本文選題：牙體缺損　切入點(diǎn)：臨床過程　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過5例臨床病例的收集，了解牙體缺損全瓷修復(fù)的臨床操作程序和效果，并了解目前全瓷修復(fù)的應(yīng)用現(xiàn)狀。 方法：選取5例全瓷修復(fù)治療病例：其中1例為四環(huán)素牙根管治療后要求冠修復(fù)；1例為牙齒多次充填，充填物失色，影響美觀；2例為原金屬烤瓷修復(fù)體邊緣微漏，引發(fā)牙周問題；1例因?yàn)榛栏鈫栴}拆除原修復(fù)體行根管治療后重新修復(fù)。 以上幾個(gè)病例通過臨床接診，口腔檢查，制定修復(fù)計(jì)劃，牙體預(yù)備，制取印模，修復(fù)體制作及完成，口內(nèi)試戴粘接，術(shù)后隨訪觀察等步驟進(jìn)行。操作過程中應(yīng)確�；朗墙】档模浪柩辣仨氝M(jìn)行完善的根管治療確保根尖區(qū)無炎癥。如患者本身有高血壓、心臟病、糖尿病等系統(tǒng)疾病需控制后方可進(jìn)行修復(fù)治療。修復(fù)治療過程中應(yīng)當(dāng)及時(shí)與患者進(jìn)行溝通，向患者說明牙體、牙列缺損的原因，可選擇的修復(fù)治療方法、可選擇的修復(fù)材料、修復(fù)過程、費(fèi)用及愈后情況。牙體預(yù)備之前要進(jìn)行排齦，良好的排齦技術(shù)不僅可以減少在預(yù)備齦下肩臺(tái)時(shí)對(duì)牙齦組織的損傷和出血，同時(shí)也為齦下牙體預(yù)備提供良好的空間和清晰的視野。前牙修復(fù)中還應(yīng)該應(yīng)特別注意在比色環(huán)節(jié)與患者的交流以確保制作完成的修復(fù)體在外觀上能使患者滿意。修復(fù)治療完成后需向患者交待口腔維護(hù)知識(shí)，以及修復(fù)體使用過程中的注意事項(xiàng)來確保修復(fù)體的使用壽命。結(jié)果：修復(fù)體完成后經(jīng)過3-6個(gè)月隨訪，全瓷修復(fù)體解決了患者以往牙齦邊緣腫脹的問題，在功能及形態(tài)、色澤方面都能使患者滿意，恢復(fù)了口腔頜面系統(tǒng)的健康。 1、5例病例應(yīng)用二氧化鋯修復(fù)體3-6個(gè)月復(fù)診未發(fā)現(xiàn)牙齦紅腫、出血等異�，F(xiàn)象。 2、通過5例患者反饋的情況，一件合格的修復(fù)體不僅僅是為了恢復(fù)了患者牙齒的功能，更應(yīng)該考慮修復(fù)體的美觀及健康問題。前牙修復(fù)的比色尤其重要，不是越白最好，一定要與周圍牙齒顏色協(xié)調(diào)，這樣才能使戴入修復(fù)體后整體效果更逼真，更美觀。 結(jié)論：5個(gè)病例選用目前比較先進(jìn)的二氧化鋯進(jìn)行修復(fù)，解決了以往金屬烤瓷修復(fù)中牙齦邊緣易變色的問題。其中有幾個(gè)病例還應(yīng)用了纖維樁加強(qiáng)抗力，纖維樁的彈性模量接近牙本質(zhì)，有利于應(yīng)力在牙根周圍分布，緩解牙本質(zhì)應(yīng)力，降低根折發(fā)生率。對(duì)于提高修復(fù)治療的成功率，，粘接材料的選擇也非常重要。對(duì)于全瓷修復(fù)體的粘接我們通常選用的是樹脂粘接材料，其固化后強(qiáng)度高、粘接性強(qiáng)、無明顯水溶性。作為一名合格的口腔修復(fù)科醫(yī)生就是要通過系統(tǒng)的修復(fù)治療，選用合適的材料帶給患者健康、美觀、實(shí)用的修復(fù)體。
[Abstract]:Objective: to investigate the clinical procedure and effect of all ceramic restoration of tooth defect by collecting 5 clinical cases, and to understand the present application status of all porcelain restoration. Methods: five cases of all-ceramic prosthesis were selected: one case was a tetracycline dental root canal, one case needed crown restoration, one case was tooth filling, the filling was discolored, and the other 2 cases had slight leakage at the edge of porcelain prosthesis. Periodontal problems were caused in 1 case after root canal treatment due to abutment root apical problem. The above cases were treated by clinical examination, oral examination, making restoration plan, tooth preparation, making impression, repairing system and finishing. During the operation, the abutment teeth should be healthy, and the dead pulp teeth must be treated with perfect root canal to ensure that there is no inflammation in the apical region. If the patient has hypertension, heart disease, Diabetes and other systemic diseases need to be controlled before they can be repaired. In the process of repair and treatment, timely communication should be made with the patients to explain to the patients the causes of tooth and dentition defects, alternative methods of repair and treatment, and optional repair materials. Repair process, cost and recovery. Gingival retraction is required before preparation. Good gingival retraction techniques can not only reduce the damage and bleeding to the gingival tissue during the preparation of the subgingival shoulder table, At the same time, it also provides good space and clear vision for subgingival tooth preparation. Special attention should be paid to communicating with patients in colorimetry in order to ensure that the finished prosthesis can satisfy the patients in appearance. After the repair treatment is completed, oral maintenance knowledge should be given to the patients. Results: after 3-6 months follow-up, the all-ceramic prosthesis solved the problem of the swelling of the gingival edge in the past, in function and shape. Color can make the patient satisfied, restore the oral and maxillofacial system health. 1No abnormal phenomena such as gingival redness and bleeding were found in 5 cases with Zirconia prosthesis for 3 to 6 months. 2. According to the feedback from 5 patients, a qualified prosthesis is not only to restore the function of the patient's teeth, but also to consider the beauty and health of the prosthesis. Must be compatible with the color of the surrounding teeth, so that the overall effect after wearing the prosthesis more realistic, more beautiful. Conclusion: five cases were repaired with zirconia, which was advanced at present, which solved the problem of gingival edge discoloration in the past metal porcelain restoration. Some of the cases also used fiber post to strengthen resistance. The elastic modulus of the fiber post is close to that of the dentin, which is beneficial to the distribution of stress around the root, relieving the stress of the dentin and reducing the incidence of root fracture. The selection of adhesive materials is also very important. For all-ceramic restorations, we usually use resin adhesives, which have high strength and high adhesion after curing. There is no obvious water solubility. As a qualified prosthodontic doctor, it is necessary to select suitable materials to bring healthy, beautiful and practical restorations to the patients through systematic repair therapy.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.3

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