牙体缺损全瓷修复病例分析报告

发布时间：2018-03-17 13:50

本文选题：牙体缺损　切入点：临床过程　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过5例临床病例的收集，了解牙体缺损全瓷修复的临床操作程序和效果，并了解目前全瓷修复的应用现状。方法：选取5例全瓷修复治疗病例：其中1例为四环素牙根管治疗后要求冠修复；1例为牙齿多次充填，充填物失色，影响美观；2例为原金属烤瓷修复体边缘微漏，引发牙周问题；1例因为基牙根尖问题拆除原修复体行根管治疗后重新修复。以上几个病例通过临床接诊，口腔检查，制定修复计划，牙体预备，制取印模，修复体制作及完成，口内试戴粘接，术后随访观察等步骤进行。操作过程中应确保基牙是健康的，死髓牙必须进行完善的根管治疗确保根尖区无炎症。如患者本身有高血压、心脏病、糖尿病等系统疾病需控制后方可进行修复治疗。修复治疗过程中应当及时与患者进行沟通，向患者说明牙体、牙列缺损的原因，可选择的修复治疗方法、可选择的修复材料、修复过程、费用及愈后情况。牙体预备之前要进行排龈，良好的排龈技术不仅可以减少在预备龈下肩台时对牙龈组织的损伤和出血，同时也为龈下牙体预备提供良好的空间和清晰的视野。前牙修复中还应该应特别注意在比色环节与患者的交流以确保制作完成的修复体在外观上能使患者满意。修复治疗完成后需向患者交待口腔维护知识，以及修复体使用过程中的注意事项来确保修复体的使用寿命。结果：修复体完成后经过3-6个月随访，全瓷修复体解决了患者以往牙龈边缘肿胀的问题，在功能及形态、色泽方面都能使患者满意，恢复了口腔颌面系统的健康。 1、5例病例应用二氧化锆修复体3-6个月复诊未发现牙龈红肿、出血等异常现象。 2、通过5例患者反馈的情况，一件合格的修复体不仅仅是为了恢复了患者牙齿的功能，更应该考虑修复体的美观及健康问题。前牙修复的比色尤其重要，不是越白最好，一定要与周围牙齿颜色协调，这样才能使戴入修复体后整体效果更逼真，更美观。结论：5个病例选用目前比较先进的二氧化锆进行修复，解决了以往金属烤瓷修复中牙龈边缘易变色的问题。其中有几个病例还应用了纤维桩加强抗力，纤维桩的弹性模量接近牙本质，有利于应力在牙根周围分布，缓解牙本质应力，降低根折发生率。对于提高修复治疗的成功率，，粘接材料的选择也非常重要。对于全瓷修复体的粘接我们通常选用的是树脂粘接材料，其固化后强度高、粘接性强、无明显水溶性。作为一名合格的口腔修复科医生就是要通过系统的修复治疗，选用合适的材料带给患者健康、美观、实用的修复体。
[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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.3

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