铸造Twin-Flex卡环修复KennedyⅡ类牙列缺损的临床应用

目的研究整体铸造法制作的Twin-Flex卡环在KennedyⅡ类牙列缺损修复中的使用效果。方法15例KenendyⅡ类牙列缺损患者,应用铸造支架材料整体铸造Twin-Flex卡环进行活动义齿修复,评价义齿的美学效果,固位、支持及稳定性。结果 15例患者,采用整体铸造法制作的Twin-Flex卡环,KennedyⅡ类牙列缺损的末端基牙避免了唇颊侧卡环的暴露,美学效果良好,义齿固位、支持及稳定效果良好。结论整体铸造法制作的Twin-Flex卡环应用于KennedyⅡ类牙列缺损修复,符合游离端设计的基牙及牙槽骨生物力学要求,可取得较好的美学效果及临床应用效果。     

隐形卡环在铸造支架式可摘局部义齿中的应用

目的：探讨隐形卡环在支架式可摘局部义齿中的临床应用效果。方法：55例患者制作83件隐形卡环支架式可摘局部义齿修复体,观察义齿的使用效果。结果：除1件修复体因咬合过紧致牙面脱落、一件修复体基牙脱落外。其余修复体使用效果良好,无基牙及牙周组织破坏。结论：只要选择合适的适应症,采用隐形卡环支架式可摘局部义齿修复可取得良好的临床疗效。     

面接触冷弯卡环丝与弯制钳的临床应用

可摘局部义齿是修复牙列缺损最常用的一种修复体 ,卡环是可摘局部义齿最主要的固位体。自 1996年开始作者使用改良冷弯卡环制作可摘局部义齿 ,临床试用后取得了满意的效果[1] 。改良冷弯卡环使用圆形不锈钢丝锤扁磨改成半圆形后弯制卡环臂 ,卡环体及肩部使用扁圆过渡段和圆丝成     

铸造支架与透明卡环联合应用初步观察

铸造支架义齿是牙列缺损修复常用的方法.临床应用中不足的是当多数牙缺失,必须在前牙或双尖牙上放置卡环,患者将因说话或微笑时显露金属而影响美观[1].2003年7月至2004年7月,我科应用铸造支架与透明卡环联合修复牙列缺损53例,效果较为满意.     

铸造支架可摘局部义齿修复后出现的问题分析

作者随访了自1994年1月以来171例227件铸造支架可摘局部义齿病例,并讨论戴用义齿后出现的问题及其原因,并提出预防措施,以提高修复体的质量。　　作者单位:100011北京黄寺美容外科医院总装备部牙科中心　　一、临床资料和方法自1994年1月至1999年12月期间我科收治的171例铸造支架可摘局部义齿修复病例,观察时间为半年至5年。义齿件数227件,男103例,女68例,年龄在28～69岁之间,平均51岁。按Ｋｅｎｅｄｙ分类分布见表1。表1　义齿分类情况Ⅰ类Ⅱ类Ⅲ类Ⅳ类上颌40461918下颌29372810总计69834728　　根据缺失牙的情况,选择基牙及其固位方式,进…     

高熔铸造支架修复牙列游离缺失临床疗效观察

本文分别采用钴铬合金铸造支架和普通冷加工支架修复牙列游离缺失可摘部分义齿各 50例 ,对其在发音、适应性、固位及强度方面作了比较 ,并在一个月及一年后复查。结果发现一个月后在发音、适应性及固位方面前者优于后者。一年后比较发现 ,铸造支架强度明显优于冷加工支架     

RPI卡环的改良设计

描述了改良ＲＰＩ卡环的设计,并与传统的ＰＲＩ卡环相比较,改良ＲＰＩ卡固位尖端只需进入基牙颊面最远的较小倒凹则可获得听固位,而且更美观,同时也符合远中游离鞍基围绕近中Ｈｅ支托转下沉中,Ｉ杆固位尖端与基牙脱离接触原则。因此发言奶卡环可小或避免伟给基牙持力,量种适用远中淳离端可摘局部义齿的新型止环设计。     

钛合金铸造支架可摘局部义齿临床疗效观察

目的 观察用钛合金铸造金属支架进行可摘局部义齿修复的临床疗效.方法 2003～2006年制作45件钛合金铸造支架可摘局部义齿,戴入后追踪观察2年,了解义齿使用情况及基牙健康状况. 1年后将其与48件钴铬合金支架及塑料基托义齿的修复效果对比.结果 1年后钛合金支架义齿功能良好率为93.3%,基牙健康状况良好;不良症状明显低于钴铬合金支架及塑料基托义齿.结论 钛合金铸造支架可摘局部义齿具有良好的功能,适合于治疗义齿的临床应用.     

