牙列重度磨耗伴颞下颌关节紊乱病咬合重建 序列治疗临床效果探究

Clinical Effect of Occlusal Reconstruction Sequence Treatment of Severe Dentition Wear and Temporomandibular Joint Disorders

摘要: 目的：探讨牙列重度磨耗伴颞下颌关节紊乱病咬合重建序列治疗方法及治疗效果。方法：选取我院2023年5月~2025年2月期间收治的70例牙列重度磨耗伴颞下颌关节紊乱病患者作为研究对象，应用随机数字表法，行分组对照研究(观察组35例：咬合重建序列治疗；对照组35例：常规咬合重建治疗)，对比治疗效果。结果：治疗后12个月，观察组牙列重度磨耗伴颞下颌关节紊乱病患者的咀嚼效率[(82.02 ± 6.41)%]更高(P < 0.05)。治疗后12个月，观察组牙列重度磨耗伴颞下颌关节紊乱病患者的咬合力[(6185.49 ± 97.52)]更高(P < 0.05)。治疗后12个月，观察组牙列重度磨耗伴颞下颌关节紊乱病患者的下颌关节紊乱指数[(0.05 ± 0.01)]、颞下颌关节功能障碍指数[(0.08 ± 0.01)]、肌肉压痛指数[(0.05 ± 0.01)]更低(P < 0.05)。观察组牙列重度磨耗伴颞下颌关节紊乱病患者的美观满意度[(93.87 ± 4.35)分]、舒适度[(92.09 ± 3.96)分]更高(P < 0.05)。观察组的治疗优良率(94.29%)更高(P < 0.05)。治疗后12个月，观察组牙列重度磨耗伴颞下颌关节紊乱病患者的SF-36评分[(75.60 ± 4.27)分]更高(P < 0.05)。治疗后12个月，观察组牙列重度磨耗伴颞下颌关节紊乱病患者的HAMD评分[(10.70 ± 1.85)分]更低(P < 0.05)。结论：在牙列重度磨耗伴颞下颌关节紊乱病的临床治疗中，实施咬合重建序列治疗，能够有效改善咬合、咀嚼功能，恢复肌肉与关节的生理性协调，获得令患者满意的治疗效果。

Abstract: Objective: To investigate the treatment method and therapeutic effect of occlusal reconstruction sequence for severe dentition wear and temporomandibular joint disorders. Methods: A total of 70 patients with severe dentition wear and temporomandibular joint disorders admitted to our hospital from May 2023-February 2025 were selected as the research objects, and a group control study was conducted using the random number table method (35 cases in the observation group: occlusal reconstruction sequence treatment; 35 cases in the control group: conventional occlusal reconstruction treatment), compared with the treatment effect. Results: At 12 months after treatment, the chewing efficiency of patients with severe dentition wear and temporomandibular joint disorders in the observation group was higher [(82.02 ± 6.41)%] (P < 0.05). At 12 months after treatment, the occlusal force [(6185.49 ± 97.52)] was higher in the observation group (P < 0.05) in patients with severe dentition wear and temporomandibular joint disorders. At 12 months after treatment, the mandibular joint disability index [(0.05 ± 0.01)], temporomandibular joint dysfunction index [(0.08 ± 0.01)], and muscle tenderness index [(0.05 ± 0.01)] were lower (P < 0.05) in the observation group. The aesthetic satisfaction [(93.87 ± 4.35) points] and comfort [(92.09 ± 3.96) points] of patients with severe dentition wear and temporomandibular joint disorders in the observation group were higher (P < 0.05). The excellent treatment rate (94.29%) was higher in the observation group (P < 0.05). At 12 months after treatment, the SF-36 score of patients with severe dentition wear and temporomandibular joint disorder in the observation group was higher [(75.60 ± 4.27 points] (P < 0.05). At 12 months after treatment, the HAMD score of patients with severe dentition wear and temporomandibular joint disorder in the observation group was lower [(10.70 ± 1.85) points] (P < 0.05). Conclusion: In the clinical treatment of severe dentition wear and temporomandibular joint disorders, the implementation of occlusal reconstruction sequence therapy can effectively improve occlusal and chewing functions, restore the physiological coordination of muscles and joints, and obtain satisfactory treatment effects for patients.