安氏Ⅱ～1类人群下颌三种基本运动中的（牙合）接触情况分析
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摘要
目的研究安氏Ⅱ1类人群下颌在开闭口、前伸、侧方运动过程中的HE接触情况,探讨肌位牙位不调及HE干扰情况的存在与牙颌颅面形态之间的关系。
方法对60名未经过正畸治疗的安氏Ⅱ1类受试者进行检查,采用T-ScanⅡ咬合分析系统分别记录其开闭口、前伸、侧方运动中的HE接触情况,在模型及头颅侧位片上分析牙颌颅面的形态,利用SPSS12.0对数据进行分析。
结果①ICP位的HE力中心点与中线的垂直距离、左右侧HE力差值及HE接触点数目在三次重复测量中的均无显著差异。②肌位牙位不调与否的两组间在上下牙弓的后段宽度上的存在差异。③是否存在前伸HE干扰的两组间比较显示在Y轴角、MP-FH、U1-L1、A-ptm、上下牙弓前段长度的比值、磨牙近远中向指数上存在差异;Logistic多元回归显示:MP-FH是促成前伸HE干扰发生的危险因子,而A-ptm为其保护因子。④是否存在侧方HE干扰的两组间在A-ptm、U1-SN、上下前段牙弓的长度、磨牙近远中向指数上存在差异。
结论①安氏Ⅱ1类人群具有一定的牙尖交错位的稳定性,肌位牙位不一致与牙弓后段宽度的异常有关。②高角的安氏Ⅱ1类错HE人群容易发生前伸HE干扰,较大的下颌平面角是前伸HE干扰发生的危险因素。③上颌骨长度与前伸HE干扰及侧方HE干扰的发生呈负相关,较小的A-ptm是HE干扰的发生危险因素。④磨牙尖对尖关系较完全远中关系更容易发生前伸HE及侧方HE干扰。
Objective: The purpose of this study was to analyse the occlusal contacts in ClassⅡDivisionⅠMalocclusions during opening/closeing, protrusive and lateral movement of the mandibible and investigate the dentofacial morphological factors related to the ICP -MCP discrepancy and occlusal interferences.
Methods: A total of 60 ClassⅡDivisionⅠMalocclusions with no history of orthodontic treatment were employed. T-Scan II system was used to record and analyse the occlusal contacts during opening/closeing, protrusive and right/left lateral movement of the mandibible.Dentofacial morphological data was dertermined by measuring plaster mold and the lateral cephalometric radiography.SPSS 12.0 for windows was used for the statistics.
Results:①There was no significant difference among three repeated measurements of the vertical distance from the center of occlusive force to the midline,the D-value of occlusive force between the right and the left side , the numbers of occlusal contacts in the intercuspal position.②Significant difference of the later arch-widths was observed between the group with and without ICP–MCP discrepancy.③There was significant difference in Y-angle,MP-FH, U1-L1,A-ptm,the ratio of front arch-widths and the molar mesiodistal indexs between the group with and withnot protrusive occlusal interference. Logistic analysis showed that MP-FH is the dangerous factor in the protrusive occlusal interference,while A-ptm served as the protect one.④Significant differences ofA-ptm, U1-SN, the front upper/lower arch-widths,the molar mesiodistal indexs were found between the group with and without lateral occlusal interference.
Conclusions:①C lassⅡDivisionⅠMalocclusions is characterized by intercupided occlusion stability, abnormal later arch-width may associate with ICP–MCP discrepancy.②“High-angle”patients are more likely to incur protrusive occlusal interference,Mandibular plane angle is the dangerous factor for the occlusal interference.③Maxillary length is negative correlated to protrusive and lateral occlusal interference, and it’s the protective factor of the occlusal interference.④C uspid-cuspid molar distoclusion is more likely to occur occlusal interference than complete post-normal occlusion do.
方法对60名未经过正畸治疗的安氏Ⅱ1类受试者进行检查,采用T-ScanⅡ咬合分析系统分别记录其开闭口、前伸、侧方运动中的HE接触情况,在模型及头颅侧位片上分析牙颌颅面的形态,利用SPSS12.0对数据进行分析。
结果①ICP位的HE力中心点与中线的垂直距离、左右侧HE力差值及HE接触点数目在三次重复测量中的均无显著差异。②肌位牙位不调与否的两组间在上下牙弓的后段宽度上的存在差异。③是否存在前伸HE干扰的两组间比较显示在Y轴角、MP-FH、U1-L1、A-ptm、上下牙弓前段长度的比值、磨牙近远中向指数上存在差异;Logistic多元回归显示:MP-FH是促成前伸HE干扰发生的危险因子,而A-ptm为其保护因子。④是否存在侧方HE干扰的两组间在A-ptm、U1-SN、上下前段牙弓的长度、磨牙近远中向指数上存在差异。
结论①安氏Ⅱ1类人群具有一定的牙尖交错位的稳定性,肌位牙位不一致与牙弓后段宽度的异常有关。②高角的安氏Ⅱ1类错HE人群容易发生前伸HE干扰,较大的下颌平面角是前伸HE干扰发生的危险因素。③上颌骨长度与前伸HE干扰及侧方HE干扰的发生呈负相关,较小的A-ptm是HE干扰的发生危险因素。④磨牙尖对尖关系较完全远中关系更容易发生前伸HE及侧方HE干扰。
Objective: The purpose of this study was to analyse the occlusal contacts in ClassⅡDivisionⅠMalocclusions during opening/closeing, protrusive and lateral movement of the mandibible and investigate the dentofacial morphological factors related to the ICP -MCP discrepancy and occlusal interferences.
