后牙复合树脂修复的临床评价

随着后牙复合树脂在临床日益广泛的应用,人们对其在后牙修复中是否能代替银汞合金以及确切的临床效果仍存有疑虑。作者对后牙复合树脂的一般情况、常用的临床评价标准以及近年来的临床研究结果等进行综述。     

银汞合金与P60复合树脂充填后牙窝洞的疗效观察

目的　对比银汞合金和P6 0复合树脂充填后牙窝洞的疗效。方法　应用银汞合金充填后牙窝洞4 0例99颗牙,应用P6 0复合树脂充填后牙窝洞4 5例112颗牙,经18～30个月复查。结果　银汞合金和P6 0复合树脂充填Ⅰ类洞成功率为95 .0 %和97.0 % ,无统计学差异;充填Ⅱ类洞成功率为76 .9%和95 .6 % ,两者有统计学差异。结论　在观察时间内,P6 0复合树脂充填Ⅱ类洞显示良好的充填效果。     

后牙复合树脂修复的研究进展

20世纪 60年代初 ,Ｂｏｗｅｎ合成了Ｂｉｓ -ＧＭＡ(双酚 -Ａ -二甲基丙烯酸缩水甘油酯 )树脂。 1 986年 ,以Ｂｉｓ-ＧＭＡ为基质的复合树脂被厂家推荐用于Ⅱ类洞的修复 ,但因材料内填料颗粒大 ,理化性能不佳 ,未能得到临床医生的认可[1] 。 70年代 ,光固化复合树脂的引入促进了复合树脂在牙体修复方面的应用 ,随后 ,研制出了小颗粒的复合树脂和早期的粘接剂。 80年代初 ,复合树脂开始用于后牙修复 ,近几年来 ,复合树脂的理化性能得到显著改进 ,加之患者对修复美观要求的增加及人们对汞合金修复中汞污染的顾虑 ,后牙复合树脂修复引起了人们…     

后牙残冠修复治疗临床疗效观察

后牙残冠修复治疗临床疗效观察上海市长宁区同仁医院江一凡本科自１９９２年９月至１９９４年６月对３５２个牙冠缺损超过一半以上、髓室底存在、松动在Ⅰ°以内的后牙以根管为单位，视不同的根管情况行根管治疗和塑化治疗，并行根管内置钉加以玻璃离子充填。最后用成品冠...     

后牙复合树脂修复的临床评价

随着后牙复合树脂在临床日益广泛的应用，人们对其在后牙修复中是否能代替银汞合金以及确切的临床效果仍存有疑虑。作者对后牙复合树脂的一般情况、常用的临床评价标准以及近年来的临床研究结果等进行综述。     

后牙复合树脂修复各类洞形4年临床疗效评估

目的：采用USPHS＆Ryge标准，对比评估后牙复合树脂CLEARFILAP—X／SEBOND在成人后牙不同洞形（[牙合]面洞、邻[牙合]面洞、牙颈部洞）的4年临床疗效。方法：对61人、100个患牙（[牙合]面龋51，邻[牙合]面龋20，牙颈部龋29）进行复合树脂充填修复。分别于治疗后1、2、4年对修复体的保存率以及边缘密合性、继发龋、表面粗糙度、颜色匹配状况、边缘着色、磨耗、牙龈健康状况进行疗效评估。结果：CLEARFILAP—X的4年保存率达到97％；磨耗、继发龋、边缘密合性、边缘着色、粗糙度、色泽匹配和牙龈刺激性的疗效评估结果满意率分别为：92．6％、92．6％、92．6％、77．9％、93．7％、77．9％和100％。1年与4年疗效存在明显统计学差异（P〈0．05），但是各洞形之间的保存率和临床疗效没有明显差异。结论：后牙复合树脂CLEARFILAP—X在不同洞形的修复治疗中具有良好的临床适用性。     

