目的 针对单个第一磨牙缺失的病例,研究种植及可摘局部义齿(RPD)两种不同修复方法所恢复的牙列咬合接触特征.方法 选择15名单个第一磨牙缺失的患者作为实验组,15名正常牙列人群作为对照组,其中,实验组每位患者同时进行种植及RPD修复,应用TeeTester咬合分析仪,嘱对照组和实验组在未修复、RPD修复及种植义齿修复后3种状态下分别做正中咬合及咀嚼运动,分析其咬合接触特征(总咬合力、总接触面积、(牙合)不平衡指数、单次咀嚼循环时间、OT/DT比值),并进行统计学分析.结果 患者做正中咬合时,在总咬合力、总接触面积、(牙合)不平衡指数方面,患者未修复时分别为(48.76±12.82)kg,(317.59±58.47)mm2,(24.78±7.40)％,行RPD修复时分别为(54.36±10.59)kg,(355.81±77.43)mm2,(18.29±8.42)％,行种植修复时分别为(61.94±12.36)kg,(398.17±83.86)mm2,(17.80±6.69)％;患者咀嚼运动时在总咬合力、总接触面积、(牙合)不平衡指数、单次咀嚼循环时间及t0/td方面,患者行种植修复时分别为(52.14±16.53)kg,(348.08±81.76)mm2,(15.69±9.16)％,(0.4072±0.10)s,(1.718±0.26).统计学分析表明,RPD、种植义齿修复和对照组的部分咬合接触特征结果无显著性差异,但与未修复前结果有显著性差异.单次咀嚼循环时间及t0/td在各组间均无显著性差异.结论 在恢复咬合力及咬合接触面积方面,种植义齿优于RPD,较接近天然牙列,并明显优于不修复.全牙列的总咬合力及总接触面积在正中咬合时明显大于咀嚼运动时,但(牙合)不平衡指数在两者之间无明显统计学差异.%Objective To compare the occlusal contact characteristics of two different restoration methods of implant crown and re-movable partial denture while one single first molar was missing.Methods 15 adults with one single first molar missing were selected as the experimental group,15 normal dentition adults were selected as the control group.Each patient of the experimental group was re-stored with implant crown and removable partial denture,then the occlusal contact characteristics(total occlusal force,total contact ar-ea,asymmetry index of occlusal force,chewing duration and t0/tdratio)of each patient of experimental group under three different states(no repair,removable partial denture and implant crown)were compared with the control group.Each subject was detected with the TeeTester occlusal analyzer during centric occlusion and mastication movement.And SPSS 24 software was used for statistical analy-sis.Results During centric occlusion,the total occlusal force,total contact area and asymmetry index of occlusal force of the patients with no repair were(48.76±12.82)kg,(317.59±58.47)mm2and(24.78±7.40)％,the results of patients with removable partial den-ture were(54.36±10.59)kg,(355.81±77.43)mm2,(18.29±8.42)％,the results of patients with implant crown were(61.94±12.36)kg,(398.17±83.86)mm2,(17.80±6.69)％.During mastication movement,the total occlusal force,total contact area,asymmetry index of occlusal force,chewing duration and t0/tdratio of the patients with implant crown were(52.14±16.53)kg,(348.08±81.76)mm2,(15.69±9.16)％,(0.4072±0.10)s and(1.718±0.26).The statistical analysis showed no significant difference in occlusal contact characteristics in implant crown,removable partial denture and the control group,but there was significant difference between the patients with no repair and other groups.There was no significant difference in chewing duration and the t0/tdratio of all groups.Conclusion In the aspect of total occlusal force and contact area,implant crown is better than removable partial denture,closer to natural dentition,and obviously better than no restoration.The total bite force and total contact area during centric occlusion are signifi-cantly greater than those during mastication movements,but there is no significant difference in the asymmetry index of occlusal force.
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