Objective: To observe the stability of vertical dimension of occlusion (VDO) and mandibular position in full-mouth occlusal reconstruction subjects by means of digital occlusal analysis. Methods: Six subjects who had completed full-mouth occlusal reconstruction by intraoral functional generated path technique for more than three years in the Department of Prosthodontics, Peking University School and Hospital of Stomatology were enrolled for follow-up observation, all six patients were male, with an age of (53.6±8.4) years. The digital dentition model and occlusal contact at baseline and three years follow-up review after restoration were recorded by intraoral laser scanning, and the changes in occlusal surface morphology, occlusal contact area and mandibular position (mandibular overall deviation and mandibular reference plane average angle deviation) were measured in reverse engineering software. The Wilcoxon signed rank test was used to statistically analyze the changes of horizontal and vertical overbite of anterior teeth and VDO of posterior teeth between baseline and three years follow-up after reconstruction. Results: The prosthesis in the 6 subjects were intact at the time of follow-up, and there was no significant change in occlusal morphology compared with that at the baseline right after restoration delivery, and the occlusal contact in maximum intercuspid position was stable. The overall deviation of the lower jaw was (0.19±0.06) mm, and the angular deviation of the mandibular reference plane was 0.72°±0.38°. The chromatic scale of occlusal contact showed that the occlusal contact in some areas was heavier during the three years post-delivery, and the overbite of anterior teeth and the VDO of posterior teeth showed no statistical difference compared with that in the baseline (P>0.05). Conclusions: This study suggests that the occlusal contact distribution and jaw position relationship can be maintained after 3 years of full-mouth occlusal reconstruction, and there is no significant change in the anterior overbite and VDO.
目的: 探讨全口咬合重建后3年患者牙尖交错位咬合稳定性,以期为临床提供参考。 方法: 回顾性选取2018年3月至2020年12月于北京大学口腔医学院·口腔医院修复科应用功能引导路径技术获取修复体功能性(牙合)面形态并完成全口咬合重建的男性患者6例,(53.6±8.4)岁。口内扫描获取修复后即刻和修复后3年患者上下颌牙列数字化模型和咬合接触情况,观察修复体(牙合)面形态、咬合接触区和颌位关系(下颌整体偏差及下颌参考平面角度偏差)的变化,使用Wilcoxon符号秩检验比较两时间点前牙覆(牙合)、覆盖和后牙咬合垂直距离的差异。 结果: 修复后3年6例患者修复体完整,与修复后即刻相比,(牙合)面形态无明显变化,牙尖交错位咬合接触稳定。与修复后即刻相比,修复后3年下颌整体偏差为(0.19±0.06)mm,下颌参考平面角度偏差为0.72°±0.38°。咬合接触色阶图显示修复后3年修复体(牙合)面部分区域咬合接触更紧密,修复后3年前牙覆(牙合)、覆盖及后牙咬合垂直距离与修复后即刻相比差异均无统计学意义(P>0.05)。 结论: 全口咬合重建修复后3年修复体可保持咬合接触分布和颌位关系基本稳定,前牙覆(牙合)、覆盖和后牙咬合垂直距离无明显变化。.