应用舌翼增强下颌总义齿固位的初步报告

全口义齿修复中,常见一些患者的牙槽骨严重吸收萎缩,致使用常规方法制作的全口义齿固位不良,稳定与支持作用差,达不到恢复咀嚼、语言和美观的功能要求。这种情况在无牙下颌更为常见,也更明显。如何解决下颌总义齿固位不良的问题,一直是一个复杂的难题。笔者近年来采用舌翼制作下颌总义齿的方法,修复治疗全口牙列缺失并且下颌齿槽     

下颌总义齿舌翼下缘位置的确定

下颌总义齿舌翼下缘位置与义齿的固位和稳定密切相关，为了确定舌翼下缘位置，必须了解影响下颌总舌翼下缘位置的因素，掌握舌翼肌能修整的临床方法，本文对此作了综述。     

舌的功能运动与下颌总义齿修复的关系

<正> 下颌总义齿修复后固位和稳定性差是临床上一大难题,如遇到下颌齿槽重度萎缩的病例,修复后效果则更不理想。笔者自1987年共修复了30例齿槽重度萎缩的下颌牙列缺失的病人,着重在协调舌的功能运动和下颌总义齿间的相互关系作了些尝试,充分利用舌的功能运动和解剖生理来帮助下颌总义齿的固位和稳定,取得了较为满意的修复效果。报道如下:     

下颌息止位在总义齿修复中的临床意义

对总义齿修复后的评价 ,是否正中是一个常用的基本指标 ,它直接关联到咀嚼功能恢复的好坏与否。在临床总义齿修复过程中 ,取颌位记录往往容易出现虽经努力但结果仍不理想的局面。本文通过收集近 5年来 80例总义齿修复成功的病例 ,发现确定下颌息止位有十分可靠的临床意义。临　床　资　料1　 80例总义齿修复病例中 ,男性 32例 ,女性4 8例。年龄最大 93岁 ,最小 34岁。牙列缺失时间最长 3 5年 ,最短 2个月。初次修复者 5 9例 ,再次修复者 2 1例。牙槽嵴吸收严重呈低平窄者 2 7例 ,牙槽嵴过高且前突者 7例。牙列缺失后面部下 1/ 3变形明显者…     

下颌总义齿的种植固定修复3例体会

临床上经常见到下颌无牙颌患者,由于牙槽骨严重吸收,虽经托牙修复,咀嚼功能受到严重影响,患者迫切要求改善咀嚼功能,种植义齿修复满足了患者的要求。我科采用完全由种植体支持的下颌总义齿修复３例,效果满意,现报告如下。材料和方法本组共３例,男２例,女１例,年龄６０～６４岁,都因牙周病龋病而致下颌牙缺失。种植体由北京莱顿生物材料有限公司提供,柱状,表面喷涂ＨＡ。一、术前准备１－印模,求咬合关系,排牙,制作托牙,如患者原有托牙,可用琼酯包埋复制托牙,以备作手术导板用。２－Ｘ线检查：将直径均匀一致的钢球两粒用…     

牙槽嵴严重萎缩的下颌总义齿有关固位问题的探讨

牙槽嵴严重萎缩的下颌总义齿有关固位问题的探讨山东省枣庄市第一卫生学校贾志祥下颔总义齿的固位差，尤以槽嵴低平者为甚。从其生理组织上的原因分析已在教材中明确阐述。但除此之外尚有不少是属在操作过程中未能将不利于义齿固位的因素及时消除而造成。经临床实践总结影...     

口腔混合唾液与下颌总义齿固位力

目的：探讨口腔混合唾液黏度和分泌量对下颌总义齿固位力的影响。方法：对31例患进行唾液黏度，分泌量及下颌总义齿固位力的测试。结果：切变率的改变可明显影响唾液黏度（P＜0．01），不同唾液黏度的两组间和不同唾液分泌量的两组间，下颌总义齿固位力略有差异，但差异均没有显性（P＞0．05）。结论：口腔混合唾液黏度和分泌量是影响下颌总义齿固位力的因素之一，但不是决定性因素。     

异常颌型全口义齿的修复设计与模型处理

目的 探讨异常颌型全口义齿的修复与固位。方法 在工作模唇、颊、舌侧视情况填塞倒凹,下颌舌侧基托均要盖过颌舌骨嵴,上下颌模型周边封闭处理。结果 140例中固位好者105例(75.0％),一般30例(21.4％),差5例(3.6％)。结论异常颌型全口义齿的设计制作应因人而异,合理设计和模型处理是增强全口义齿固位的关键。     

两种剂型义齿粘附剂对全口义齿咀嚼功能影响的初步研究

目的：评价两种剂型义齿粘附剂对牙槽嵴较为低平的无牙颌患者的作用效果,并对两种粘附剂进行相互比较.方法：测定10名牙槽嵴较为低平的无牙颌患者使用两种粘附剂前后咀嚼效能,同时以问卷形式调查患者的主观评价.结果：使用两种剂型粘附剂后,患者的咀嚼效能都得到显著改善,主观评价也较为理想.结论：义齿粘附剂可显著改善牙槽嵴较为低平的无牙颌患者的咀嚼功能.     