Solitaire修复后牙龋损的疗效观察

1998年以来 ,我们采用Ｓｏｌｉｔａｉｒｅ充填修复后牙龋损 ,经临床观察 ,疗效满意。1　临床资料1.1　病例门诊患者 6 80例 1432牙。经 1～ 2年复查到 5 40例12 6 6牙。男 2 5 3例 5 98牙 ,女 2 87例 6 6 8牙 ,年龄 7～ 78岁。其中牙合面洞 5 2 1牙 ,近中 (远中 )邻牙合面洞 5 98牙 ,颊面近颈部洞 147牙。1.2　材料Ｓｏｌｉｔａｉｒｅ(贺利氏 -上海齿科有限公司 )。ＮＴ粘合剂 (登士柏牙科有限公司 )。光固化氢氧化钙 (Ｋｅｒｒ公司 )。2　充填方法制备洞形后彻底冲洗、吹干。麝香草酚消毒 1ｍｉｎ ,吹干。未制洞者则用漂白粉打磨 1ｍｉｎ ,…     

高密度后牙修复材料修复二类洞疗效观察

近几年来登士柏公司推出了高密度后牙修复材料ｓｕｒｅｆｉｌ,称其具备银汞合金的一切优点 ,同时具有复合树脂的美观性 ,耐磨耗性和银汞合金相似。我们采用了ｓｕｒｅｆｉｌ修复恒牙Ⅱ类洞与银汞合金比较 ,观察 6个月～ 18个月 ,现介绍如下。　　作者单位 :40 0 0 15重庆医科大学附属口腔医院　　一、材料和方法1.材料 :ｓｕｒｅｆｉｌ树脂及粘接剂 :银汞合金 ;成型片 ,银汞充填器。2 .方法 :随机选择门诊就诊的需作Ⅱ类洞的患者 ,仔细检查并记录龋坏牙位及缺损情况 ,将患者随机分为两组 ,甲组用ｓｕｒｅｆｉｌ修复 95例 ,男 38例 ,女 5 7例…     

光谱级树脂作前牙美容修复和后牙充填的疗效比较

目的：比较光谱级树脂（Spectrum TPH)在前牙邻面Ⅲ、Ⅳ类洞及后牙邻He面Ⅰ、Ⅱ类洞充填治疗的疗效比较。方法：前牙Ⅲ类洞68例95个牙，Ⅳ类洞35例55个牙；后牙Ⅰ类洞53例82个牙，Ⅱ类洞48列67个牙，充填后2－2.5年随访观察。结果：前牙修复成功率，Ⅲ类洞89.5%，Ⅳ类洞83.6%。后牙修复成功率，Ⅰ类洞93.9%，Ⅱ类洞81.6%。结论：Spectrum TPH树脂是较好的通用型复合树脂。     

粘结复合树脂嵌体的3年纵向临床观察

目的：①评价signum复合树脂嵌体的3年临床表现：②比较前磨牙和磨牙树脂嵌体修复的临床效果;③评价单、双面及多面嵌体的差异。材料与方法：30名患者的113个嵌体入选本研究．临床上由一名医师设计戴入,所有嵌体由同一名技师使用同一种复合树脂材料（signum．Heraeus Kulzer）制作完成．采用三步粘结系统和同一种树脂粘结水门汀进行粘结。嵌体戴入后,由另一名不知情的医师按照改良美国公共卫生服务标准（USPHS）对修复体进行评估。结果：3年后．113个嵌体中有3个进行了重新修复．总失败率为26％。基线时,各项评价指标中被评为完好（A）的嵌体有88．5％～100％．3年后,嵌体的表面粗糙度、边缘解剖形态、边缘完整性和嵌体完整性与基线比较均存在显著的统计学差异（P〈0.05）。除了边缘解剖形态和边缘完整性以外,前磨牙与磨牙,单、双面与多面嵌体的临床效果比较无显著差异。结论：复合树脂嵌体的3年成功率很高（97．4％）．修复体的大小和牙位对其临床修复效果均无显著影响。     

应用锥状螺纹种植体作义齿修复的临床报告

目的：总结应用国产CDIC锥状螺纹种植体及配套机械IMS-Ⅲ型牙种植机，行种植义齿的临床结果.方法：选择身体健康无系统疾病156名惠者，按常规操作植入牙种植体，术后0～2周暂时冠修复，3～6个月永久修复一结果：经5年临床应用观察，2枚种植体因分别植入下颌神经管；穿入上颌窦拔除；1枚种植体因手术中折断；其余153枚种植体稳固，永久修复后，均能正常行使功能，成功率为98．07％.结论：锥状种植体作义齿修复具有独特的优势.     

