非う蝕性頸部病変と咬合面摩耗の生体内相関

In vivo correlation of noncarious cervical lesions and occlusal wear.

抄録

問題提起:

非う蝕性頸部病変の病因はよく分かっていない。病因を理解することは、臨床医が適切な治療と管理戦略を決定するのに役立つ。目的 本研究は、非う蝕性頸部病変と咬合（または切歯）摩耗の関係を評価した。

STATEMENT OF PROBLEM: The etiology of noncarious cervical lesions is not well understood. An understanding of the etiology helps the clinician determine appropriate treatment and management strategies. Purpose This study evaluated the relationship between noncarious cervical lesions and occlusal (or incisal) wear.

材料と方法:

歯科学生から作製した鋳造物（n=299）を半調節性咬合器に咬合させ、評価した。データには、非う蝕性頸部病変（NCL）の有無と輪郭、咬合面／切歯面の摩耗の有無、位置、重症度が含まれる。また、Angleの分類、咬合誘導パターン、正中線、トーリの存在、歯の修復、逆咬合（クロスバイト）、開咬関係、および存在する場合は後方排列接触も含まれます。キャリブレーションを行った後、2人の評価者がそれぞれ独立してギプスを観察しました。第一の評価者は、各被験者の各歯について、NCLの有無と重症度、咬合・近心修復の有無と程度、逆咬合と開咬の有無を記録しました。第1評価後、第2評価者のNCL観察に対する盲検化のため、各歯の歯頸部辺縁に赤いロープワックスを塗布した。第2評価者は，咬頭・切歯の磨耗の程度と位置，後方排列の有無，Angleの分類，咬合誘導様式，正中線の不一致，トーリの有無などを記録した．データの解析には、スピアマン相関係数とカイ2検定を用いた（α=.05）。

MATERIAL AND METHODS: Casts (n = 299) made from dental students were articulated in a semi-adjustable articulator and evaluated. Data included the presence and contour of noncarious cervical lesions (NCLs) and the presence, location, and severity of any occlusal/incisal wear facets. Also included were Angle's classification, occlusal guidance patterns, midline, presence of tori, tooth restoration, reverse articulation (crossbite), open occlusal relationship, and posterior excursive contacts where present. Following a calibration procedure, 2 evaluators made independent observations on the casts. The first evaluator recorded for each tooth in each subject: presence and severity of NCLs, presence and extent of occlusal/proximal restorations, and presence of reverse articulation and open occlusal relationship. Following the first evaluation red rope wax was placed at the cervical margins of each tooth for the purpose of blinding the second evaluator from NCL observations. The second evaluator recorded severity and location of occlusal/incisal wear, presence or absence of posterior excursive contacts, Angle's classification, occlusal guidance pattern, any midline discrepancy, and presence or absence of tori. The Spearman correlation coefficient and chi 2 tests were used to analyze the data (alpha=.05).

結果:

非う蝕性頸部病変と咬合・切歯摩耗との間に関連性は認められなかった．また、NCLと調査した他のパラメータとの間に相関はなかった。

RESULTS: There was no relationship between noncarious cervical lesions and occlusal/incisal wear. There was also no correlation between NCLs and other parameters examined.

結論:

本研究の条件下では、noncarious cervical lesionは咬合摩耗と関係がない。

CONCLUSIONS: Under the conditions of this study, noncarious cervical lesions are not related to occlusal wear.