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评估所有乳磨牙预成金属冠修复后牙合及颞下颌关节的情况。

Assessment of occlusion and temporomandibular joint after placing preformed metal crowns on all primary molars in children.

机构信息

Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu, China.

出版信息

Int J Paediatr Dent. 2022 Nov;32(6):915-924. doi: 10.1111/ipd.12970. Epub 2022 May 18.

Abstract

BACKGROUND

Placing preformed metal crowns (PMCs) on all eight primary molars at one single clinical visit may disrupt a child's occlusion; the literature regarding the effects on occlusion and temporomandibular joint (TMJ) is scarce.

AIM

This study aimed to quantify the changes in occlusion using T-Scan III and to investigate whether there was TMJ dysfunction after placing eight PMCs at the same time.

DESIGN

In this study, we enrolled children with severe early childhood caries (S-ECC) and dental phobia, who needed eight PMCs to be placed under general anesthesia. The participants underwent occlusal examinations with a computed occlusal analysis system. The vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge, TMJ dysfunction signs were recorded by the clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using a questionnaire. The data were collected before treatment (T ), 1 week after treatment (T ), and 1 month (T ) and 3 months (T ) after treatment during follow-up visits. Repeated-measures analysis of variance and Friedman's test were used for occlusal data analysis. In addition, the Di and symptoms were compared over time using McNemar's test.

RESULTS

Forty patients (mean age = 4.25 ± 0.63 years, age range = 3-5 years, 21 boys and 19 girls) were followed up for 3 months. The occlusal contact area 3 months after treatment did not return to the pretreatment status (p = .03). The total of force at the 3-month follow-up visit increased significantly (p = .009) compared with that at the pretreatment. The asymmetric ratio of occlusal force at the 1-month follow-up visit was restored to pretreatment. Concerning the occlusion time, no significant changes were observed for any time intervals (p = .069). The VDO was recovered at the 1-month follow-up visit. The statistical analysis of TMJ dysfunction showed no significant differences in the Di and TMJ dysfunction symptoms before and after treatment (p > .05).

CONCLUSION

After undergoing eight PMC restorations under general anesthesia, occlusal re-equilibration was attained approximately after 1 month. There were no significant signs and symptoms of TMJ dysfunction after treatment.

摘要

背景

在一次临床就诊中为所有八颗乳磨牙放置预成型金属冠(PMC)可能会破坏儿童的咬合;关于咬合和颞下颌关节(TMJ)影响的文献很少。

目的

本研究旨在使用 T-Scan III 量化咬合变化,并研究同时放置八颗 PMC 是否会导致 TMJ 功能障碍。

设计

本研究纳入了患有严重幼儿期龋(S-ECC)和牙科恐惧症的儿童,他们需要在全身麻醉下放置八颗 PMC。参与者接受计算机咬合分析系统的咬合检查。使用牙科垂直距离计测量垂直咬合距离(VDO),通过临床功能障碍指数(Di)记录 TMJ 功能障碍迹象,通过问卷记录 TMJ 功能障碍症状。在治疗前(T0)、治疗后 1 周(T1)、治疗后 1 个月(T2)和 3 个月(T3)的随访期间收集数据。使用重复测量方差分析和 Friedman 检验进行咬合数据分析。此外,使用 McNemar 检验比较 Di 和症状随时间的变化。

结果

40 名患者(平均年龄 4.25 ± 0.63 岁,年龄范围 3-5 岁,21 名男孩和 19 名女孩)随访 3 个月。治疗后 3 个月的咬合接触面积未恢复到治疗前状态(p=0.03)。治疗后 3 个月的总受力明显增加(p=0.009)。治疗后 1 个月的咬合力不对称比恢复到治疗前水平。关于咬合时间,任何时间间隔都没有观察到明显变化(p=0.069)。VDO 在 1 个月的随访中得到恢复。TMJ 功能障碍的统计分析显示,治疗前后 Di 和 TMJ 功能障碍症状无显著差异(p>0.05)。

结论

全身麻醉下进行八颗 PMC 修复后,大约在 1 个月后达到咬合再平衡。治疗后无明显 TMJ 功能障碍迹象和症状。

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