チューイン法による関節窩形態の変化に関する研究 : 術者間および日間の差について

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In prosthodontics, an articolator is considered as an indispensable tool for reconstructing an occlusal relationship that has been lost in a patient. The various types of an articulator have been on the market and are in wide use, but studies dealing with their accuracies and other considerations in the clinical field are still comparatively few, the majority being based on the empirical evaluations of dental clinicians. In the present study, therefore, the author was concerned with three-dimensional measurements of the glenoid fossa formed by the TMJ articulator in an effort to elucidate its clinical accuracy, with the two particular attentions on the following points. i) Differences among the operators in the form of glenoid fossa according to the chew-in method. ii) Daily variations of the same operator in working out the above procedure. By way of study subjects, 3 students in Nihon University School of Dentistry were selectively used and the operators consisted of 2 experienced and 1 inexperienced dentists. The production of chew-ins took place at an interval of one week and the three operators produced them for the one and same subjects at the vertical interjaw distance, using the same clutch. In this manner, 3 chew-ins were produced per individual, the total resulting in 9 chew-ins altogether. These chew-ins were transferred to the TMJ articulator and were fixed at the innermost aspect of the inter-condylar distance (82mm). The formation of the glenoid fossa was made by the reline method and three-dimensional measurements were made only of their left side. As a result of the study, the author arrived at the following conclusions : 1. Three-dimensional morphology of each glenoid fossa was found to have a scatter of less than 200μ within the functional range of 2mm from centric relation position. Therefore, reproducibility of the TMJ articulator was interpreted as being satisfactory. 2. There were observed no statistical differences in the daily variations of the same operator in producing chew-ins by the TMJ articulator. 3. Similarly, there were observed no differences stastically among different operators, experienced and inexperienced. 4. The mean values of the operators at centric relation position of chew-ins were 31μ for subject P1, 30μ for subject P2 and 17μ for subject P3. 5. When examined in terms of mandibular movement, the reproducibility of glenoid fossa had a higher degree of accuracy on the working side rather than on the balancing side. 6. By setting the inter-condylar distance of the TMJ articulator at the innermost aspect, it was possible to simplify the morphology of glenoid fossa to be produced. It was also confirmed that glenoid fossa of different individuals could be collectively treated in similar morphological groups. 7. It was established that the reproducibility of TMJ articulator would remain effective without regard to different skills of the operators.
社団法人日本補綴歯科学会の論文
1979-05-31

著者

大坪卓史
日本大学大学院歯学研究科歯科補綴学専攻

チューイン法による関節窩形態の変化に関する研究 : 術者間および日間の差について

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