目的 对KennedyⅡ类牙列缺损种植义齿修复后不同时期的咬合数据进行动态分析,为临床精准调牙合提供理论依据。方法 选取KennedyⅡ类牙列缺损种植术后待修复患者26例,CAD/CAM联袂Tosoh二氧化锆全瓷冠修复,应用TeeTester测定患者修复当日,修复后1、3、6、12个月的最大咬合力、牙合力中心点(COF)及左右侧牙合力百分比差值并比较其差异。结果 种植义齿修复后的最大咬合力和左右侧牙合力百分比差值和修复前[(76.73±17.67)kg,(22.72±4.20)%]相比,差异均有统计学意义(P＜0.01);修复后6个月[(120.38±29.66)kg,(2.60±1.76)%]、12个月[(125.27±28.13)kg,(2.00±1.16)%]和修复当日[(98.40±25.63)kg,(4.56±2.49)%]、修复后1个月[(100.09±26.66)kg,(4.60±2.38)%]相比,差异均有统计学意义(P＜0.01);修复后12个月的最大咬合力和左右侧牙合力百分比差值和修复后3个月比较,差异均有统计学意义(P＜0.05);修复后3个月的左右侧牙合力百分比差值低于修复当日和修复后1个月(P＜0.05)。种植义齿修复前COF偏向未缺牙的一侧,修复后位于中心灰色椭圆区内。结论 KennedyⅡ类牙列缺损种植义齿修复后通过渐进性的骨受载,6个月后达到稳定。Teetester的咬合力分析数据能够客观、准确地显示咬合接触状态,精确指导临床调牙合,为保证种植修复体的长期稳定提供依据。

Objective To analyze dynamically the occlusion data from different periods with Tee Tester after restoring the Kennedy Ⅱ patients’ teeth with implant support dentures, so as to provide a theoretical basis for clinical precision adjustable occlusion. Methods Twenty-six Kennedy Ⅱ patients after osseointegration were selected, restoring with CAD/CAM zirconia ceramic crown. TeeTester system was used to test the total occlusal force, bilateral differences of contact forces, and the position of center of force (COF) of implant support dentures on the same day of treatment ,one month, three months, six months and one year after restoration. Results There was a significant difference in the total occlusal force and the bilateral differences in contact forces between restoration before [(76.73±17.67)kg,(22.72±4.20)%] and after(P＜0.01). There was also a significant difference between 6 months [(120.38±29.66)kg,(2.60±1.76)%] and 12 months [(125.27±28.13)kg,(2.00±1.16)%] after restoration along with the same day of restoration [(98.40±25.63)kg,(4.56±2.49)%] and one month after restoration[(100.09±26.66)kg,(4.60±2.38)%](P＜0.01). A difference was also found in the total occlusal force and bilateral differences in contact forces between 12 months after restoration and 3 months after restoration(P＜0.05). The bilateral differences in contact forces 3 months after restoration decreased compaired with that on the same day and one month after restoration(P＜0.05). The COF also moved to the center area after restoration with implant support dentures. Conclusions For the Kennedy Ⅱ patients, the total occlusal force of implant support dentures achieves stability in 6 month after restoration through progressive load. Occlusion data from Tee tester is objective, accurate, displays a state of occlusal contact, and has a precise guide for clinical occlusal adjustment. Once finished, it provides a basis to ensure the long-term stability of plant restoration.