磁性附着体义齿临床病例报告分析

发布时间：2018-08-27 10:56

【摘要】：目的:观察磁性附着体义齿在修复缺损与缺失牙列的效果。方法:选取2015年7月至2016年9月来大连医科大学附属大连市口腔医院接受治疗并实施磁性附着体修复的10例患者。男性1例,女性9例。年龄在50至90岁之间,平均年龄72岁。所有患者都为牙列缺损,同时保有不同数目的剩余牙齿为残根、残冠。松动度不足二度,经过完善的牙体牙周治疗。10例患者一共设置19只Magfit磁性附着体,其中MagfitMD800型设置数量为10只,MagfitEX600型设置数量为9只。共修复磁性附着体义齿12件,其中包括:全口覆盖义齿5件、卡环与磁性附着体联合固位的可摘部分义齿6件、上颌修补义齿1件。修复前询问患者是否有过敏史、全身性疾病,口外检查颞下颌关节和开口度有无异常。对患者口内具体情况进行详细分析,通过影像学辅助检查了解患者口腔内余留牙健康状况。积极与患者沟通,告知患者治疗方法、过程及所需要的费用。患者知情同意,最后确定修复治疗方案。修复中,经过完善根管治疗2周后,患牙叩(-)、无不适,基牙牙体预备,齐龈截冠,预备根管,制取桩道印模。衔铁蜡型完全覆盖根面。衔铁高于根面的部分应形成钝角,依根面的大小选择600型号或800型号的磁性附着体。镍铬合金铸造完成、抛光,用富士粘接剂将其粘固于根管内。将磁铁准确固定在衔铁表面,制取终印模。制作全口义齿或可摘局部义齿,8例患者10件义齿选择使用维他林金属支架或钛支架。患者在粘固磁铁前试戴义齿2周无不适后,用自凝塑料粘固磁铁。自凝塑料结固,打磨抛光,完成义齿修复。修复后6个月,患者来医院复查。通过患者对义齿的咀嚼功能、稳定性、美观性、舒适度、语言功能等5项和义齿总体的满意度进行评价,了解修复治疗的效果和义齿的使用情况。通过检查义齿的完整性、基牙牙周情况、有无龋坏、粘膜是否有压痛,作出客观的临床评价。结果:10组病例患者均有过可摘局部义齿修复经历。10组病例患者对磁铁粘固后6个月义齿的咀嚼功能的满意度,均高于磁铁粘固前义齿的咀嚼功能的满意度。患者对磁铁粘固后6个月义齿的稳定性、美观性、舒适度、语言功能、义齿总体满意度均较高。12件义齿获得了满意的临床修复效果。满足了所有患者的要求。12件义齿未发现义齿固位不良、衔铁脱落、继发龋坏、基牙松动、义齿折断、义齿翘动、牙龈炎等不良现象。结论:磁性附着体义齿对修复缺损牙列具有良好的临床修复效果。明显提高义齿的固位力,提高稳定性,改善美观性与舒适性,在适宜的情形下,磁性附着体义齿是一个较好的选择。
[Abstract]:Objective: to observe the effect of magnetic attachment denture in repairing defect and missing dentition. Methods: from July 2015 to September 2016, 10 patients were treated and repaired with magnetic attachment in Dalian Stomatological Hospital affiliated to Dalian Medical University. There were 1 male and 9 female. It is between 50 and 90 years old, with an average age of 72. All patients had dentition defects and retained different numbers of residual teeth with residual roots and crowns. The degree of mobility was less than two degrees. 19 Magfit magnetic attachments were set up in 10 patients with periodontal treatment, of which 10 were MagfitMD800 type and 9 were MagfitEX600. A total of 12 magnetic attachment dentures were repaired, including 5 complete overdentures, 6 removable partial dentures with clasp and magnetic attachment, and 1 maxillary prosthetic denture. Patients were asked if they had a history of allergies, systemic diseases, and extraoral examination of the temporomandibular joint and degree of opening. The status of residual teeth in oral cavity was analyzed in detail, and the health status of residual teeth in oral cavity was studied by imaging assisted examination. Actively communicate with patients and inform them of the treatment, procedures and costs involved. Patient informed consent, the final repair treatment program. During the restoration, after 2 weeks of perfect root canal treatment, the affected teeth percussed (-) without discomfort, the abutment teeth were prepared, the crown of the gingival was cut, the root canal was prepared, and the impression of the post canal was made. Armature wax completely covers the root surface. The part of armature above the root surface should form obtuse angle, depending on the size of the root surface, the type 600 or 800 type magnetic attachment should be selected. Nickel-chromium alloy is cast, polished and glued in root canal with Fuji adhesive. The magnet is accurately fixed on the surface of the armature and the final impression is made. Ten complete or removable partial dentures of 8 patients with complete denture or removable partial denture were treated with Vitamin metal or titanium stent. A self-solidified plastic magnet was used to fix the denture magnet after the patient tried to wear it without discomfort for 2 weeks before cementing the magnet. Self-solidified plastic fastening, grinding and polishing, complete denture repair. Six months after the repair, the patient came to the hospital for reexamination. Five items of masticatory function, stability, beauty, comfort, language function and the overall satisfaction degree of denture were evaluated to understand the effect of prosthetic treatment and the use of denture. Objective clinical evaluation was made by examining the completeness of denture, periodontal condition of abutment, caries and tenderness of mucous membrane. Results all the patients in 10 groups had the experience of removable partial denture restoration. The patients of 10 groups had satisfaction with masticatory function of denture 6 months after magnet bonding, which was higher than that of predenture with magnet bonding. The stability, beauty, comfort, language function and overall satisfaction of the dentures were all higher than that of the patients in 6 months after magnet bonding. The clinical results were satisfactory. All patients were satisfied with the requirements. 12 dentures were not found to have poor denture retention, armature fall off, secondary caries, abutment loosening, denture fracture, denture tilting, gingivitis, and so on. Conclusion: magnetic attachment denture has good clinical effect in repairing defective dentition. The retention force, stability and comfort of denture can be improved obviously. Magnetic attachment denture is a better choice under suitable 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】：2017
【分类号】：R783.6
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本文编号：2207063