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正中咬合与最大牙尖交错位的关系及其在全口修复治疗中的应用:最佳证据共识声明。

The Relationship Between Centric Occlusion and The Maximal Intercuspal Position and Their Use as Treatment Positions for Complete Mouth Rehabilitation: Best Evidence Consensus Statement.

机构信息

Advanced Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, CA.

Prosthetic Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

出版信息

J Prosthodont. 2021 Apr;30(S1):26-33. doi: 10.1111/jopr.13316.

Abstract

PURPOSE

The purpose of this Best Evidence Consensus Statement was to evaluate the existing literature relative to two focus questions: How often does centric occlusion coincide with maximal intercuspal position in dentate and partially dentate populations?; and should centric occlusion or maximal intercuspal positions be equivalent for dentate and partially dentate patients undergoing complete mouth rehabilitation?

MATERIALS AND METHODS

Keywords used in the initial search were: intercuspal position, centric occlusion, centric relation, maximal intercuspal position, prosthodontic rehabilitation, and occlusion. The search was then limited to Systematic Reviews, Randomized Controlled Studies, Meta-analyses and Clinical Trials.

RESULTS

The initial search strategy related to the selected search terms resulted in more than 15,000 articles. When the subsequent search was limited to Systematic Reviews, Randomized Controlled Studies, and Meta-Analysis and Clinical Trials, 313 articles were selected for further analysis.

CONCLUSIONS

Review of the literature reveals that most dentate and partially dentate patients do not have coincident centric occlusion and maximal intercuspal position. There is support for coincidence between centric occlusion and maximal intercuspal position as the preferred occlusal relationship in complete mouth rehabilitations. The literature does not report conclusive evidence of adverse prosthodontic outcomes with complete rehabilitations in centric occlusion or maximal intercuspal position in a healthy population. However, there is support for an association between centric occlusion-maximal intercuspal position discrepancies and occlusal instability as well as temporomandibular joint disorders. Hence, it is concluded that partially and completely dentate patients requiring complete mouth rehabilitation should be restored in centric occlusion.

摘要

目的

本最佳证据共识声明的目的是评估与两个焦点问题相关的现有文献:在有牙和部分有牙人群中,中心咬合与最大正中关系位重合的频率是多少?;以及在接受全口修复的有牙和部分有牙患者中,中心咬合或最大正中关系位是否应该等同?

材料和方法

在初始搜索中使用的关键词是:正中关系位、中心咬合、正中关系、最大正中关系位、修复治疗和咬合。然后将搜索范围限制在系统评价、随机对照研究、荟萃分析和临床试验。

结果

最初的搜索策略与选定的搜索词相关,结果产生了超过 15000 篇文章。当随后的搜索仅限于系统评价、随机对照研究和荟萃分析和临床试验时,选择了 313 篇文章进行进一步分析。

结论

文献回顾表明,大多数有牙和部分有牙的患者的中心咬合和最大正中关系位并不重合。有证据支持中心咬合和最大正中关系位重合是全口修复的首选咬合关系。文献没有报告在健康人群中,全口修复时处于正中关系位或最大正中关系位的无牙颌患者会出现不良的修复体结果的结论性证据。然而,有证据表明,中心咬合-最大正中关系位差异与咬合不稳定以及颞下颌关节紊乱之间存在关联。因此,可以得出结论,需要全口修复的部分和完全有牙的患者应恢复到中心咬合位。

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