牙列缺损老年人的口腔修复医疗费用分布与影响因素分析

目的:讨牙列缺损老年人的口腔修复医疗费用分布情况及其影响因素。方法:对在第四军医大学口腔医学院修复科就诊的168名牙列缺损的老年人(年龄≥60岁)进行问卷调查并对数据进统计学分析,明确老年患者的口腔修复费用分布情况及影响口腔修复医疗费用的因素。结果:牙列缺损老年患者口腔修复医疗费用的影响因素是:修复方式、一年内曾行口腔治疗的费用和每月经济收入(P<0.05)。结论:牙列缺损老年患者的口腔修复费用在不同特征组间分布不同,其主要影响因素为口腔修复方式、一年内口腔治疗费用及每月经济收入。     

老年人龈下牙体缺损修复五年临床观察

目的：观察老年人龈下牙体缺损的临床及修复特点。方法：通过5年的临床病例观察及修复治疗，从临床上对老年人龈下牙体缺损的病因进行分类，并对修复方法进行初步的总结与归纳。结果：采用改进洞型的预备、辅助固位方法等修复老年人龈下牙体缺损，取得了良好的临床修复效果，2年后随访的修复成功率为86．4％。结论：老年人龈下牙体缺损因其固有特点，其修复方法应认真设计和慎重选择。     

老年人牙体修复后牙折的临床分析

目的：分析老年人牙体修复后牙折的状况,探讨其原因及预防措施。方法：对240例老年人牙体修复后牙折做临床调查,并对牙折原因进行分析。结果：老年人牙体修复后牙折与窝洞类型、根面龋,重度磨损,楔形缺损,修复频率及咬合创伤等因素有关。结论：老年人牙体修复后牙折例的原因复杂,应针对其原因早期采取有效的预防措施。     

老年人牙隐裂治疗临床疗效分析

目的:探讨老年人牙隐裂治疗的临床疗效及其影响因素。方法:对44颗隐裂患牙根据其临床表现不同,分别采用活髓全冠修复(5颗)、根管治疗前即刻暂时冠修复 根管治疗后全冠修复(6颗)、大量调 根管治疗后全冠修复(25颗)、桩核冠修复(6颗)及冠延长术 桩核冠修复(2颗)等不同的治疗方法,治疗后追踪半年-5年。结果:修复后的成功率84.1%,临床疗效受多种因素的影响,其中隐裂纹的深度、隐裂纹涉及的边缘嵴数、牙周袋的深度均影响治疗的成功率。结论:针对不同程度的牙隐裂,采取不同的临床治疗方法是治疗成功的关键。     

老年人楔状缺损临床治疗评价

目的:总结老年人楔状缺损治疗特点及最有效的方法。方法:选择60岁以上的老年人178例共452颗楔状缺损牙齿,用不同的材料进行临床治疗研究。结果:Dyract复合体与Seal&ProtectTM脱敏剂共同修复楔状缺损在临床上取得很好效果。结论:老年人楔状缺损是常见病、多发病,Dyract复合体与Seal&ProtectTM脱敏剂是一种较好的修复方法。     

老年人楔状缺损临床修复疗效相关因素分析

目的:分析老年人楔状缺损临床修复疗效相关因素。方法:选择相邻的前磨牙楔状缺损患者76例218颗患牙,随机分为2组,第一组修复前预备洞型;第二组修复前不预备洞型。两组均采用可流动复合树脂修复。检查时记录相关影响因素。结果:预备洞型者成功率明显高于未预备洞型者,且与患者的咀嚼、饮食和刷牙习惯有关。结论:老年人楔状缺损临床修复前预备洞型是非常重要,同时考虑并消除相关因素的影响。     

三种钉核修复老年人后牙残冠的临床评价

老龄齿的突出特征是(牙合)面磨耗,临床牙冠变短及根管钙化,这些均给后牙残冠的修复治疗带来困难.临床工作中,我们体会:修复老年人后牙残冠以钉为主要固位方式,选择合适的钉核是其修复治疗成功的关键之一.故此,我们自1994～1999年为96例老年人103颗后牙残冠采用根管钉树脂核、根管钉银汞核及铸造根管钉核3种方法制作钉核,分别用铸造冠和烤瓷冠完成最后修复.随访l～5年,通过临床观察,对其出现的问题进行分析.     