支架式可摘局部义齿在牙周炎牙列缺损修复中的应用

目的：研究支架式可摘局部义齿对牙周炎伴牙列缺损的修复效果。方法：对10例完成牙周治疗的患者采用支架式可摘局部义齿修复,分别记录义齿戴入时,半年,1年和2年后的菌斑指数（PI）,龈沟出血指数（SBI）和牙周袋深度（PD）。结果：2年后PI和SBI指数增加,但1年后和2年后PD指数均有统计学意义的下降。结论：支架式可摘局部义齿对修复牙周炎伴牙列缺损具有一定稳定基牙,利于牙周恢复的效果。     

烤瓷铸造支架可摘义齿的修复

近年来我科根据牙列缺损患者对义齿修复的要求 ,采用了烤瓷铸造支架式可摘义齿的修复方法。报告如下 :1　临床资料和方法1.1　临床资料牙列缺损患者 47例 ,男性 2 0例 ,女 2 7例 ,年龄最小 2 5岁 ,最大 5 5岁。Ｋｅｎｎｅｄｙ第三类 3 6例 ,其中第三类第一亚类2 0例 ,第三类第二亚类 11例。Ｋｅｎｎｅｄｙ第四类 11例。共修复193颗牙齿 ,上颌前牙 5 7颗 ,前磨牙区 2 4颗 ,磨牙 12颗。下颌前牙 60颗 ,前磨牙区 19颗 ,磨牙 2 1颗。1.2　材料藻酸盐类印模材料或硅橡胶印模材料。铸造支架采用北京钢铁研究院研制牙用钴铬合金 ,铸造基底冠采用牙…     

Titanium clasp fabricated by selective laser melting,CNC milling,and conventional casting: a comparative in vitro study

Purpose

This study aimed to investigate the effects of selective laser melting (SLM), milling methods, and casting on the behavior of titanium clasp.

Clinical application of removable partial dentures using thermoplastic resin. Part II: Material properties and clinical features of non-metal clasp dentures

This position paper reviews physical and mechanical properties of thermoplastic resin used for non-metal clasp dentures, and describes feature of each thermoplastic resin in clinical application of non-metal clasp dentures and complications based on clinical experience of expert panels. Since products of thermoplastic resin have great variability in physical and mechanical properties, clinicians should utilize them with careful consideration of the specific properties of each product. In general, thermoplastic resin has lower color-stability and higher risk for fracture than polymethyl methacrylate. Additionally, the surface of thermoplastic resin becomes roughened more easily than polymethyl methacrylate. Studies related to material properties of thermoplastic resin, treatment efficacy and follow-up are insufficient to provide definitive conclusions at this time. Therefore, this position paper should be revised based on future studies and a clinical guideline should be provided.     

Color stability of glass-fiber-reinforced polypropylene for non-metal clasp dentures

Purpose

The purpose of this study was to investigate the color stability of a glass-fiber-reinforced thermoplastic (GFRTP), for use in non-metal clasp dentures (NMCDs).

铸造支架式弹性义齿在修复KennedyⅠ、Ⅱ类牙列缺损中的效果观察

目的：通过两种不同的KennedyⅠ、Ⅱ类可摘局部义齿的临床效果观察，为优化义齿没计提供临床依据。方法：对18例末端游离缺失的牙列缺损患者，每人分别制作两种义齿（Ⅰ号义齿：铸造支架＋塑料，Ⅱ号义齿：铸造支架＋弹性义齿材料），进行临床效果观察及患者满意度调查，结果用Fisher确切概率法进行统计分析。结果：美观效果Ⅱ号义齿优于Ⅰ号义齿（P〈0．05）{功能效果Ⅱ号义齿与Ⅰ号义齿相近（P〉0．05）。结论：无金属卡环显露的铸造支架与弹性义齿材料结合的可摘局部义齿设计，是一种值得推广的临床没计。     

可摘局部义齿改良RPI卡环固位力测试

目的 :测试改良RPI卡环的固位力 ,为临床应用提供实验依据。方法 :采用人离体下颌骨作为模型 ,在垂直脱位力作用下 ,测试改良RPI卡环的固位力 ,并分别与RPA卡环及RPI卡环比较。结果 :改良RPI卡环的固位力 ( 6 .86± 1.2 0 )N ,RPA卡环的固位力 ( 7.6 1± 0 .87)N ,RPI卡环的固位力 ( 7.41± 1.19)N无显著性差异 ,3种卡环固位力两两间无显著性差异。结论 :采用具有天然牙列的离体下颌骨作为测定卡环固位力的模型是可行的。改良RPI卡环的固位力与RPA卡环和RPI卡环的固位力相当 ,临床可接受。     

可摘局部义齿修复肯氏III类缺损的应力分析

目的:比较可摘局部义齿单侧、双侧设计修复肯氏III类缺损时,基牙及黏膜应力分布的差异。方法:建立5个牙列缺损及可摘局部义齿的有限元模型,并按单、双侧设计分为A、B2组。在ANSYS有限元软件下,进行有限元力学计算和分析。数据通过SAS6.2统计软件包的配对t检验进行统计学分析。结果:最大应力均出现在第一前磨牙及第二磨牙的近中颈部。A、B2组比较,P>0.05,基牙应力和黏膜应力均无显著性差异。结论:从基牙应力角度分析,可摘局部义齿修复肯氏III类缺损,单侧设计没有对基牙产生过大的负荷。     

