【摘要】：牙列缺損是口腔修復(fù)科的常見病、多發(fā)病，一般有以下三種修復(fù)方案：固定義齒，可摘式活動義齒，種植義齒。但并不是每一位病患都有這三種方式可選擇，每一種修復(fù)方案都有其相應(yīng)的適應(yīng)癥和禁忌癥。當出現(xiàn)牙周病伴發(fā)牙列缺損的病例，選擇以上單一的某種方案就可能達不到理想的修復(fù)效果。牙周病患者由于牙周組織的破壞、牙周膜面積減小，牙槽骨不同程度的吸收，最后導(dǎo)致牙齒松動、移位，脫落，根冠比例不協(xié)調(diào)，承受咬合能力下降，牙列的完整性受到破壞。這些都增加了義齒修復(fù)的難度。進行修復(fù)治療時，修復(fù)科醫(yī)師既要盡量保留并延長余留牙的壽命，又要考慮需滿足患者對義齒的固位、穩(wěn)定、咀嚼效能各個方面的要求，故而有了套筒冠義齒的應(yīng)用。臨床研究表明套筒冠義齒的使用的確在以上特殊病例中解決了修復(fù)科醫(yī)師的一大難題。那么套筒冠義齒與其它的修復(fù)方法聯(lián)合應(yīng)用修復(fù)牙列缺損的設(shè)計方案亦隨之應(yīng)用而生�？傊�，根據(jù)回顧性的臨床研究表明圓錐型套筒冠義齒修復(fù)牙周病伴牙列缺損的臨床效果是令人滿意的，它與其它修復(fù)方式聯(lián)合應(yīng)用修復(fù)各種特殊病例更有廣闊的前景和平臺，能滿足患者更多更高的要求。本實驗通過對山西醫(yī)科大學(xué)口腔醫(yī)院就診的修復(fù)科患者中，選擇10例應(yīng)用圓錐型套筒冠義齒修復(fù)的病例進行追蹤回訪，得出相應(yīng)結(jié)論，并為圓錐型套筒冠義齒在醫(yī)療工作中的合理使用提供一定的依據(jù)。 目的：臨床收集10例牙周病伴發(fā)牙列缺損的病患，，均應(yīng)用圓錐型套筒冠義齒進行修復(fù)并綜合評價其臨床療效。 方法：選擇10例患有中度牙周病伴發(fā)牙列缺損的病人，通過系統(tǒng)的牙周基礎(chǔ)治療和完善根管治療后，制作套筒冠13副，對患者在修復(fù)后一年復(fù)查，通過記錄患者的主觀感覺（固位力、咀嚼力、美觀度），臨床檢查（牙齦指數(shù)，基牙松動度）綜合評價治療效果。 結(jié)果：對這10例牙列缺損的患者進行雙套冠義齒修復(fù)一年后回訪，其中有8例患者自述義齒固位良好，異物感較小，咀嚼效能提高。有1例患者自述義齒固位不佳，咀嚼食物時容易脫落。將其外冠組織面用自凝樹脂材料重襯后效果明顯改善。另外1例患者自述咀嚼無力，適當調(diào)牙合后并囑咀嚼注意事項。其中有4例使用全瓷內(nèi)冠，美觀效果優(yōu)于金屬內(nèi)冠。這10例患者基牙牙齦緣均無紅腫，出血等癥狀，牙齦緣無牙石軟垢附著，基牙松動度與修復(fù)前相比有明顯改善。 結(jié)論：圓錐型套筒冠義齒作為修復(fù)牙周病伴發(fā)牙列缺損的現(xiàn)代較為理想的修復(fù)方式，以上10例病人的修復(fù)效果均良好，尤其是采用全瓷內(nèi)冠+金沉積外冠修復(fù)的4例病例，美觀效果也非常滿意,基牙松動度有所改善，也不會加重牙菌斑的附著幾率。
[Abstract]:Dentition defect is a common disease in prosthodontic department. There are three kinds of restoration schemes: fixed denture removable denture and implant denture. But not every patient has these three options, and each repair protocol has its own indications and contraindications. In the case of periodontal disease accompanied with dentition defect, choosing a single scheme above may not achieve the ideal repair effect. Due to the destruction of periodontal tissue, the area of periodontal ligament decreases and the alveolar bone absorbs to different degrees, which leads to tooth loosening, displacement, loss of root and crown ratio, reduction of tolerance and occlusal ability, and destruction of the integrity of dentition. These all increase the difficulty of denture restoration. In the course of prosthetic treatment, the prosthesiologist should not only keep and prolong the life of the remaining teeth as far as possible, but also consider the need to meet the requirements of the patients for the retention, stability and masticatory efficacy of denture. Therefore, the application of the sleeve crown denture has been obtained. Clinical studies have shown that the use of sleeve crown dentures does solve a major problem for prosthesiologists in these special cases. Therefore, the design of socket crown denture combined with other methods to repair dentition defect is also applied. All in all, according to the retrospective clinical studies, the clinical effect of conical socket crown denture for periodontal disease with dentition defect is satisfactory, and it has a broad prospect and platform for the repair of various special cases in combination with other repair methods. Can satisfy the patient more and higher request. In this experiment, 10 cases were selected from the Department of Restoration, Shanxi Medical University Stomatology Hospital, and 10 cases were treated with conical sleeve crown denture, and the corresponding conclusions were drawn. It also provides some basis for the rational use of cone-type sleeve crown denture in medical work. Objective: 10 patients with periodontal disease associated with dentition defect were treated with conical socket crown denture and their clinical efficacy was evaluated. Methods: ten patients with moderate periodontal disease accompanied with dentition defect were selected. After systematic periodontal basic treatment and complete root canal therapy, 13 pairs of sleeve crowns were made, and the patients were reexamined one year after repair. The patients' subjective feelings (retention, mastication, beauty) and clinical examination (gingival index, abutment mobility) were recorded. Results: ten patients with dentition defect were treated with double crown denture for one year. Among them, 8 cases reported that the denture retention was good, the foreign body feeling was small, and the masticatory efficiency was improved. In one case, denture retention was poor and easy to fall off when chewing food. The effect of relining the outer crown surface with self-coagulating resin was improved obviously. Another patient reported weakness in mastication, adjusted the occlusal properly and ordered the masticatory precautions. In 4 cases, all-ceramic inner crown was used, and the aesthetic effect was better than that of metal crown. The gingival margin of the abutment teeth were not redness, bleeding and other symptoms. There was no soft scaling attached to the gingival margin, and the mobility of abutment teeth was significantly improved compared with that before restoration. Conclusion: conical telescopic crown denture is a modern and ideal method for repairing periodontal disease associated with dentition defect. The results of all the above 10 cases are satisfactory, especially in 4 cases with all porcelain inner crown and gold deposit external crown. Aesthetic effect is also very satisfactory, abutment mobility has improved, also will not aggravate plaque attachment probability.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.6

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