Methods: A total of 60 ClassⅡDivisionⅠMalocclusions with no history of orthodontic treatment were employed. T-Scan II system was used to record and analyse the occlusal contacts during opening/closeing, protrusive and right/left lateral movement of the mandibible.Dentofacial morphological data was dertermined by measuring plaster mold and the lateral cephalometric radiography.SPSS 12.0 for windows was used for the statistics.
Results:①There was no significant difference among three repeated measurements of the vertical distance from the center of occlusive force to the midline,the D-value of occlusive force between the right and the left side , the numbers of occlusal contacts in the intercuspal position.②Significant difference of the later arch-widths was observed between the group with and without ICP–MCP discrepancy.③There was significant difference in Y-angle,MP-FH, U1-L1,A-ptm,the ratio of front arch-widths and the molar mesiodistal indexs between the group with and withnot protrusive occlusal interference. Logistic analysis showed that MP-FH is the dangerous factor in the protrusive occlusal interference,while A-ptm served as the protect one.④Significant differences ofA-ptm, U1-SN, the front upper/lower arch-widths,the molar mesiodistal indexs were found between the group with and without lateral occlusal interference.
Conclusions:①C lassⅡDivisionⅠMalocclusions is characterized by intercupided occlusion stability, abnormal later arch-width may associate with ICP–MCP discrepancy.②“High-angle”patients are more likely to incur protrusive occlusal interference,Mandibular plane angle is the dangerous factor for the occlusal interference.③Maxillary length is negative correlated to protrusive and lateral occlusal interference, and it’s the protective factor of the occlusal interference.④C uspid-cuspid molar distoclusion is more likely to occur occlusal interference than complete post-normal occlusion do.
引文
[1]. 王美青主编.现代 HE 学.北京:人民卫生出版社,2006:1-3.
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[5]. 郑明,胡志刚等.咬合力分析系统及咬合片的可重复性.福建医科大学学报,2005,39(2):229-230
[6]. 胡志刚.正常 HE 者从肌位到牙尖交错位咬合过程的动态研究.福建医科大学硕士研究生毕业论文.2004
[7]. 陈一怀,王惠芸,马轩祥等.正常 HE 肌接触位、下颌后退接触位咬合接触的计算机图像分析.实用口腔医学杂志,2000,16(6):472-476.
[8]. 易新竹主编.HE 学.北京:人民卫生出版社,2003:49.
[9]. Athanasiou AE, Melsen B, Kimmel P. Occlusal tooth contacts in natural normal adult dentition in centric occlusion studied by photocclusion technique. Scand J Dent Res. 1989 Oct;97(5):439-445.
[10]. 陈一怀,王惠芸,马轩祥等,不同 HE 力牙尖交错位咬合接触的计算机图像分析.实用口腔医学杂志,2000,16(4):268-271.
[11]. 焦凯,牛丽娜,王美青.颞下颌关节紊乱病患者牙弓宽度的测量分析.实用口腔医学杂志,2005,21(5):596.
[12]. 王胜林,张君,王旭霞等.医源性牙位、肌位不调再正畸治疗的疗效评价.上海口腔医学,2004,13(5):367-370.
[13]. Hiyasat AL, Alhaija ABU.The relationship between static and dunamic occlusion in 14-17-year-old school children. J Oral Rehabil.,2004,31:628-633.
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53. Nebbe B, Major P W, Prasad N G, et al. TMJ internal derangement and adolescent craniofacial morphology:A pilot study. Angle orthod.,1997,67(6),407-414.
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[2]. 皮昕主编.口腔解剖生理学(第 5 版). 北京:人民卫生出版社.2003:85-87.
[3]. 丁玲,杨宠莹等.咬合干扰对颅颌系统影响的研究现状.国外医学口腔医学分册,1998,25(3):164-166
[4]. 周振,王美青等.颞下颌关节紊乱病患者的三维咬合接触观察.实用口腔医学杂志,2005,21(1):99-101.
[5]. 郑明,胡志刚等.咬合力分析系统及咬合片的可重复性.福建医科大学学报,2005,39(2):229-230
[6]. 胡志刚.正常 HE 者从肌位到牙尖交错位咬合过程的动态研究.福建医科大学硕士研究生毕业论文.2004
[7]. 陈一怀,王惠芸,马轩祥等.正常 HE 肌接触位、下颌后退接触位咬合接触的计算机图像分析.实用口腔医学杂志,2000,16(6):472-476.
[8]. 易新竹主编.HE 学.北京:人民卫生出版社,2003:49.
[9]. Athanasiou AE, Melsen B, Kimmel P. Occlusal tooth contacts in natural normal adult dentition in centric occlusion studied by photocclusion technique. Scand J Dent Res. 1989 Oct;97(5):439-445.
[10]. 陈一怀,王惠芸,马轩祥等,不同 HE 力牙尖交错位咬合接触的计算机图像分析.实用口腔医学杂志,2000,16(4):268-271.
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