遗传性乳光牙患者附着体修复的效果观察

[摘要] 目的 探讨遗传性乳光牙本质患者固定修复与附着体可摘局部义齿修复的可行性、临床疗效及随访观察。方法 对2例遗传性乳光牙患者进行咬合重建,采用固定修复及附着体可摘局部义齿修复缺失牙部分,并长期随访评价修复后效果,观察疗效及出现的问题和处理方法。结果 义齿修复效果良好,2年后1例患者义齿部分损坏,仍可达到良好的咀嚼效果。结论 遗传性乳光牙本质患者进行附着体义齿修复是可行的,但须长期随访观察及处理。     

遗传性乳光牙本质病的家系调查及修复方法

目的:了解遗传性乳光牙本质(又名牙本质发育不全Ⅱ型,DGI-Ⅱ)的遗传特征,探讨其治疗方法。方法:调查在上海发现的1例遗传性乳光牙本质患者的家系成员,进行系谱分析。对先证者作金瓷修复体治疗,并调查该家系受累者的修复情况。结果:该遗传性乳光牙本质家系中,患者连续5代出现,子代患病率接近50%。该家系子代义齿修复率90%,修复方式包括金瓷修复体和可摘局部义齿,以金瓷修复体为主,修复后美观和咀嚼功能良好。结论:遗传性乳光牙本质家系发病率高,金瓷修复体能达到预防牙体磨损和崩裂、恢复美观和咀嚼功能的效果。     

遗传性乳光牙本质的固定修复体会

目的：探讨遗传性乳光牙本质固定修复的可行性、操作要领及临床疗效。方法：本文有3例遗传性乳光牙本质患者进行了固定修复并行双颌的咬合重建，恢复到患者的最适颌位，随访观察疗效。结果：临床检查结果显示，半年后有3颗基牙的龈缘探诊出血；1年后有1颗烤瓷冠崩瓷；3例患者均对修复体满意。结论：遗传性乳光牙本质的固定修复是可行的，但患者的牙齿抗折裂性仍需进一步临床观察，双颌的咬合重建规范仍需完善。     

乳光牙重度磨耗套筒冠可摘义齿修复1例

遗传性乳光性牙本质,属于常染色体显性遗传病,临床及组织病理变化的特点是：牙本质小管数量少,粗细不等,排列紊乱,牙本质矿化不良,与釉质结合力差。临床上牙体表面常呈釉质脱落,牙本质重度磨耗,影响咀嚼和美观。由于患牙牙体组织脆弱,根管髓腔小闭锁,如何在牙根上进行咬合重建,给修复带来极大的困难。套筒冠可摘义齿是以套筒冠作为固位体。优点是：义齿功能好,咀嚼效率高;能够保护余留牙的健康,减少牙槽嵴的吸收;可以恢复低位咬台,进行咬合重建,并舒适美观。在临床中,我们采用了套筒冠可摘义齿修复体,为１位遗传性乳光牙…     

一例遗传性乳光牙本质的治疗及家系调查

目的：探讨遗传性乳光牙本质治疗修复的特殊性、可行性及操作中应注意的问题。方法：通过对1例遗传性乳光牙本质患者的家系调查,治疗修复及双颌的咬合重建,恢复患者的最适颌位,并随访观察疗效。结果：遗传性乳光牙本质家系中涉及4代9人患病。对先证者进行治疗,并经6年临床随诊观察,患者对修复体较满意。结论：遗传性乳光牙本质患者采用多种治疗修复方法可恢复牙齿美观及咀嚼功能。     

咬合重建相关病例回顾及修复流程研究

目的根据咬合异常的不同临床表现，应用不同的修复方法进行咬合重建，评价临床效果，讨论与咬合重建相关疾病的临床诊断及修复设计流程。方法64例咬合异常患者按照修复前检查-诊断-修复设计-咬合重建修复-修复后评价的临床步骤，进行固定修复、固定-可摘局部义齿修复及可摘局部义齿修复咬合重建，于修复前后分别检查颞颌关节健康状况、义齿使用情况与咀嚼效能。结果咬合重建修复1年后，30例颞颌关节紊乱病患者中的25例治愈，对关节区疼痛与关节弹响的疗效差异有统计学意义：全部患者对咬合重建修复的临床效果满意，与可摘局部义齿修复相比较，固定修复、固定-可摘局部义齿修复在义齿舒适度（X^2=5．25，P〈0．05）和对发音影响（X^2=10．86，P〈0．05）等方面的满意度较高，差异有统计学意义；不同种类修复之间及选用不同种类修复咬合重建修复前（F=9．248，P〈0．05）和修复后（F=4．858，P〈0．05），患者咀嚼效能的差异有统计学意义。总结和制定与咬合重建相关疾病的临床诊断流程及修复设计流程。结论运用系统化的临床诊断流程及修复设计流程，能保障获得准确的诊断与针对性的修复设计，保证咬合重建诊疗修复取得成功。     