树脂卡环的临床应用效果观察

目的：观察树脂卡环的临床应用效果。方法：76例94个树脂卡环临床使用6至45个月后，对卡环固位力、易折性、支持稳定性、美观性、牙菌斑检测和对基牙及牙周组织的影响等情况进行追踪观察。结果：树脂卡环固位良好；具有美观的特点，可按基牙颜色进行比色；能提供一定的支持稳定作用；并具有良好的生物相容性，对基牙及牙周围组织无损伤。结论：树脂卡环是一种美观适用可以推广的可局部义齿固位体，尤其是在前牙上使用效果更佳。     

The effect of thermo-mechanical fatigue on the retentive force and dimensional changes in polyetheretherketone clasps with different thickness and undercut

PURPOSEEsthetic expectations have increased the use of polyetheretherketone (PEEK) clasps as alternatives to Cr-Co in removable partial dentures (RPDs). The objective of this study was to evaluate the retentive force and dimensional change of clasps with different thickness and undercut made from PEEK by the thermo-mechanical fatigue.MATERIALS AND METHODSPEEK clasps (N = 48) with thicknesses of 1 or 1.50 mm and 48 premolar monolithic zirconia crowns with undercuts of 0.25 mm or 0.50 mm were fabricated. Samples are divided into four groups (C1-C4) and were subjected to 7200 thermal aging cycles (at 5 - 55℃). The changes in the retentive force and dimensions of the clasps were measured by micro-stress testing and micro-CT devices from five measurement points (M1 - M5). One-way ANOVA, paired t-test, two-way repeated ANOVA, and post-hoc tests were used to analyze the data (P < .05).RESULTSThe retentive forces of C1, C2, C3, and C4 groups in initial and final test were found to be 4.389-3.388 N, 4.67 - 3.396 N, 5.161 - 4.096 N, 5.459 - 4.141 N, respectively. The effects of retentive force of all PEEK clasps groups were significant decreased. Thermo-mechanical cycles caused significant dimensional changes at points with M2, M4, and M5, and abraded the clasp corners and increased the distance between the ends of the clasp, resulting in reduced retentive forces (P^* = .016, P^* = .042, P < .001, respectively).CONCLUSIONThermo-mechanical aging decreases the retentive forces in PEEK clasps. Increasing the thickness and undercut amount of clasps decreases the amount of dimensional change. The values measured after aging are within the clinically acceptable limits.     

应力中断设计修复下颌Kennedy II类缺损舒适度的评价

目的 比较应力中断设计的活动义齿中,不同裂隙长度对义齿修复效果的影响. 方法 符合纳入标准的下颌游离端缺牙需行可摘局部义齿修复的患者共60人,随机分为三组.义齿戴入后1周复诊,评估游离端基牙及黏膜疼痛情况.对比三组出现修复后疼痛情况的差异.结果 应力中断设计能够减少义齿修复后出现游离端基牙疼痛的情况(P<0.05).裂隙长度超过中线可以进一步减少游离端基牙疼痛(P<0.05).三种设计方案对黏膜压痛的疼痛发生率差异无统计学意义(P>0.05).结论 使用应力中断设计可以减少义齿修复后游离端基牙疼痛.裂隙长度增加可以进一步减少基牙疼痛.游离端基牙条件差时可以通过延长裂隙,降低修复后出现游离端基牙疼痛的几率,提高患者舒适度.     

Guidelines for the choice of circumferential wrought wire and cast clasp arms for removable partial dentures

PurposeThe aim of this study was to establish guidelines for the selection of cast and wrought-wire clasps for removable partial dentures (RPDs) that would be appropriate for clinically encountered undercuts and facial curvatures.MethodsRandomly selected discarded casts were collected and 30 premolars and 30 molars were surveyed, sectioned to a line representing the clasp and scanned using a flatbed scanner. The average clasp curvature and length for each group was determined and a three-dimensional model printed, to which wrought wire clasps of 0.9- and 1.0-mm diameter were adapted. Standard wax clasp patterns were adapted and cast in a stellite alloy. Each clasp was deformed beyond its proportional limit; and the forces exerted at that limit and at deflections of 0.25 mm, 0.5 mm, and 0.75 mm were measured, and a safety limit was calculated that would ensure elastic deformation at the required undercuts.ResultsA table was produced with guidelines for those clasps that would provide the highest retentive force within the proposed safety limit. The highest forces were provided by cast clasps in a 0.25-mm undercut. Wrought round wire of 1-mm diameter provided the next highest retentive forces, in a 0.25-mm undercut for premolar clasps arms and 0.5-mm for molar clasps.ConclusionsThe results provide valid guidelines for the use of combinations of clasp material and undercut that would exert the maximum retentive force without deformation for both short (premolar) as well as long (molar) clasps, for wrought and cast clasps.