A Comparative Study of Mandibular Incisor Relation to the Lingual Frenum in Natural Dentition and in Complete Denture Wearers

The determination of the occlusal vertical dimension and proper positioning of the anterior teeth are major factors in making complete dentures which will give optimum service. In this study, efforts were made to evaluate the reliability of measurement of vertical distance between the anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors in natural dentition among different age groups and in complete denture wearers. Three hundred dentulous subjects belonging to different age groups and hundred edentulous patients wearing complete dentures were selected. The dentulous group was divided into three groups, group I (20–40 years), group II (41–60 years), group III (61 years and above) and the edentulous subjects being group IV ( 40–60 years). Mandibular irreversible hydrocolloid impression (Alginate) was made using modified stock tray. In edentulous subjects impression was made with denture in position. The vertical distance between anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors was measured on the dentulous casts and casts of complete denture wearer using dental surveyor and the vernier calipers. The values were tabulated and statistically analysed. The mean vertical distance between anterosuperior most point on the lingual frenum and mesioincisal edges of mandibular central incisors among dentulous subjects was 12.3 mm and among complete denture wearers was found to be 13.2 mm. There was no significant variation in the mean vertical distance among dentulous subjects belonging to different age groups. At 5 % significance level, statistically there was a significant difference in the mean vertical distance between group I and group IV; group II and group IV.     

Comfort义齿粘附剂对全口义齿咀嚼效能影响的临床评价

目的 评价自行研制的Comfort义齿粘附剂（Cmfort-DA）的临床效果。方法 测定10名患者使用粘附剂前后,新旧全口义齿的最大咬合力及咀嚼效能,以问卷形式调查患者的主观评价。结果 无论义齿基托与粘膜密合或不密合,所研制的粘附剂均可提高义齿的最大咬合力,但仅后者有统计学意义;患者的咀嚼效能得到显著改善;多数患者认为此粘附剂可提高义齿的固位、稳定及咀嚼力,粘附时间为6－8h。结论 所研制的粘附剂可显著提高全口义齿的咀嚼效能。     

树脂基托、钛基托全口义齿戴用前后语音效果的对比研究

目的对全口义齿初戴前后的临床语音适应效果做出主观评价。方法以患者自评和语音专业人员共同评价汉语语音清晰度的方法,分析30例全牙列缺失患者在义齿初戴前、初戴时、初戴后1、2、4、8周的语音变化规律。结果全口义齿初戴时,两实验组均感觉发音不适,初戴1周后,金属基托组已感觉能适应义齿,塑料基托组需2周以上时间。语音清晰度测评显示,义齿初戴后1周,两组之间有显著性差异(P<0.05),此时金属基托组已显示与初戴前有非常显著差异(P<0.01),塑料基托组需2周以上时间。结论减少全口义齿基托厚度,重建腭皱形态,有助于牙列缺失患者语音功能的恢复,其语音清晰度值较高。     

义齿粘附剂在全口义齿中的应用及临床评价

目的 评价两种义齿粘附剂的临床效果。方法分别测定25例患者使用义齿粘附剂前，使用Protefix粘着膏后和使用Protefix粘着粉后，全口义齿的最大切端咬合力及咀嚼效能。以问卷形式调查患者的主观评价。结果 粘着膏和粘着粉都可提高义齿的最大切端咬合力；患者的咀嚼效能得到明显改善；多数患者认为粘着膏和粘着粉都可提高义齿的固位，稳定及咀嚼力。结论 Protefix义齿粘附剂可以显著提高全口义齿的咀嚼效能。     

全口义齿的二次上架与三次上架

二次上架与三次上架是对全口义齿进行必要的咬合调改,目的是确保义齿能够与患者口腔结构良好适合并具有良好的咬合关系。二次上架一般在技工室由技工完成,内容是将基托成型后的义齿连同无牙颌模型一起复位至原先架上。通过原有颌位关系记录指导消除因义齿制作过程造成的咬合问题。与二次上架不同的是,三次上架则是由医师在临床完成。医师在进行全口义齿初戴时,重新记录患者上下颌的颌位关系,并将其与新义齿转移至架上进行最终的咬合调整。经过二次与三次上架的操作,全口义齿能够在患者口内具有良好的咬合关系。     

异常吞咽与牙根外吸收相关性的研究

目的：探讨异常吞咽对牙根吸收的影响。方法：选择11-16岁异常吞咽患者和正常吞咽患者各24名,拍全口曲面断层片,分别测量2组上下颌8个切牙的牙根吸收等级,并经过计算机进行统计学检验。结果：2组的牙根吸收等级差异有统计学意义（P〈0．05）。结论：异常吞咽是牙根吸收的高危因素。     

Changes of Hyoid,Tongue and Pharyngeal Airway after Mandibular Setback Surgery by Intraoral Vertical Ramus Osteotomy

Objective:To assess changes in hyoid, tongue, pharyngeal airway, and head posture in patients who had mandibular setback surgery by intraoral vertical ramus osteotomy (IVRO) and to investigate the influence of LeFort I osteotomy.Materials and Methods:Sixty patients with skeletal Class III malocclusion were evaluated. All patients had mandibular setback surgery via IVRO, and 45 patients had additional maxillary impaction surgery via LeFort I osteotomy. Lateral cephalograms were taken before, immediately after, approximately 1 month after, and at least 1 year after surgery. Parameters indicating the hyoid, tongue, pharyngeal airway, and head posture were evaluated.Results:The hyoid significantly moved inferoposteriorly immediately after surgery and relapsed superoanteriorly during observation periods. The tongue significantly moved posteriorly during all periods. The final position of the hyoid and tongue was significantly posterior, and the final pharyngeal airway was significantly narrower compared with its presurgical position. Significant cervical hyperflection occurred during observation periods and was strongly correlated with anterior movement of the hyoid. The hyoid and tongue showed similar positions regardless of the presence of different genders or LeFort I osteotomy after the long-term observation period.Conclusions:The hyoid and tongue moved posteriorly after mandibular setback surgery via IVRO, and there was a tendency to relapse back to its original position. However, the final pharyngeal airway width remained narrower after the long-term observation period. Based on our results, careful monitoring of the airway may be needed after mandibular setback surgery via IVRO.