牙列缺损伴重度磨耗的咬合重建及修复

目的探讨牙列缺损伴重度磨耗咬合重建及修复方法。方法本文重点介绍了牙列缺损并伴有严重磨耗,面下1/3高度变短的病例,采用固定义齿与简单或垫式通可摘局部义齿进行联合性修复,以获得永久性咬合重建治疗。结果对牙列缺损伴重度磨耗的病例,可通过暂时性修复进行过渡,固定义齿与简单或垫式可摘局部义齿进行联合性修复以达到满意的疗效。结论合理的咬合重建修复治疗可有效恢复患者正中颌位关系及正常的咀嚼功能、治疗及预防颞下颌关节疾病、改善美观。     

附着体用于活动-固定义齿联合修复牙列缺损187例的临床研究

目的 观察附着体用于活动-固定义齿联合修复牙列缺损患者的临床效果。方法 对本院口腔科就诊的187例牙列缺损的患者采用附着体活动-固定义齿联合修复。共201件修复体,其中上颌76件,下颌125件。修复后定期临床追踪,以临床检查和影像学检查评价修复效果。结果 至最后1次复查,186例患者临床检查未见修复体松动、折断、损坏,修复体固位好、稳定。结论 附着体式可摘局部义齿周围组织稳定,可用于牙列缺损的修复。     

牙列重度磨耗伴缺损老年患者两种咬合重建治疗的效果比较

目的:观察牙列重度磨耗伴缺损的老年患者分别采用垫式可摘局部义齿与固定义齿进行咬合重建治疗的效果,并进行对比研究。方法:24例牙列重度磨耗伴缺损的老年男性患者,分别采用垫式可摘局部义齿与固定义齿进行咬合重建治疗,其中垫式可摘局部义齿咬合重建组15例,固定义齿咬合重建组9例,并分别对患者治疗前后的自我感觉(美观、舒适)、临床表现、咀嚼效率、颞下颌关节紊乱病临床症状的变化等指标进行评估及分析。结果:垫式可摘局部义齿与固定义齿咬合重建治疗后,患者均主观感觉良好、临床症状改善、咀嚼效率增加,差异显著(P<0.01)。固定义齿咬合重建组患者较垫式可摘局部义齿咬合重建组患者主观感觉更好,咀嚼效率增加更多(P<0.05)。有颞下颌关节病症状的患者咬合重建后症状均有改善,两种咬合重建方法间未见明显差异。结论:垫式可摘局部义齿与固定义齿咬合重建治疗均能一定程度恢复牙列重度磨耗伴缺损老年患者的口颌功能,改善颞下颌关节病症状。采用固定义齿进行咬合重建治疗更具有美观、舒适、提高咀嚼效率的作用。     

酸蚀症患者的咬合重建修复

目的：探讨咬合距离降低的酸蚀症患者的修复治疗方法。方法：对酸蚀症患者进行咬合重建序列治疗,包括暂时性[牙合]垫式可摘局部义齿、冠延长术、根管治疗术以及固定与可摘局部义齿联合修复。结果：患者的咬合距离抬高、咀嚼和美观功能得到很好的恢复,无牙周炎症和颢下颌关节的异常。结论：对于咬合距离降低的酸蚀症患者进行修复时要注重咬合重建序列治疗。     

Interim rehabilitation of occlusal vertical dimension using a double-crown-retained removable dental prosthesis with polyetheretherketone framework

Polyetheretherketone (PEEK) is a polymeric material that has recently been introduced in dentistry and can be used as framework material for fixed and removable dental prostheses. This clinical report describes the fabrication of a double-crown–retained prosthesis with a PEEK framework in a patient with a substantially diminished occlusal vertical dimension. The insertion of the removable dental prosthesis with a PEEK framework resulted in the functional and esthetic rehabilitation of the patient; however, removable dental prostheses fabricated from PEEK should currently be regarded as interim restorations because of the limited available scientific evidence.     

