Int J Comput Dent. 2022 Mar 24;25(1):47-56.
Sufficient occlusion is a basic prerequisite for the functional efficiency of the occlusal surfaces. Exactly where and in what number the occlusal contacts in the posterior region should be present for this purpose is controversial. The present study investigated the number and location of occlusal contacts on posterior teeth without dental findings, ie, without caries or restorative restorations such as fillings, crowns, etc. Such natural posterior teeth were present in 709 subjects (males (m) = 446: 48.9 ± 13.04 years, females (f) = 283: 52.4 ± 14.23 years) of a subject collective of 1223 subjects (m = 648, f = 575) of the regional baseline study 'Study of Health in Pomerania 1' (SHIP-1). Silicone bite registrations in habitual intercuspation (IP) were evaluated, whereby the test persons were asked to fix the bite block with biting force without biting firmly. The registrations were scanned with a document scanner in incident and transmitted light; a calibration strip was used to determine the transparency threshold of a layer thickness of 20 μm, below and equal to which the transparent zone was considered as a contact or contact area. The Greifswald Digital Analyzing System 2 (GEDAS 2) software was used to determine the number and location of occlusal contact areas tooth by tooth. To define the localization of the contacts, a cross with two concentric circles symmetric to the longitudinal fissure was superimposed on the occlusal surface; this resulted in four inner and four outer quadrants. Thus, the number of pixels in occlusal contact areas per inner and outer quadrant could be determined. The image resolution was 300 dpi. On average (median), the premolars had two occlusal contacts each, the posterior teeth had four to five, and tooth 46 had six contacts. The right and left teeth did not differ in the frequency of occlusal contacts in the Mann-Whitney U test for independent samples. In the maxillary premolars, frequent contact areas were primarily located mesially on the inner and outer slopes of the palatal cusp. In the maxillary molars, the palatal slope of the distopalatal cusp and the inner slopes of the mesiopalatal and distopalatal cusps were frequently affected. On the mandibular premolars, the inner slopes of the buccal cusps and the buccal slope of the distobuccal cusp were particularly frequently addressed; in teeth 35 and 45, the buccal slope of the mesiobuccal cusp was also somewhat more frequently addressed. Teeth 36 and 46 frequently had contact areas on the buccal slope of the distobuccal cusp as well as on the inner slopes of the distal cusps (distobuccal and distolingual), whereas teeth 37 and 47 tended to behave similarly. Epidemiologically, the focus of the frequent contact areas on the respective supporting cusps of the maxillary and mandibular posterior teeth and a distribution of contacts stabilizing the tooth in its position in the dental arch through the interlocking were confirmed. It makes sense to take this into account when designing occlusal surfaces in the posterior region.
足够的咬合是咬合面功能效率的基本前提。为了达到这个目的,在后牙区域中应该存在多少个以及在何处存在咬合接触点,这是有争议的。本研究调查了在后牙区域中没有牙齿发现(即没有龋齿或填充体、牙冠等修复体)的情况下,后牙的咬合接触点的数量和位置。在“波美拉尼亚健康研究 1 号”(SHIP-1)的一个受试者总群体(共 1223 名受试者,男性(m)=648 名:48.9±13.04 岁,女性(f)=575 名:52.4±14.23 岁)中,709 名受试者(m=446 名:48.9±13.04 岁,f=283 名:52.4±14.23 岁)的后牙没有任何牙科发现,存在天然后牙。在习惯的咬合(IP)中进行硅橡胶咬合记录,要求测试者用咬合力固定咬合块,但不要用力咬紧。将记录用文档扫描仪以入射光和透射光进行扫描;使用校准条确定层厚为 20μm 的透明度阈值,在此之下和等于该透明度阈值的透明区域被认为是接触或接触区域。使用 Greifswald 数字分析系统 2(GEDAS 2)软件逐牙确定咬合接触区域的数量和位置。为了定义接触点的定位,在咬合面上叠加一个带有两个与纵裂对称的同心圆的十字,这产生了四个内象限和四个外象限。因此,可以确定每个内象限和外象限的咬合接触区域的像素数量。图像分辨率为 300dpi。平均而言(中位数),前磨牙每个有两个咬合接触点,后牙有四个到五个,46 号牙有六个接触点。在独立样本的曼-惠特尼 U 检验中,左右牙齿的咬合接触点频率没有差异。在上颌前磨牙中,频繁的接触区域主要位于腭尖的内斜和外斜面上。在上颌磨牙中,腭尖的远中颊斜面和近中颊尖、远中颊尖的内斜面上经常受到影响。在下颌前磨牙中,颊尖的内斜和远中颊尖的颊斜面特别频繁地被涉及;在 35 号牙和 45 号牙中,近中颊尖的颊斜面也稍微更频繁地被涉及。36 号牙和 46 号牙经常在远中颊尖的颊斜面和远中尖、远中舌尖的内斜面上有接触区域,而 37 号牙和 47 号牙的情况类似。从流行病学角度来看,上颌和下颌后牙的各个支持尖上频繁接触区域的分布以及通过互锁稳定牙齿在牙弓中的位置的接触点分布得到了证实。在设计后牙区域的咬合面时,考虑到这一点是有意义的。