Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands.
Radboud University Medical Center, Department of Oral and Maxillofacial Surgery, 3D Facial Imaging Research Group, Nijmegen, The Netherlands.
J Dent. 2018 Jun;73:105-109. doi: 10.1016/j.jdent.2018.04.014. Epub 2018 Apr 22.
Evaluate the effect of a full rehabilitation, including an increase of vertical dimension of occlusion (VDO), in patients with severe tooth wear on changes in facial appearance.
Patients with severe tooth wear were restoratively treated using direct composite restorations, including an increase of the VDO. Before and one month after treatment 3D stereophotographs were taken and facial changes were measured with the use of 3D cephalometric landmarks. Cast models were used to determine the Tooth Wear Index (TWI) and the VDO-increase. The Orofacial Esthetic Scale-questionnaire was used to evaluate subjective happiness with appearance. Paired Student's t-tests were used to evaluate the changes after full rehabilitation. The relation between the facial changes, VDO-increment and TWI-score were analyzed using multiple regression models (p < 0.05).
44 Patients (35 men, 9 women, mean age: 38.2 ± 7.1 y) participated in this study. Mean TWI-score at baseline was 3.3 ± 0.5 and the mean increase in VDO was 1.6 ± 0.9 mm. Lower face height increased by 1.9 mm (p ≤ 0.001). Patients reported a significant improvement in orofacial appearance: OES-summary score of 34.3 ± 11.2 before and 59.9 ± 6.8 one month after treatment (p < 0.001). The increase of VDO resulted in an increase in Lower Face Height (p ≤ 0.002), whereas the TWI-score at baseline had no effect on the facial changes. The applied increase in VDO and TWI-score were not related to changes in OES-scores.
A full rehabilitation with an increase in VDO resulted in objective differences in facial height as measured with 3D stereophotogrammetry.
In patients with severe tooth wear, receiving a full rehabilitation including an increase in vertical dimension of occlusion, an objectively change will occur in the Lower facial height, but this effect will be subjectively judged as a positive change.
评估全修复治疗（包括增加垂直向颌位）对重度磨耗患者面部外观变化的影响。
采用直接复合树脂修复治疗重度磨耗患者，包括增加垂直向颌位。治疗前和治疗后 1 个月分别拍摄 3D 立体照片，并使用 3D 头影测量标志点测量面部变化。使用Cast 模型确定牙磨损指数（TWI）和垂直向颌位增加量。使用 Orofacial Esthetic Scale 问卷评估患者对外观的主观满意度。采用配对学生 t 检验评估全修复治疗后的变化。采用多元回归模型分析面部变化、垂直向颌位增加量和 TWI 评分之间的关系（p＜0.05）。
本研究共纳入 44 例患者（35 名男性，9 名女性；平均年龄：38.2±7.1 岁）。基线时 TWI 评分的平均值为 3.3±0.5，垂直向颌位增加量的平均值为 1.6±0.9mm。下面高增加了 1.9mm（p≤0.001）。患者报告称他们的口颌面部外观有显著改善：治疗前 OES 综合评分为 34.3±11.2，治疗后 1 个月为 59.9±6.8（p＜0.001）。垂直向颌位的增加导致下面高增加（p≤0.002），而基线时的 TWI 评分对面部变化没有影响。应用的垂直向颌位增加量和 TWI 评分与 OES 评分的变化无关。
全修复治疗（包括增加垂直向颌位）可导致 3D 立体摄影测量的面部高度出现客观差异。
在重度磨耗的患者中，接受全修复治疗（包括增加垂直向颌位）后，下面高会发生客观变化，但这种变化会被主观判断为积极变化。