Endodontic Treatment For A Molar Resorbed By A Dentigerous Cyst

A case is presented where an unerupted lower third molar in a 56-year-old woman developed a dentigerous cyst. The pressure of the enlarging cyst caused distal displacement of the third molar and resorption of the roots of the first molar. The first molar was treated endodontically prior to surgery on the cyst, and a thirteen year follow-up shows successful healing.     

嵌体冠修复磨牙残冠的临床研究

目的探讨和研究固位力欠佳的磨牙残冠的临床修复方法及效果。方法用金刚砂车针对患牙作常规的牙体预备,牙冠外形按全冠进行牙体预备,髓室部分制作箱状固位形,取印模、灌制模型,完成铸造嵌体冠,临床试戴、调改、黏结。结果经过2～5年随访观察,122颗患牙经过修复治疗后获得满意效果,个别患牙出现修复体食物嵌塞、牙龈炎症、颈缘密合不良。结论利用髓室固位的铸造金属嵌体冠对于治疗磨牙残冠是一种简单易行、效果良好的修复方法,严格的选择适应证以及准确的牙体预备和精确的加工制作是修复成功的前提和关键。     

Intrusion of Supraerupted Maxillary Molar Using a High Interim Restoration on the Defective Opposing Tooth: A Clinical Report

Wear, extraction, or fracture of all or part of a mandibular first molar can lead to the supraeruption of the opposing maxillary molar, resulting in occlusal interference and lack of restoration space. This report describes a method to gain sufficient vertical space for permanent restoration. A direct composite resin restoration was placed on the occlusal surface of a lower molar, intentionally making the interim restoration high and intruding the maxillary molar. After 6 weeks, the extruded tooth returned to the desired position, and functional occlusion was restored, enabling a ceramic restoration on the mandibular molar. No marked adverse sensory reaction was reported in this therapeutic process, and no deleterious signs were detected in the teeth, periodontium, or temporomandibular joints. The simple treatment type was effective, noninvasive, and time saving, while also preserving maximum tooth structures.     

牙冠延长术应用于后牙残根的临床研究

目的观察牙冠延长术应用于后牙残根保留的效果。方法选取远中缺损的后牙残根15颗,患者15例,应用牙冠延长术完成牙周软组织和牙槽骨硬组织的外科治疗,形成牙本质肩领,术后1周拆线,3个月后行桩核及冠桥修复。永久修复后2周复查,观察疗效。结果 15颗后牙残根无不适症状,术区牙龈颜色、形态和质地恢复正常,修复体无松动、脱落,基本恢复咀嚼功能,患者满意。结论牙冠延长术有利于后牙残根的保留和修复,但要注意适应证的选择。     

