CAJ | 학술논문

目的：应用CBCT技术，分析全口义齿再修复时颞下颌关节盘的间隙变化，以确定患者一次垂直距离恢复的最大值，为临床提供依据。方法选择全口义齿使用超过5年的需要再修复患者30例，按常规制作新的全口义齿，根据患者全口义齿垂直距离恢复情况分为3组，A组为恢复1.0mm~2.5mm，B组为恢复2.5mm~5.0mm，C组为恢复大于5.0mm。通过自身对照，观察新旧全口义齿垂直距离改变，并在CBCT下记录颞下颌关节盘间隙变化，结合临床患者资料，分析垂直距离改变和颞下颌关节盘间隙的关系，明确垂直距离恢复程度对关节的影响。结果 A组关节盘上、前、后变化在（0.10～0.50）±0.20mm区间，患者新全口义齿一周内可适应；B组关节盘上、前、后变化在（0.50～1.11）±0.32mm区间，患者新全口义齿适应时间相对长；C组关节盘上、前、后变化在>（1.50±0.50）mm区间，患者新全口义齿失败可能性明显增加。结论全口义齿再修复时建议一次性恢复垂直距离高度以不超过2.5mm为宜，最大值在5mm以内，以减少全口义齿修复失败和诱导颞下颌关节疾病的可能，大于5mm以上明显存在失败风险。
목적：응용CBCT기술，분석전구의치재수복시섭하합관절반적간극변화，이학정환자일차수직거리회복적최대치，위림상제공의거。방법선택전구의치사용초과5년적수요재수복환자30례，안상규제작신적전구의치，근거환자전구의치수직거리회복정황분위3조，A조위회복1.0mm~2.5mm，B조위회복2.5mm~5.0mm，C조위회복대우5.0mm。통과자신대조，관찰신구전구의치수직거리개변，병재CBCT하기록섭하합관절반간극변화，결합림상환자자료，분석수직거리개변화섭하합관절반간극적관계，명학수직거리회복정도대관절적영향。결과 A조관절반상、전、후변화재（0.10～0.50）±0.20mm구간，환자신전구의치일주내가괄응；B조관절반상、전、후변화재（0.50～1.11）±0.32mm구간，환자신전구의치괄응시간상대장；C조관절반상、전、후변화재>（1.50±0.50）mm구간，환자신전구의치실패가능성명현증가。결론전구의치재수복시건의일차성회복수직거리고도이불초과2.5mm위의，최대치재5mm이내，이감소전구의치수복실패화유도섭하합관절질병적가능，대우5mm이상명현존재실패풍험。
Objective To clarify the maximum vertical dimension of occlusion on patients who received complete denture secondary restoration. Methods The 30 patients wearing complete denture more than 5 years and requiring secondary restoration were chosen for treatment with new complete denture. The change in vertical dimension of occlusion on patients between old and new denture treatment was recorded, and the change in the temporomandibular joint space was observed by CBCT, and the relationship between vertical dimension and TMJ space were analyzed according to the clinical data. Results When the vertical distance was less than 2.5mm, the patients were adapted to the new denture within one week and the temporomandibular joint disc change was within the range of (0.10~0.50) ± 0.20mm. When the vertical distance was between 2.5 to 5.0mm , the patients spent longer time on adapting to the new denture and the temporomandibular joint disc change was within the range (0.50~1.11)±0.32mm. When the vertical distance was more than 5.0mm, the risk of failure increased signifi-cantly and the temporomandibular joint disc change was more than 1.50±0.50mm. Conclusion To reduce the risk of failure for total denture restoration and the possible induction of temporomandibular joint disease, the best vertical dimension should be less than 2.5mm and 5mm is the maximum in complete denture secondary restoration.