圆锥型套筒冠义齿的应用

发布时间：2018-08-03 09:57

【摘要】：牙列缺损是口腔修复科的常见病、多发病，一般有以下三种修复方案：固定义齿，可摘式活动义齿，种植义齿。但并不是每一位病患都有这三种方式可选择，每一种修复方案都有其相应的适应症和禁忌症。当出现牙周病伴发牙列缺损的病例，选择以上单一的某种方案就可能达不到理想的修复效果。牙周病患者由于牙周组织的破坏、牙周膜面积减小，牙槽骨不同程度的吸收，最后导致牙齿松动、移位，脱落，根冠比例不协调，承受咬合能力下降，牙列的完整性受到破坏。这些都增加了义齿修复的难度。进行修复治疗时，修复科医师既要尽量保留并延长余留牙的寿命，又要考虑需满足患者对义齿的固位、稳定、咀嚼效能各个方面的要求，故而有了套筒冠义齿的应用。临床研究表明套筒冠义齿的使用的确在以上特殊病例中解决了修复科医师的一大难题。那么套筒冠义齿与其它的修复方法联合应用修复牙列缺损的设计方案亦随之应用而生。总之，根据回顾性的临床研究表明圆锥型套筒冠义齿修复牙周病伴牙列缺损的临床效果是令人满意的，它与其它修复方式联合应用修复各种特殊病例更有广阔的前景和平台，能满足患者更多更高的要求。本实验通过对山西医科大学口腔医院就诊的修复科患者中，选择10例应用圆锥型套筒冠义齿修复的病例进行追踪回访，得出相应结论，并为圆锥型套筒冠义齿在医疗工作中的合理使用提供一定的依据。目的：临床收集10例牙周病伴发牙列缺损的病患，，均应用圆锥型套筒冠义齿进行修复并综合评价其临床疗效。方法：选择10例患有中度牙周病伴发牙列缺损的病人，通过系统的牙周基础治疗和完善根管治疗后，制作套筒冠13副，对患者在修复后一年复查，通过记录患者的主观感觉（固位力、咀嚼力、美观度），临床检查（牙龈指数，基牙松动度）综合评价治疗效果。结果：对这10例牙列缺损的患者进行双套冠义齿修复一年后回访，其中有8例患者自述义齿固位良好，异物感较小，咀嚼效能提高。有1例患者自述义齿固位不佳，咀嚼食物时容易脱落。将其外冠组织面用自凝树脂材料重衬后效果明显改善。另外1例患者自述咀嚼无力，适当调牙合后并嘱咀嚼注意事项。其中有4例使用全瓷内冠，美观效果优于金属内冠。这10例患者基牙牙龈缘均无红肿，出血等症状，牙龈缘无牙石软垢附着，基牙松动度与修复前相比有明显改善。结论：圆锥型套筒冠义齿作为修复牙周病伴发牙列缺损的现代较为理想的修复方式，以上10例病人的修复效果均良好，尤其是采用全瓷内冠+金沉积外冠修复的4例病例，美观效果也非常满意,基牙松动度有所改善，也不会加重牙菌斑的附着几率。
[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.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6

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