中国实用口腔科杂志

中国实用口腔科杂志 ›› 2026, Vol. 19 ›› Issue (5): 574-579.DOI: 10.19538/j.kq.2026.05.008

• 论著 • 上一篇    下一篇

邻接紧密度与接触区位置对冠修复后食物嵌塞的影响研究

何珍珍1，胡志刚2   

  1. 1. 华侨大学附属厦门长庚医院口腔科，福建 厦门 361028；2. 福建医科大学口腔医学院·附属口腔医院口腔修复科，福建 福州 350002
  • 出版日期:2026-09-30 发布日期:2026-09-30
  • 通讯作者: 胡志刚
  • 基金资助:
    福建省医学创新基金项目（2014-CX-27）

  • Online:2026-09-30 Published:2026-09-30

摘要： 目的    通过量化邻接紧密度和设计不同邻面接触区位置的方法探讨冠修复体邻接关系对食物嵌塞的影响。方法    选取2024年6月至2025年6月于福建医科大学附属口腔医院口腔修复科就诊的符合下颌第一磨牙全冠修复适应证的患者30例。分别制作远中邻面接触区在中间（近𬌗1/3中间）和颊侧（近𬌗1/3偏颊侧）的计算机辅助设计与制造（computer-aided design and manufacturing，CAD/CAM）树脂冠，按照偏紧（> 3.0 ~ 4.8 N）、适中（1.3 ~ 3.0 N）和偏松（0.5 ~ < 1.3 N）定量调整邻接紧密度后，分析不同冠修复体邻接紧密度和接触区位置时的食物嵌塞发生情况差异。结果    邻接紧密度适中时的食物嵌塞发生风险明显低于偏松时，差异有统计学意义（OR = 0.342，95%CI：0.156 ~ 0.752，P = 0.008）；邻接紧密度偏紧时的食物嵌塞发生风险低于偏松时，但差异无统计学意义（OR = 0.460，95%CI：0.210 ~ 1.008，P = 0.052）。接触区位置位于中间时的食物嵌塞发生风险明显高于颊侧时，差异有统计学意义（OR = 3.715，95%CI：1.966 ~ 7.021，P < 0.001）。结论    将第一磨牙冠修复体的远中邻面接触区设计在近𬌗1/3偏颊侧并将邻接紧密度调整至适中时，有利于减少冠修复后食物嵌塞的发生。

关键词: 冠修复, 食物嵌塞, 邻接紧密度, 邻面接触区, 量化研究

Abstract: Objective    To investigate the influence of the proximal contact relationship of different crown restorations on food impaction by quantifying proximal contact tightness and designing different locations for the proximal contact area. Methods    Thirty patients who attended the Department of Prosthodontics，Affiliated Stomatological Hospital of Fujian Medical University，between June 2024 and June 2025 and met the indications for full crown restoration of the mandibular first molar were selected. Computer-aided design and manufacturing（CAD/CAM）resin crowns were fabricated with the distal proximal contact area located either in the middle（middle of the occlusal third）or on the buccal side（buccal side of the occlusal third）. The proximal contact tightness was quantitatively adjusted to three levels：relatively tight（>3.0 - 4.8 N），moderate（1.3 - 3.0 N），and relatively loose（0.5 - < 1.3 N）. Subsequently，the differences in the occurrence of food impaction were analyzed for crowns with varying proximal contact tightness and contact area locations. Results    The risk of food impaction was significantly lower when the proximal contact tightness was moderate compared to when it was relatively loose（OR = 0.342，95%CI：0.156 - 0.752，P = 0.008）. The risk of food impaction was lower when the proximal contact was relatively tight than when it was relatively loose，but the difference was not statistically significant（OR = 0.460，95%CI：0.210 - 1.008，P = 0.052）. The risk of food impaction was significantly higher when the contact area was located in the middle compared to when it was on the buccal side（OR = 3.715，95%CI：1.966 - 7.021，P < 0.001）. Conclusion     Designing the distal proximal contact area of a first molar crown restoration toward the buccal side of the occlusal third and adjusting the proximal contact tightness to a moderate level is beneficial for reducing the occurrence of food impaction after crown restoration.

Key words: crown restoration, food impaction, proximal contact tightness, proximal contact area, quantitative analysis

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