Goldstein Gary, Kapadia Yash, Campbell Stephen
New York University, New York, NY.
Detroit Mercy Dental, Detroit, MI.
J Prosthodont. 2021 Apr;30(S1):72-77. doi: 10.1111/jopr.13309.
The occlusal scheme required for an edentulous patient is controversial. The purpose of this Best Evidence Consensus Statement was to evaluate the existing complete denture literature related to occlusal schemes.
A literature search was limited to Meta-analyses, Systematic Reviews (SR), Randomized Controlled Studies (RCT) and Clinical Trials. Key Words were: Complete dentures, occlusion, harm; Complete dentures, occlusion alveolar bone loss; Complete dentures, occlusion, stability; Complete dentures, occlusion. Additional related articles were culled from the authors' library and reference lists in the articles found in the PubMed searches.
Of the 165 articles that met the initial search criteria, 34 related to the focus questions and were evaluated and rated.
There is strong support that the average denture patient, with good residual ridges and no neuromuscular problems, will function adequately with a properly fabricated complete denture regardless of the occlusal scheme. There is neither strong support for or against bilateral balanced occlusal schemes as it relates to patient satisfaction, preference or chewing ability. There is some support for increased alveolar bone loss with complete dentures that have a non-balanced occlusion. There is a need for bilateral balanced occlusal schemes for patients presenting with loss of stability and retention as a result of their presenting conditions (PDI III and IV).
无牙颌患者所需的咬合方案存在争议。本最佳证据共识声明的目的是评估与咬合方案相关的现有全口义齿文献。
文献检索仅限于Meta分析、系统评价（SR）、随机对照研究（RCT）和临床试验。关键词为：全口义齿、咬合、危害；全口义齿、咬合与牙槽骨吸收；全口义齿、咬合、稳定性；全口义齿、咬合。其他相关文章从作者的图书馆以及在PubMed搜索中找到的文章的参考文献列表中筛选而来。
在符合初始检索标准的165篇文章中，34篇与重点问题相关，并进行了评估和评级。
有充分证据表明，对于平均水平的义齿患者，若剩余牙槽嵴状况良好且无神经肌肉问题，无论采用何种咬合方案，制作精良的全口义齿都能使其功能良好。在患者满意度、偏好或咀嚼能力方面，对于双侧平衡咬合方案既没有有力的支持证据，也没有有力的反对证据。有一些证据支持，采用非平衡咬合的全口义齿会导致牙槽骨吸收增加。对于因自身状况（义齿性口炎III级和IV级）而出现稳定性和固位丧失的患者，需要采用双侧平衡咬合方案。
