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即刻种植即刻负载全口固定义齿修复后对颞下颌关节形态改变的锥形束 CT 研究。

A CBCT study of changes in temporomandibular joint morphology with immediate implant placement and immediate loaded full-arch fixed dental prostheses.

机构信息

Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University, Hangzhou, 310009, China.

International School of Medicine, Zhejiang University, Yiwu, 322000, China.

出版信息

BMC Oral Health. 2024 Nov 16;24(1):1392. doi: 10.1186/s12903-024-05187-5.

Abstract

BACKGROUND

Dental implants are becoming a popular treatment of choice. Immediate implant placement with immediate loaded full-arch fixed dental prostheses (IPILFFDP) presents an attractive solution for edentulous and partially edentulous patients because of its high success rate, reduction in overall treatment time, and improved esthetics. However, whether it can minimize the risk of temporomandibular disorder (TMD) has not been previously studied.

OBJECTIVE

To quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT).

METHODS

Twelve participants without TMJ symptoms undergoing IPILFFDP were included in the study. Preoperative and 1-year postoperative assessment of CBCT scans were performed on 18 items related to TMJ and vertical dimensions. Mimics software was used for data analysis. T-test, Pearson, and Spearman correlation analyses were performed.

RESULTS

There were no significant differences in bilateral joints between pre and post IPILFFDP. Compared with pre-treatment CBCT, post-treatment CBCT showed a significant increase in posterior joint space. There was an approximately 2 mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space.

CONCLUSIONS

For patients without TMJ-related signs and symptoms, the IPILFFDP could keep the neuromuscular memory of patient's facial muscles and occlusion, and use adapted centric posture as a guide, which led to more precise restoration of the original jaw position and may shed light in future related clinical studies.

摘要

背景

种植牙正成为一种流行的治疗选择。对于无牙和部分缺牙患者,即刻种植即刻负重全口固定义齿(IPILFFDP)具有较高的成功率、缩短整体治疗时间和改善美观等优点,因此成为一种有吸引力的解决方案。然而,它是否能最大限度地降低颞下颌关节紊乱(TMD)的风险尚未得到研究。

目的

使用锥形束计算机断层扫描(CBCT)定量评估 IPILFFDP 前后颞下颌关节(TMJ)的形态变化。

方法

本研究纳入了 12 名无 TMJ 症状且接受 IPILFFDP 的参与者。对 18 项与 TMJ 和垂直维度相关的项目进行术前和术后 1 年的 CBCT 扫描评估。使用 Mimics 软件进行数据分析。进行了 T 检验、Pearson 和 Spearman 相关性分析。

结果

双侧关节在 IPILFFDP 前后均无显著差异。与治疗前 CBCT 相比,治疗后 CBCT 显示后关节间隙明显增加。IPILFFDP 后垂直维度增加了约 2mm,这与内侧关节间隙的增加有关。

结论

对于无 TMJ 相关体征和症状的患者,IPILFFDP 可以保持患者面部肌肉和咬合的神经肌肉记忆,并使用适应性的正中位作为指导,从而更精确地恢复原有的颌位,这可能为未来的相关临床研究提供启示。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/734d/11569609/58766a24ff07/12903_2024_5187_Fig1_HTML.jpg

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