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咬合板治疗口颌系统的功能紊乱已有100余年历史,并且至今仍在广泛使用。虽然各种假说一直用来解释其作用,但科学证据不多。普遍认为,咬合板具有保护牙齿不被磨耗的作用,但咬合板在颞下颌关节紊乱病(TMD)处理中的功效始终很难确定。尽管许多研究认为咬合板减少了夜磨牙发生的频率,但并不表明这会消除磨牙症。戴用咬合板会使咀嚼肌和关节疼痛减少,但也可能是安慰剂效应和症状随时间而自然回归的结果。最新的系统回顾和Meta分析显示,合理调改硬质稳定咬合板对治疗TMD疼痛有效,有证据表明其他类型的咬合板包括软质稳定咬合板、再定位咬合板、松弛咬合板也有一些减少TMD疼痛的功效,但其潜在的副效应也存在,建议在密切监测下使用。本文对目前临床上使用的咬合板的种类及其作用机制进行了评述,重点对咬合板特别是稳定咬合板的作用、治疗价值、应用和注意事项等进行了介绍。强调合理选用和调改咬合板是治疗口颌系统功能紊乱能否成功的关键因素。
Bite plate treatment of oral mandibular system dysfunction has more than 100 years of history, and is still widely used. Although various hypotheses have been used to explain their role, there is little scientific evidence. It is generally accepted that bite plates have the effect of protecting the teeth from being abraded, but the efficacy of bite plates in the treatment of temporomandibular disorder (TMD) remains difficult to determine. Although many studies suggest that bite plates reduce the incidence of bruxism, it does not indicate that this will eliminate bruxism. Wear bite plates can reduce masticatory muscle and joint pain, but may also be a natural consequence of the placebo effect and symptoms over time. Recent systematic reviews and meta-analyzes have shown that rational modification of hard-stable bite plates is effective in treating TMD pain and there is evidence that other types of bite plates include soft, stable bite plates, reposition bite plates, loose bite plates, and some reduce TMD Pain, but its potential side effects also exist, it is recommended to use under close monitoring. This article reviews the types of occlusal plates currently used clinically and their mechanism of action, and focuses on the role of bite plates, especially the stability of bite plates, the therapeutic value, applications and precautions. Emphasis on the rational selection and modification of occlusal plate is the key factor in the success of oral and maxillofacial dysfunction.