种植修复对单侧游离端多牙缺失患者双侧颞下颌关节髁突位置的影响

doi:10.19438/j.cjoms.2026.05.006

中国口腔颌面外科杂志 ›› 2026, Vol. 24 ›› Issue (5): 477-482.doi: 10.19438/j.cjoms.2026.05.006

种植修复对单侧游离端多牙缺失患者双侧颞下颌关节髁突位置的影响

郭子溦^1,*, 刘艺^2,*, 沈欣然¹, 郑亚卿³, 潘颖丹^3#, 毕玮^1#

1.复旦大学附属中山医院口腔科,上海 200032;
2.上海市徐汇区中心医院口腔科,上海 200237;
3.复旦大学附属中山医院厦门医院口腔科,福建厦门 361006

收稿日期:2025-12-26 修回日期:2026-03-11 出版日期:2026-09-20 发布日期:2026-10-10
通讯作者: 毕玮,E-mail: bi.wei@zs-hospital.sh.cn;潘颖丹,E-mail: panyingdanpyd@163.com。^#共同通信作者
作者简介:郭子溦（2000—）,女,硕士,住院医师,E-mail: 15961090865@163.com;刘艺（1990—）,女,硕士,主治医师,E-mail: shineely@163.com。^*并列第一作者
基金资助:
福建省自然科学基金（2022J011424）

Effect of implant restoration on the condylar position of bilateral temporomandibular joints in patients with unilateral free-end multiple tooth loss

Guo Ziwei¹, Liu Yi², Shen Xinran¹, Zheng Yaqing³, Pan Yingdan³, Bi Wei¹

1. Department of Stomatology, Zhongshan Hospital, Fudan University. Shanghai 200032;
2. Department of Stomatology, Xuhui District Central Hospital. Shanghai 200237;
3. Department of Stomatology, Zhongshan Hospital (Xiamen) Fudan University. Xiamen 361006, Fujian Province, China

Received:2025-12-26 Revised:2026-03-11 Online:2026-09-20 Published:2026-10-10

摘要/Abstract

摘要： 目的：探讨单侧游离端多牙缺失患者种植固定义齿修复前后双侧颞下颌关节（temporomandibular joint, TMJ）髁突位置的变化。方法：采用回顾性分析,纳入2024年1月—2025年1月于复旦大学附属中山医院接受单侧游离端种植修复的患者40例,收集临床资料及CBCT数据。通过CBCT分别测量种植修复前后双侧TMJ的6项关节间隙指标—前间隙（anterior joint space, AJS）、上间隙（superior joint space, SJS）、后间隙（posterior joint space, PJS）、外侧间隙（lateral joint space, LJS）、中间间隙（intermediate joint space, IJS）及内侧间隙（medial joint space, MJS）,同时测量双侧髁突骨皮质密度、骨松质密度、髁突内外径（mediolateral length, MLL）、髁突前后径（anteroposterior length, APL）,观察髁突有无形态破坏及骨吸收。结果：种植固定义齿修复后,患侧仅SJS较修复前呈显著减小（平均变化量为-0.29 mm,P=0.001）,提示种植修复后患侧髁突发生了垂直向复位;健侧仅MJS呈显著减小（平均变化量为-0.91 mm,P=0.001）,提示健侧髁突发生内上方的适应性重定位。其余各关节间隙指标修复前后差异均无统计学意义（P>0.05）。修复前后双侧髁突骨皮质密度、骨松质密度、MLL、APL均无显著变化（P>0.05）,无新发髁突形态破坏及骨吸收病例。结论：种植固定义齿修复可促使双侧TMJ髁突发生适应性移位,进而恢复双侧关节的平衡关系,且不会造成髁突硬组织的病理性损伤,精准恢复咬合垂直高度,重建稳定的三维咬合平衡,对维护颞下颌关节健康具有重要意义。

关键词: 单侧游离端多牙缺失, 种植固定义齿, 颞下颌关节, 髁突

Abstract: PURPOSE: To investigate the positional changes of the condyles in bilateral temporomandibular joints (TMJ) in patients with unilateral free-end edentulism before and after implant-supported fixed denture restoration. METHODS: A retrospective analysis was performed on 40 patients who received implant restoration for unilateral distal-extension tooth loss in Zhongshan Hospital, Fudan University from January 2024 to January 2025. Clinical data and CBCT images were collected and analyzed. Six joint space parameters of bilateral TMJ were measured on CBCT: anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), lateral joint space (LJS), intermediate joint space (IJS), and medial joint space (MJS). Condylar cortical bone density, trabecular bone density, mediolateral length (MLL), anteroposterior length (APL) were also measured, and condylar morphological destruction and bone resorption were evaluated. RESULTS: Following implant-fixed restoration, a significant reduction was observed only in the SJS on the affected side (mean change: -0.29 mm, P=0.001), indicating a vertical repositioning of the affected condyle. On the healthy side, only the MJS demonstrated a significant decrease (mean change: -0.91 mm, P=0.001), suggesting a superomedial adaptive relocation. No significant differences were found in the other joint space parameters on either side(P>0.05). Furthermore, no significant changes were detected in bilateral condylar cortical and trabecular bone density, MLL, or APL(P>0.05), and no cases of new-onset condylar morphological destruction or bone resorption were identified. CONCLUSIONS: Implant-fixed prostheses can facilitate adaptive displacement of bilateral TMJ condyles, thereby restoring balanced joint relationships without causing pathological damage to condylar hard tissues. Precisely restoring the occlusal vertical dimension and establishing a stable three-dimensional occlusal balance are of significant importance for temporomandibular joint health.

Key words: Unilateral free-end edentulism, Implant-supported fixed denture, Temporomandibular joint, Condyle

中图分类号:

R782

郭子溦, 刘艺, 沈欣然, 郑亚卿, 潘颖丹, 毕玮. 种植修复对单侧游离端多牙缺失患者双侧颞下颌关节髁突位置的影响[J]. 中国口腔颌面外科杂志, 2026, 24(5): 477-482.

Guo Ziwei, Liu Yi, Shen Xinran, Zheng Yaqing, Pan Yingdan, Bi Wei. Effect of implant restoration on the condylar position of bilateral temporomandibular joints in patients with unilateral free-end multiple tooth loss[J]. China J Oral Maxillofac Surg, 2026, 24(5): 477-482.

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种植修复对单侧游离端多牙缺失患者双侧颞下颌关节髁突位置的影响

Effect of implant restoration on the condylar position of bilateral temporomandibular joints in patients with unilateral free-end multiple tooth loss

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