An unusual presentation of opalescent dentin and Brandywine isolate hereditary opalescent dentin in an Ashkenazic Jewish family

Two children of Austrian Ashkenazic Jewish background, related as second cousins, have a variant of opalescent dentin in their deciduous teeth. This has been classified by Witkop as Brandywine isolate hereditary opalescent dentin and by Shields as dentinogenesis imperfecta type III. One of the children also has dysmorphic facial features, seizures, and severe mental retardation. Her mother has dysmorphic facial features and mild mental retardation. The mothers of both children and several other family members have classic opalescent dentin (dentinogenesis imperfecta type II). Radiographs of the deciduous and permanent dentitions of one mother showed obliterated pulp chambers. Confirmation of obliterated pulp chambers in the deciduous teeth of the mother of a child with Brandywine isolate hereditary opalescent dentin makes it unlikely that classic opalescent dentin and Brandywine isolate hereditary opalescent dentin are separate genetic disorders. Evidence from this family supports the hypothesis that Brandywine isolate hereditary opalescent dentin is a variant of opalescent dentin.     

Restoration of occlusal vertical dimension by means of a silica-coated onlay removable partial denture in conjunction with dentin bonding: a clinical report.

The prosthesis described in this article allowed restoration of occlusal height by means of an onlay removable partial denture and composite resin bonded veneers. Reasons for its selection are: 1. It is a reversible procedure. 2. The patient can easily clean any plaque accumulation due to supragingival margins. 3. The cost to the patient was much lower than that of a fixed prostheses. 4. Chair time is less than with a fixed prosthesis. 5. Tooth structure remains relatively unaltered except for recontouring prior to onlay construction. 6. Repairs are easily done. 7. The onlays of the removable partial denture transfer the occlusal load on the abutment teeth along their long axes. 8. The procedure is less stressful and fatiguing to the patient than that involving a fixed prosthesis.     

Wear of resin denture teeth in partial removable dental prostheses

PurposeTo investigate occlusal wear of resin denture teeth in partial removable dental prostheses worn by partially edentulous patients.MethodsThirty patients with partial removable dental prostheses were included in the study. Thirty-two patients with complete dentures served as a reference group. Occlusal wear after two years was evaluated indirectly using gypsum casts and a three-dimensional laser-scanner device. Overall wear of complete occlusal surfaces and maximum wear of occlusal contact areas were measured. Patient and prosthesis data were analyzed using univariate and multiple linear mixed models.ResultsOverall wear of denture teeth in partial removable dental prostheses was 91 (SD 85) μm, and maximum wear of occlusal contact areas was 329 (SD 204) μm (means and standard deviations). Average and maximum wear values for teeth in complete dentures were both lower than those for teeth in partial removable dental prostheses. However, differences between wear of different types of denture did not reach statistical significance after adjustment for gender, type of tooth, dental status of the opposing jaw, and antagonist material. Statistical analysis revealed that wear was greater for denture teeth occluding with ceramic crowns and/or fixed partial dentures as antagonists.ConclusionsResin denture teeth in partial removable and complete dental prostheses are subjected to clinically important occlusal wear that might destabilize occlusion and cause further problems. Patient-related factors and dental status affect wear behavior and should be taken into consideration when treating patients with removable dentures.     

遗传性乳光牙本质系谱调查及修复治疗1例

遗传性乳光牙本质是一种牙本质发育异常的常染色体显性遗传病,发病率低。本文报道1例遗传性乳光牙本质患者的家系调查及修复治疗,并探讨该病的发病机制和治疗方法。     

Multi-unit fixed partial denture for a bilateral cleft palate patient: a clinical report

Patients with cleft palates eventually require definitive fixed or removable dental prostheses after the maintenance of arch alignment and occlusal relationship during adolescence. This case report presents application of a resin composite veneered fixed partial denture utilized as a definitive prosthesis for a bilateral cleft palate patient after stable occlusion had been established orthodontically. The composite veneered long span fixed partial denture provides adequate aesthetics and function.     

A restorative-orthodontic treatment approach in the older patient

This report presents a case requiring a combination of restorative dentistry and orthodontic treatment in a mature adult patient. Occlusal splint and periodontal therapies were used initially. Orthodontic treatment combined the use of the occlusal splint and fixed appliance in the maxillary arch. Sectional fixed appliances were used in the mandibular arch. The final restorations were fixed--movable bridges in the mandibular arch and a removable tooth and mucosally borne prosthesis in the maxilla. Retention of the orthodontic result was provided by the fixed prostheses in the lower arch and the continued wear of a full coverage maxillary occlusal splint at night served to prevent relapse of the upper teeth.     

Full-mouth rehabilitation of a patient with severely worn dentition and uneven occlusal plane: a clinical report

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. Using mini-implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46-year-old man was referred for restoration of his worn and missing teeth. After diagnostic work-up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini-implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom-cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal-ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow-up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.