Molar Intrusion with Implants Using a Bite Plane Appliance: A Case Report

Background: Orthodontic forces for tooth intrusion ought to be continuous and low, which may be achieved with the help of osseointegrated implants. Purpose: The aims of this study were to describe a method to intrude supererupted maxillary molars using interarch intrusion mechanics (a bite plane appliance) with implants and to assess anchor implant stability through resonance frequency analysis (RFA; Osstell?, Mentor version 2, Integration Diagnostics AB, Göteborg, Sweden) in comparison with nonanchorage control implants during orthodontic intrusion. Materials and Methods: A 48‐year‐old female patient was treated with implants (36 and 37 regions, Brånemark Implant System®, MkIII TiUNite?, Nobel Biocare AB, Göteborg, Sweden; lengths, 13 and 10 mm; diameter, 5 mm) serving as orthodontic anchorage for intrusion of supraerupted teeth in the maxilla (teeth 26 and 27) using a bite plane appliance. The force of intrusion applied was individual discontinuous bite force in the present case. The control implants were in the sites 45, 46, and 47 with healing abutments out of loading. Stability of both the anchorage and control implants was assessed by RFA from the commencement of orthodontic intrusion (7 months after the first‐stage surgery) to the end of the study (19 months after the first‐stage surgery). Marginal bone height measurements of both implants were performed on radiographs at the same time. Results: The treatment was completed without complications or abnormalities of the intruded teeth or the opposite anchorage implants. However, implant stability quotient values of the anchored implants obviously changed during the initial 4 months after commencement of intrusion compared with control implants. In the present case, an intrusion of 2.2 mm was achieved in 12 months. Conclusions: The present method made it possible to intrude molars successfully. However, further studies with more cases are needed to clarify the reliability of the method and determine how to control the bite forces applied as orthodontic load.     

127例磨牙急性牙髓炎治疗的临床评价

目的 比较2种治疗磨牙急性牙髓炎方法的临床疗效。方法 应用干髓术和根管充填术治疗127例磨牙急性牙髓炎，随访3a，对是否有残髓炎或根尖周炎进行比较。结果 64例根管治疗的患牙在1a、2a随访中无1例有残髓炎或根尖炎发生。3a随访中有2例发展成根尖炎。63例干髓治疗的患牙，在la内无1例有残髓炎或根尖炎，在2a、3a随访中分别有8例和11例根尖周炎或残髓炎发生。2种治疗方法经X2检验分析，有显著差异。结论磨牙急性牙髓炎采用根管治疗。其疗效在3a期间优于干髓术。建议在尽可能的情况下给予根管治疗。     

正畸关闭下颌第一恒磨牙缺失间隙的疗效观察

目的探讨正畸关闭下颌第一恒磨牙缺失间隙的疗效和矫治特点。方法选取16例下颌第一恒磨牙拔除超过1年以上的患者,与患者充分沟通后采用直丝弓矫治技术关闭缺牙间隙,观察疗效并分析矫治特点。结果16例患者均在19～26个月完成正畸治疗,所有患者第一恒磨牙缺失间隙关闭,前牙覆验覆盖正常,尖牙中性关系,磨牙为尖窝交错关系。软组织侧貌协调,患者对治疗效果满意。结论正畸法关闭第一恒磨牙缺失间隙可取得较好的临床治疗效果。     

Guided Endodontic Access in a Maxillary Molar Using a Dynamic Navigation System

The treatment of calcified root canals is challenging in endodontic practice. A 63-year-old man was referred to the postgraduate endodontic clinic at the University of Maryland School of Dentistry, Baltimore, MD, for the treatment of tooth #3. Because of the patient’s history of head and neck radiation and the high risk of developing osteoradionecrosis, a nonsurgical endodontic approach was found to be the most reasonable treatment option despite the questionable prognosis of the tooth. During the endodontic treatment, the distobuccal canal appeared to be partially calcified and was not possible to be located freehand even with use of the dental operating microscope and cone-beam computed tomographic approximated approach. Therefore, the dynamic navigation system using the X-Guide system (X-Nav technologies, LLC, Lansdale, PA) was used, which allowed for the successful location of the canal. Conventional endodontic treatment was completed following standardized instrumentation, irrigation, and obturation. Details on how to use the dynamic navigation system are described including its advantages, disadvantages, and limitations.     

3D打印在第三磨牙自体移植中的临床研究

目的:探讨锥形束CT(cone-beam computed tomography,CBCT)联合3D打印制作的个性化牙模型在上、下颌第三磨牙移植修复缺失磨牙病例中的临床疗效.方法:收集2017年5月—2019年4月在温州医科大学附属口腔医院上、下颌第一或第二磨牙缺失并需拔除第三磨牙的46例病例(52颗牙).按照手术方式...