Arakawa Y, Yamaguchi H
Arakawa Orthodontic, Tokyo, Japan.
Cranio. 1997 Jul;15(3):208-20. doi: 10.1080/08869634.1997.11746014.
Orthodontic models hand-articulated into maximum intercuspation of 720 untreated subjects were evaluated by 17 criteria for grading an ideal anatomic occlusion including good dental interdigitation and alignments. Of the 720 subjects screened, the best 17 subjects were divided into three groups that contained 11 near ideal occlusions scored with 92-98%, three lower evaluated occlusions scored with 86-88% and three near ideal occlusions with TM signs or symptoms scored with 90-94%. Border and chewing movements were recorded using incisor tracking instrument (Visitrainer, model 3). Border movements in asymptomatic subjects demonstrated a well-defined intercuspal position, smooth and equal lateral excursions, and straight opening/closing movements. However, one subject with pain of right joint recorded an inconsistent intercuspal position, restricted excursions and a deviated path corresponding to a reciprocal click in opening/closing movements. Chewing movements in asymptomatic subjects with near ideal occlusion demonstrated either no or a lower rate of opening gliding tooth contact along the lateral border movement on non-working side, and a higher rate of closing gliding tooth contact along border movement on the working side. Chewing movements in symptomatic subjects with near ideal occlusion showed opening and closing without gliding along the lateral excursions, and closing point was inconsistent with maximum intercuspal position in the pain subject. In examining these near ideal occlusion subjects, the different characteristic chewing and border movements were defined for subjects with and without TM symptoms, respectively. Asymptomatic subjects with near ideal occlusion and lower evaluated occlusion showed almost the same chewing function. The goal of orthodontic treatment might be anatomic ideal occlusion with good chewing and border movements indicated in this study.
通过17项评估理想解剖学咬合的标准，对720名未经治疗的受试者手工铰接至最大牙尖交错位的正畸模型进行评估，这些标准包括良好的牙列交错和排列。在筛选的720名受试者中，最佳的17名受试者被分为三组，其中11名接近理想咬合的受试者得分在92%-98%之间，三名评估较低的咬合受试者得分在86%-88%之间，三名有颞下颌关节（TM）体征或症状的接近理想咬合受试者得分在90%-94%之间。使用切牙追踪仪（Visitrainer，型号3）记录边缘运动和咀嚼运动。无症状受试者的边缘运动显示出明确的牙尖交错位、平滑且相等的侧方移动以及直线的开闭运动。然而，一名右侧关节疼痛的受试者记录到牙尖交错位不一致、移动受限以及与开闭运动中相互弹响相对应的路径偏差。接近理想咬合的无症状受试者的咀嚼运动显示，在非工作侧沿着侧方边缘运动时，开口滑动牙接触的发生率为无或较低，而在工作侧沿着边缘运动时，闭口滑动牙接触的发生率较高。有接近理想咬合的有症状受试者的咀嚼运动显示，在侧方移动时开闭均无滑动，且疼痛受试者的闭口点与最大牙尖交错位不一致。在检查这些接近理想咬合的受试者时，分别为有和没有TM症状的受试者定义了不同特征的咀嚼和边缘运动。接近理想咬合和评估较低的无症状受试者显示出几乎相同的咀嚼功能。正畸治疗的目标可能是本研究中所示的具有良好咀嚼和边缘运动的解剖学理想咬合。