上海市静安区社区老年人群缺牙状况调查

目的:了解上海市静安区社区老年人牙齿缺失及修复情况。方法:采用问卷调查和口腔检查方法,抽样调查了上海市静安区973例社区65岁以上的老年人的牙齿缺失及修复情况。结果:在抽样调查的973例样本中,发现缺牙者888例,缺牙率为91.3%,人均缺牙数为10.34颗,缺牙修复率51.9%。在888例缺牙者中,牙列缺损者占78.1%,修复率为41.0%;牙列缺失者占21.9%,修复率为90.8%。男女老年人缺牙及修复状况均无显著差异。年龄高的老年人群缺牙比例高,而修复比例无显著差异。文化程度低的老年人群缺牙比例高。经济状况好的老年人群牙列缺损修复比例高。结论:社区老年人缺牙率高,修复率低。应加强关注老年人缺牙问题,采取相关措施提高修复率,从而提高老年人生活质量。     

牙周病患者行牙种植术的研究进展

种植修复治疗作为牙周炎患者修复缺失牙齿一种新的方式,其愈来愈引起人们的关注。对于临床医师而言,在考虑是进行牙周综合治疗还是拔除患牙行种植修复的时候,为掌握好种植治疗的时机、牙周治疗的进行,应该全面考虑到患者牙周炎的严重程度、全身基本情况等因素的影响。长期以来,种植修复在牙周病人群中的应用一直存在不少争议,现就牙周病的种植修复治疗做相关论述。     

老年人口腔修复特点及修复情况的初步调查

随着人类寿命普遍延长,60岁以上老年人在人群中的比例愈来愈高,老年人的缺牙问题倍受关注.为了解老年人口腔修复特点及修复情况,我们对南阳市1080名老年人进行了调查.现报道如下.     

不同充填材料治疗老年人根面龋的临床观察

目的 探讨治疗老年人根面龋的理想充填材料.方法 328 颗患牙随机分为三组,分别用富士 9 玻璃离子、银粉玻璃离子和光固化复合树脂充填修复.随访12～18个月.结果 富士9 玻璃离子修复成功率为90.91%,高于光固化复合树脂组(76.29%,P<0.05),与银粉玻璃离子组(89.09%)差异无统计学意义(P>0.05).富士 9 玻璃离子充填老年人根面龋者,无一例继发龋及微渗漏发生.结论 在老年人根面龋的治疗中,富士 9 玻璃离子和银粉玻璃离子疗效优于光固化复合树脂.富士 9 玻璃离子临床操作更具有便利性,为老年人根面龋较理想的充填材料.     

银粉玻璃离子治疗老年人后牙根面龋的临床疗效观察

目的：观察银粉玻璃离子治疗老年后牙根面龋的临床疗效。方法：对2年内老年后牙根面龋492颗，分别用银粉玻璃离子、卡瑞斯玛、银汞合金3种材料随机充填，随访观察12—18个月。结果：银粉玻璃离子充填成功率为91．30％，与银汞合金和卡瑞斯玛充填的疗效成功率差异均有显著性（P〈0．05）。结论：银粉玻璃离子充填老年后牙根面龋，获得较好的治疗效果。     

The ageing UK population--considerations for the restorative dentist

The scope of gerodontology and more specifically that of restorative dentistry (which in the UK includes the disciplines of endodontics, periodontics, prosthodontics and operative dentistry) within gerodontology, is expanding. This is true for several reasons. Firstly, the population, in both the UK and most of the western world is generally living longer. Secondly, more elderly patients are retaining their natural teeth longer into old age--thereby necessitating ongoing restorative dentistry input for their maintenance. In addition, many patients' expectations are increasing with regards to restorative dentistry. Natural teeth that were erstwhile considered as automatic candidates for extraction may now be regarded differently, especially if they are considered a 'strategic' tooth within the arch. The aim of this paper is to give a perspective as to how some of the more common restorative dentistry issues that beset the elderly population are addressed in the UK. This paper will focus on operative dentistry and prosthodontic aspects of restorative dentistry for elderly patients.     

