不同類型附著體用于牙列缺損修復臨床效果觀察的病例報告(碩士)

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不同類型附著體用于牙列缺損修復臨床效果觀察的病例報告(碩士)(論文32000字)
Clinical case reports of different types of attachment for clinical observation of dentition defect
摘  要
目的:通過使用不同類型附著體義齒對牙列缺損患者實施修復的臨床效果觀察,為臨床上口腔修復醫生選擇合適的附著體義齒提供參考依據。
方法:選取從2016年10月至2017年11月期間來我院修復科就診,因牙列缺損要求修復且完全接受使用附著體義齒修復的患者共為21例,其中男11例,女10例,平均年齡為62歲。
納入標準:①缺牙區牙合齦間距離≥4.0mm,非固定橋適應證患者;②對美觀要求較高者;③牙周組織健康,基牙的條件為無松動或松動度≤Ⅰ°,牙槽骨吸收≤牙根長的 1/3 且未經治療的牙或經根管治療后的根尖周組織正常的殘根殘冠;④患者無主觀精神障礙,思維清晰,無身體運動障礙性疾病等。
21例修復病例中,使用5種不同類型附著體義齒:①球帽附著體義齒9例,其中側方球帽附著體義齒3例、常規球帽附著體4例、種植球帽附著體2例;②磁性附著體義齒4例;③桿型附著體義齒(種植)2例;④栓體栓道附著體義齒3例,⑤太極扣附著體義齒3例(雙側)。隨訪觀察2~15個月,以患者主觀感覺和臨床檢查結果作為評價標準。戴牙后無主觀不適,義齒固位好,咀嚼有力,美觀,舒適,摘戴自如,且經檢查后基牙無疼痛或松動,牙齦組織健康,基托與黏膜之間密貼無縫隙,黏膜無明顯紅腫或潰瘍,則評定為滿意。患者自覺不適,義齒摘戴困難,咀嚼效率差,義齒松動脫落,異物感明顯及出現基牙松動,義齒固位差或穩定性不佳,基托與黏膜之間有縫隙或有明顯的不適感如疼痛等,經調整后仍不能達到要求者則評定為不滿意。
結果:經過2~15個月的隨訪觀察過程中,在應用5種不同類型附著體義齒修復牙列缺損的21例病例中:20例無明顯不適,義齒固位穩定,咀嚼有力,美觀,舒適,摘戴自如,牙齦健康,基托與黏膜間接觸緊密,無黏膜紅腫及潰瘍。1例患者修復4個月后出現疼痛不適,總體滿意度為95.2%。5種不同類型附著體義齒中,4種類型患者滿意度極高均達到滿分,僅在磁性附著體義齒修復中出現1例因附著體一側基牙周圍牙齦以及基托下黏膜紅腫潰瘍導致不適,后經重新調整咬合,重襯基托組織面,義齒緩戴一周后緩解。
結論: 5類附著體義齒在病例選擇恰當時均可起到改善義齒的固位、支持及穩定,提高咀嚼效率,保護基牙、延長基牙壽命的作用,可明顯提高患者對外觀、語音及咀嚼功能及舒適方面的滿意度。
關鍵詞: 附著體義齒 牙列缺損  固位

Abstract
Objective:
   In order to observe the clinical effect of denture defect and dentition defect by using different types of attachment denture, which can be helpful to select clinically appropriate denture attachment.
Methods:
Twenty-one patients with prosthetic denture repaired due to dentition defect, including 11 males and 10 females, with an average age of 62 were selected from October 2016 to November 2017 in our hospital. Inclusion criteria;① gingival gap of edentulous area ≥ 4.0mm; non-fixed bridge indications of patients;② higher aesthetic requirements;③ periodontal health, no loosening or loose abutment≤Ⅰ°, alveolar bone resorption ≤ 1/3 of the normal tooth root or residual root canals after root canal treatment;④ conscious, mental and physical movement disorders;
Among the 21 cases, 5 different types of attachment dentures were used: ① 9 cases were ball-cap attachment dentures: 3 cases were lateral ball-cap attachment denture, 4 cases were normal ball-cap attachment and 2 cases were implant-ball-cap attachment dentures. ②4 cases were magnetic attachment dentures; ③2 cases were implant-bar-clip attament dentures. ④ 3 cases were key-key way attachment dentures. ⑤ 3cases were ERA attament dentures.

Follow-up observation of 2 to 15 months, the patient's subjective feeling and clinical examination results as the evaluation criteria. After wearing the teeth no subjective discomfort, denture solid, chewing strong, beautiful, comfortable, easy to pick and check the abutment without pain or looseness, gum health, close contact with the mucosa, mucosa without obvious swelling and ulcers, as satisfied. Patients with discomfort, pick the dentures difficult to wear, chewing inefficient, loosening and loosening of the denture, foreign body sensation and the occurrence of abutment loose, poor retention or poor stability of the denture, the base and the mucosa is not close or obvious pain, can not be adjusted Reached as unsatisfactory.
Results:
After 2 to 15 months of follow-up observation, 21 cases of using 5 different types of attachment denture repair cases: 20 cases without obvious discomfort, stable denture retention, chewing strong, beautiful, comfortable, pick comfortable, gingival health, base Support and mucosal contact between close, no mucosal swelling and ulcers. One patient had pain discomfort after 4 months of repair, with an overall satisfaction of 95.2%. Of the 5 different types of attachment dentures, four types of patients reached full marks with satisfactory satisfaction. Only one case of dislocation of the gums around the abutment on the side of the attachment and the inflamed mucosa of the base caused by ulceration occurred in the magnetic attachment prosthesis , After re-adjustment occlusion, re-base surface of the organization, denture ease after a week to ease.
Conclusion:
when choice of cases is appropriate, Five kinds of attachment dentures can improve denture retention, support and stability, improve chewing efficiency, protect abutments and extend the life span of abutments, which can significantly improve the appearance, speech and masticatory function And comfort satisfaction.
key word:attachment denture  dentition defect  rentention
 
目    錄
一、摘要……………………………………………………………………………………………….…
(一)中文摘要……………………………………………………………………………………
(二)英文摘要……………………………………………………………………………..……
二、正文…………………………………………………………………………………….……………
(一)前言………………………………………………………….…………….…………………
(二)病例………………………………………………………………………………………….
1. 病例一.....................................................................................
2. 病例二....................................................................................
3. 病例三..................................................................................
4. 病例四...................................................................................
5. 病例五....................................................................................2
6. 病例六....................................................................................
7. 病例七....................................................................................3
8. 病例八....................................................................................3
9. 病例九....................................................................................4
10.病例十....................................................................................4
(三)討論……………………………………..…………………………………………………
(四)總結……………………………………………….………………………………………5
(五)參考文獻………………………………….……………………………………………
三、綜 述……………………………………………….……………………………………………5
(一)綜 述……………………………………….……………………………………………5
(二)參考文獻……………………………………………………………….………….…6
四、致 謝……………………………………………………………………………..……………

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