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双侧平衡咬合(BBO)与尖牙引导咬合(CGO)在全口义齿患者中的前瞻性临床研究。

Prospective clinical study of bilateral balanced occlusion (BBO) versus canine-guided occlusion (CGO) in complete denture wearers.

机构信息

Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University Frankfurt, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt, Germany.

Department of Prosthodontics, School of Dentistry, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

出版信息

Clin Oral Investig. 2019 Nov;23(11):4181-4188. doi: 10.1007/s00784-019-02857-5. Epub 2019 Feb 22.

Abstract

OBJECTIVES

Previous studies have often discussed occlusal concepts for complete dentures without formulating a recommendation. Various options are available, the most common ones being canine-guided occlusion (CGO) and bilateral balanced occlusion (BBO). We designed a prospective randomized study to compare these two schemes with the goal of formulating a recommendation.

MATERIALS AND METHODS

Forty patients could be evaluated. In a crossover design, they were randomized to a CGO>BBO group and a BBO>CGO group, each starting out by wearing their dentures with the first occlusal scheme for 3 months, followed by a first investigator- and patient-centered assessment. Then, each patient was transitioned to the other occlusal scheme by replacing the denture setup in the dental laboratory, followed by another 3 months of intraoral use and a second assessment. Wilcoxon-Mann-Whitney and marginal homogeneity tests were used for statistical analysis.

RESULTS

All statistically significant differences favored the CGO concept. Based on patient ratings, the CGO>BBO group preferred its esthetics (p = 0.02) and the BBO>CGO group its mandibular retention (p = 0.05), phonetics (p = 0.03), and masticatory function (p = 0.01). Based on investigator assessments, maxillary denture retention was found to significantly improve among the BBO>CGO patients after transition to CGO (p = 0.01).

CONCLUSIONS

Within the limitations of this study, canine guidance can be recommended as a comfortable alternative to bilateral balanced occlusion for complete dentures.

CLINICAL RELEVANCE

This recommendation can reduce the time requirements for the fabrication of complete dentures in dental laboratories.

摘要

目的

之前的研究经常讨论全口义齿的咬合概念,但没有提出建议。有各种选择,最常见的是尖牙引导咬合(CGO)和双侧平衡咬合(BBO)。我们设计了一项前瞻性随机研究,以比较这两种方案,旨在提出建议。

材料和方法

可评估 40 名患者。在交叉设计中,他们被随机分为 CGO>BBO 组和 BBO>CGO 组,每组患者首先佩戴第一套咬合方案的义齿 3 个月,然后进行第一次由调查员和患者共同评估。然后,通过在牙科实验室更换义齿设置,每位患者过渡到另一种咬合方案,再进行 3 个月的口腔内使用和第二次评估。使用 Wilcoxon-Mann-Whitney 和边际同质性检验进行统计学分析。

结果

所有具有统计学意义的差异都倾向于 CGO 概念。根据患者的评分,CGO>BBO 组更喜欢其美观(p=0.02),BBO>CGO 组更喜欢其下颌的固位(p=0.05)、发音(p=0.03)和咀嚼功能(p=0.01)。根据调查员评估,在过渡到 CGO 后,BBO>CGO 患者的上颌义齿固位显著改善(p=0.01)。

结论

在本研究的限制范围内,可以推荐尖牙引导作为全口义齿双侧平衡咬合的舒适替代方案。

临床意义

这种建议可以减少牙科实验室制作全口义齿的时间要求。

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