口腔不良固定修复体产生原因分析及再治疗

发布时间：2018-01-07 15:35

本文关键词：口腔不良固定修复体产生原因分析及再治疗　出处：《大连医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:现今的临床工作中,出现了很多修复后失败的病例,导致牙龈炎症、基牙牙髓或根尖周炎症、基牙松动、口腔异味、口腔黏膜病变等症状,对患者的生理和心理造成了严重的影响。不良修复体已经成为一个亟待解决的问题,本文从几个方面分析了可能造成不良修复体的原因,并且对不良修复体患者进行再治疗,为今后的临床工作提供依据。材料和方法:病例收集自2014年8月至2016年1月就诊于大连医科大学附属第一医院口腔门诊的患者,共有54例因戴有口腔不良固定修复体导致口腔疾病。通过患者主诉、采集现病史和临床检查,填写不良固定修复体调查表,分析不良修复体产生的原因,对不良修复体进行拆除和再治疗,随访1-2年,通过患者的满意度调查表来评价临床再次修复的效果。结果:54名不良修复体患者中,男性15例(38颗牙),女性39例(86颗牙),共124颗牙(前牙12颗,前磨牙48颗,磨牙64颗)。年龄26-80岁,平均年龄50.7岁。修复史2-28年。铸造冠桥13例,烤瓷冠桥25例,全瓷冠桥2例,锤造桥14例。修复体违反修复治疗原则12例,义齿设计不当20例,义齿制作不符合要求22例。39名患者出现牙龈炎,35名患者基牙出现疼痛,22名患者出现牙周疾病,基牙根折2例,修复体脱落、松动、断裂10例,口腔异味15例,口腔黏膜病变2例。26名再治疗患者中,对10名患者进行了固定修复治疗,修复治疗后基牙无疼痛感,牙龈恢复良好,根尖周暗影基本消失,咀嚼功能恢复良好,义齿形态美观;16名患者拆除不良修复体后,拔除不能保留的基牙,三个月后复诊,牙周情况恢复良好,牙槽窝形成骨组织,选用可摘局部义齿进行修复治疗。结论:1.不良修复体形成是由于违反修复治疗原则、义齿设计不当、义齿制作技术不符合要求、患者自身维护不佳导致。2.不良修复体会导致患者牙龈炎症、基牙牙髓或根尖周炎症、基牙松动、牙周病、口腔异味、口腔黏膜病变等症状。3.不良修复体的患者再治疗需要根据基牙及经济情况选择合适的修复方式。
[Abstract]:Objective: in the current clinical work, there are many cases of failure after repair, leading to gingival inflammation, abutment pulp or periapical inflammation, abutment loosening, oral odour, oral mucosal lesions and other symptoms. Bad restoration has become a problem to be solved urgently. This paper analyzes the possible causes of bad restoration from several aspects. And the patients with poor prosthesis were retreated. Materials and methods: cases were collected from August 2014 to January 2016 in the Stomatological outpatient Department of the first affiliated Hospital of Dalian Medical University. A total of 54 cases of oral diseases caused by wearing defective dental prosthesis. Through the main complaint of patients, collect the present medical history and clinical examination, fill in the questionnaire of defective fixed prosthesis, analyze the causes of bad prosthesis. The patients were followed up for 1-2 years to evaluate the effect of clinical re-repair through the questionnaire of patients' satisfaction. Results among 54 patients with poor prosthesis. A total of 124 teeth (12 premolars, 48 premolars, 64 molars, aged 26-80 years) were found in 15 males (38 teeth) and 39 females (86 teeth). The average age was 50.7 years. The restoration history was 2-28 years. There were 13 cases of cast crown and bridge, 25 cases of porcelain crown bridge, 2 cases of all porcelain crown bridge, 14 cases of hammer bridge. There were 22 cases of gingivitis and 35 cases of abutment pain and 22 cases of periodontal disease and 2 cases of base root fracture. 10 cases were removed, loosened and broken, 15 cases were odour, 2 cases were retreated with oral mucosal lesion, 10 cases were treated with fixed repair, and the abutment teeth were free of pain after repair. Gingiva recovered well, periapical shadow disappeared basically, masticatory function recovered well, denture appearance was beautiful. After removing the defective prosthesis, 16 patients pulled out the abutment teeth which could not be retained. After 3 months of treatment, the periodontal condition recovered well and bone tissue formed in the alveolar fossa. Conclusion 1. The formation of defective prosthesis is due to the violation of the principles of repair, improper design of denture, and the technology of denture making does not meet the requirements. 2. Poor maintenance of patients caused by .2. poor repair experience led to inflammation of the gingival abutment pulp or periapical inflammation abutment teeth loose periodontal disease oral odour. Oral mucosal lesions and other symptoms .3. patients with poor prostheses need to choose appropriate repair methods according to abutment and economic conditions.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R783

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