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目的:探讨咬合重建与固定义齿修复治疗老年牙齿重度磨耗伴牙列缺损的方案与效果。方法:选取牙齿重度磨耗伴牙列缺损的老年患者86例,予以咬合重建与固定义齿修复,6个月后评估治疗效果、咀嚼与颞下颌关节功能。结果:(3.0±0.5)周后,患者逐渐适应固定义齿修复体,面下1/3高度得以恢复,面部丰满,咀嚼功能显著改善,发音清晰,颞下颌关节紊乱症状消失或缓解,主观感觉良好。咀嚼功能优良率达95.35%,颞下颌关节功能紊乱率由治疗前84.88%降低至4.65%,具有显著统计学意义(χ2=32.16,P<0.01)。结论:经过咬合重建固定义齿修复,重建了牙齿重度磨耗伴牙列缺损老年患者稳定平衡的咬合关系,调整了紊乱的口颌系统,恢复了咀嚼肌、颞下颌关节的生理平衡关系,具有较好的修复效果,是一种值得推荐的修复方案。
Objective: To investigate the effect of occlusal reconstruction and fixed denture in the treatment of severe dental wear with dentition defect. Methods: Totally 86 elderly patients with severe tooth wear and dentition defect were selected for reconstruction and fixed denture. Six months later, the therapeutic effect, chewing and temporomandibular joint function were evaluated. Results: After 3.0 ± 0.5 weeks, the patient gradually became accustomed to the prosthesis. The height of the lower 1/3 of the face recovered, the face was full, the masticatory function was significantly improved, the articulation was clear, the symptoms of temporomandibular joint disappeared or relieved, and the subjective feeling was good . The excellent and good rate of chewing function was 95.35%, the rate of functional disorder of temporomandibular joint decreased from 84.88% to 4.65% before treatment, with significant statistical significance (χ2 = 32.16, P <0.01). CONCLUSIONS: The occlusal reconstruction with fixed denture rebuilds the stable and balanced occlusal relationship of elderly patients with severe dental wear and dentition defect, adjusts the disordered oral mandibular system and restores the physiological balance of the masticatory muscles and temporomandibular joint, which is better The repair effect, is a recommended repair program.