doi: 10.2298/mpns1206217s.
Optimal reconstruction of vertical dimension of occlusion is crucial for functional and physiognomic rehabilitation of edentulous patients. This article is aimed at presenting attitudes and studies on application of cephalometric analysis in obtaining optimal vertical dimension of occlusion. The review of literature presents the studies which analyse the possibilities of cephalometric analysis aimed at improving the clinical methods for vertical dimension of occlusion determination in treatment of edentulous patients. The research carried out so far can roughly be divided into: cephalometric vertical dimension of occlusion evaluation in dentulous patients performed to determine precise indicators of vertical dimension of occlusion and to establish cephalometric standards for practical application in prosthodontics; the method of producing pre-extraction cephalometric registries involves the production of cephalometric radiographs for potential prosthodontic patients in dental pre-extraction period which are kept for reference to be used in later therapy; the cephalometric method of registering the position of physiologic rest position of the mandible involves measuring cephalometric parameters in cephalometric radiographs made when the mandible is in physiologic rest position; cephalometric evaluation of vertical dimension of occlusion in complete denture therapy after clinical determination of intemaxillary relationship is recommended for timely detection of possible mistakes, with a possibility of correction in the process of complete denture production; and cephalometric analysis in edentulous patients with old complete dentures for a planned vertical dimension of occlusion extension.
Data from the literature give no proof of a scientific and universally accepted method for precise determination of vertical dimension of occlusion, which is a point many authors agree upon. Different methods proposed for vertical dimension of occlusion determination in everyday practice are usually recommended in combination with other methods. Determination of individual, morphological vertical dimension of occlusion indicators by cephalometric analysis is, in this sense, one of the directions for finding a better solution when planning an artificial occlusion complex.
咬合垂直距离的最佳重建对于无牙患者的功能和容貌康复至关重要。本文旨在阐述对头影测量分析在获取最佳咬合垂直距离中的应用所持的观点及相关研究。文献综述展示了一些研究,这些研究分析了头影测量分析的可能性,目的是改进在无牙患者治疗中确定咬合垂直距离的临床方法。迄今为止开展的研究大致可分为:对有牙患者进行咬合垂直距离的头影测量评估,以确定咬合垂直距离的精确指标,并建立在口腔修复学实际应用中的头影测量标准;制作拔牙前头影测量记录的方法,即针对可能需要进行口腔修复的患者在拔牙前阶段拍摄头影测量X线片,留存以供后续治疗参考;记录下颌生理休息位位置的头影测量方法,即在头影测量X线片上测量下颌处于生理休息位时的头影测量参数;在临床确定颌间关系后,对头影测量在全口义齿治疗中咬合垂直距离进行评估,以便及时发现可能的错误,并在全口义齿制作过程中进行纠正;以及对佩戴旧全口义齿的无牙患者进行头影测量分析,以计划咬合垂直距离的扩展。
文献数据并未证明存在一种科学且被普遍接受的精确确定咬合垂直距离的方法,这一点许多作者都表示认同。在日常实践中,为确定咬合垂直距离而提出的不同方法通常建议与其他方法结合使用。从这个意义上讲,通过头影测量分析确定个体形态学的咬合垂直距离指标,是在规划人工咬合复合体时寻求更好解决方案的方向之一。