改良式固定型马里兰桥修复老年前牙缺失的临床效果观察

目的 探讨运用改良式固定型马里兰桥修复老年患者前牙缺失的可行性,并对修复的方法设计、修复体制作过程及适应证进行总结.方法 选择个别前牙缺失,存在不同程度邻牙松动、牙龈萎缩、牙根暴露等体征的老年患者24例,运用改良式固定型马里兰桥修复缺失牙,并对完成修复的病例随访3～5年.结果 修复成功率为87.5%.24例患者有3例修复体脱落,需重新粘接;其余修复体未见明显松动.基牙无松动,桥体下方牙龈无明显红肿,患者对修复体的使用与外观效果均感满意.12例患者存在不同程度牙结石;2例患者存在舌侧轻度异物感,经过对症处理后效果满意.结论 改良式固定型马里兰桥修复老年前牙缺失具有磨牙少、效果美观,并能同时固定松动牙邻牙等优点,修复效果可靠.但其远期效果有待进一步观察.

Design and clinical application of modified fixed Maryland Bridge for restoration of geriatric anterior dentition defects

Objective The anterior dentition defects of geriatric patients were restored with modified fixed Maryland Bridge. The clinical design, tooth preparation, fabrication of prosthesis and clinical indication were summarized. Method 24 cases of geriatric patients with anterior dentition defects were restored with modified fixed Maryland Bridge. All selected cases were accompanied with different degree of loosening of neighboring teeth, gingival atrophy and exposure of root. The dentition defects were successfully restored and followed up for 3 to 5 years. Results The overall success rate was 87. 50/oo. Three patients had the prosthesis loosened and re-bonding was necessary. No loosening was found in other patients. There was no swelling or inflammation of gingival underneath the prosthesis. All patients were quite satisfactory with the function and appearance of the prosthesis. Dental calculus was observed in 12 patients, and 2 patients complained of a feeling of foreign body on the side of tongue Conclusion The modified fixed Maryland Bridge, when used in restoring the dentition defect of geriatric patients, showed the advantages of less tooth reduction, perfect esthetic effect, good fixation of loosening teeth as well as restoration of missing teeth with its splint wings. However, the long-term effect of this technique needs to be further observed.