背景:在复杂的修复治疗中评估新的垂直闭塞尺寸(VDO)被认为是放置修复体之前的必要步骤。
目的:这项随机对照试验(RCT)旨在评估中度至重度牙齿磨损患者在修复治疗前使用VDO升高评估的效果。关于OHRQoL,高速公路空间(FWS)和修复措施。
方法:纳入42例牙齿磨损患者,并随机分配到使用可移动矫正器(RA)的测试阶段或无测试阶段。恢复性治疗包括使用VDO增加的复合修复体修复所有牙齿。OHIP-score,高速公路空间(FWS)在基线和召回预约时(1个月和1年)评估修复体的临床可接受性.在材料碎裂或基牙敏感性增加的情况下,对修复的干预进行评分,这可能与咬合过载有关。ANCOVA分析,单变量Cox回归,t检验,并进行描述性分析(p<0.05)。
结果:41例患者在1年后完成临床随访。用RA测试VDO对OHIP评分没有显著影响(p=0.14)。RA组FWS减少,与对照组相比,在1年时显著降低(p=0.01,95CI-1.09至-0.15)。对修复的早期干预没有影响(p=0.94)。
结论:该RCT显示,在牙齿磨损患者的修复治疗之前,不需要使用可移除的矫正器对增加的VDO进行功能测试。
BACKGROUND: Evaluation of a new vertical dimension of occlusion (VDO) in complex restorative treatments is considered a necessary step prior to placement of restorations.
OBJECTIVE: This randomised controlled
trial (RCT) aimed to assess the effects of using an evaluation of a VDO increase before restorative treatment in patients with moderate-to-severe tooth wear, on OHRQoL, freeway space (FWS) and interventions to restorations.
METHODS: Forty-two patients with tooth wear were included and randomly allocated to either a test phase with a Removable Appliance (RA) or no test phase. Restorative treatment consisted of restoration of all teeth using composite restorations in an increased VDO. OHIP-score, freeway space (FWS) and clinical acceptability of restorations were assessed at baseline and at recall appointments (1 month and 1 year). Intervention to restoration was scored in case of material chipping or when the abutment tooth had increased sensitivity that could be linked to occlusal overloading. ANCOVA analyses, Univariate Cox regression, t-tests and descriptive analyses were performed (p < .05).
RESULTS: Clinical follow-up after 1 year was completed for 41 patients. No significant effect of testing the VDO with a RA could be found on the OHIP-score (p = .14). Reduction of FWS in the RA group, compared to the control group, was significantly lower at 1 year (p = .01, 95% CI -1.09 to -0.15). No effect on early interventions to restorations was found (p = .94).
CONCLUSIONS: This RCT showed that a removable appliance is not indicated to functionally test the increased VDO prior to restorative treatment in patients with tooth wear.