Fabrication of direct fiber-reinforced posts: a structural design concept

As the clinician continues the quest for optimal functional and esthetic success of a tooth-restorative complex, the current selection of restorative materials and techniques may prove overwhelming. Although no single system provides the ideal restorative solution for every clinical circumstance, understanding of general design criteria and the components for the various post and core systems available allow the clinician to appropriately select the method and materials compatible with the existing tooth structure and desired result. This article provides a discussion of the various post and core systems, the methods and materials inherent in these systems, and general design principles. Using that basic information and clinical experience, the authors offer an alternative procedure for the rehabilitation of the intraradicular anatomy of the post-endodontic channel with a direct composite resin–the fiber-reinforced post and core system.
CLINICAL SIGNIFICANCE
Using improved restorative materials that simulate the physical properties and other characteristics of natural teeth in combination with the proper design principles, the clinician can develop a tooth-restorative complex with optimal functional and esthetic results.     

Dental Treatment Needs in an Elderly Population

A random sample of 1,019 adults 65 years of age and older, living in their own homes, consented to a clinical dental examination and an interview. Eight hundred nine subjects were dentate and 210 were edentulous. Each dentate person was examined for caries and periodontal conditions, as well as a separate determination of restorative and extraction treatment needs. Most people in this study lacked restorative treatment needs of any kind. Blacks required restorative treatment and extractions more often than whites. Carious coronal and root surfaces, pocket depths, number of teeth, as well as educational level and time since last visit to the dentist were related to treatment needs. While clinical findings were related to treatment needs, precise determinations of treatment needs of this elderly population generally could not be based solely on clinical findings. Additional behavioral, social, and health factors appear to play a role in dentists' decisions when determining treatment needs of older persons.     

单端树脂黏结桥修复老年单个牙缺失

单端树脂黏结桥是一种微创的固定修复方法,近年来随着黏结剂和固位型设计的发展,其临床成功率不断提高,受到国内外学者的广泛关注。利用单端树脂黏结桥修复老年单个牙缺失具有良好的发展前景。     

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??Cantilevered resin-bonded bridge is a minimally invasive fixed restorative treatment. In recent years with the continuous development of adhesives and retention design??the clinical success rate is increasing??and it has received wide attention of scholars both at home and abroad. It has extensive application prospect in repairing the single tooth loss in the elderly. The related studies of cantilevered resin-bonded bridge will be reviewed to guide its clinical application.     

Restoration of root surface caries in vulnerable elderly patients: a review of the literature

The authors conducted a review to evaluate the current literature addressing root surface caries treatment in the vulnerable elderly, to identify any gaps in the literature that will need to be addressed in the future. The authors conducted a literature search of the electronic databases using MEDLINE, PubMed, to identify original clinical research articles regarding treatment of root caries lesions, with emphasis on research focused on the vulnerable elderly. Five articles were clinical studies of root caries restorations. Only one was conducted on a vulnerable elderly population. The results of the literature review show that there is a need for further studies addressing the restorative needs of the vulnerable elderly. With the aging of the American population, more research is needed to provide adequate care to this population. At this time, glass ionomers are a good treatment option.     

儿童乳磨牙金属预成冠的修复治疗

乳牙龋病是儿童常见的口腔疾病之一.第三次全国口腔健康流行病学调查结果显示,中国儿童乳牙存在患龋率高、就诊率低下的现状.由于儿童乳牙解剖形态及组织结构特点、儿童饮食特点等原因,导致儿童乳牙龋具有区别于恒牙龋的特殊临床表现,且可对继承恒牙、儿童生长发育及心理等产生不良影响.目前,针对乳牙龋的治疗主要采用药物治疗和修复治疗,修复治疗是最重要的治疗方法,其中对于较大面积的乳磨牙龋损,临床上多选择金属预成冠的修复治疗.本文从金属预成冠的背景、适应证、临床操作步骤及相关研究等方面,就儿童乳磨牙的金属预成冠修复治疗进行阐述.     

Recommendations for conducting controlled clinical studies of dental restorative materials. Science Committee Project 2/98--FDI World Dental Federation study design (Part I) and criteria for evaluation (Part II) of direct and indirect restorations including onlays and partial crowns

About 35 years ago, Ryge provided a practical approach to the evaluation of the clinical performance of restorative materials. This systematic approach was soon universally accepted. While that methodology has served us well, a large number of scientific methodologies and more detailed questions have arisen that require more rigor. Current restorative materials have vastly improved clinical performance, and any changes over time are not easily detected by the limited sensitivity of the Ryge criteria in short-term clinical investigations. However, the clinical evaluation of restorations not only involves the restorative material per se but also different operative techniques. For instance, a composite resin may show good longevity data when applied in conventional cavities but not in modified operative approaches. Insensitivity, combined with the continually evolving and nonstandard investigator modifications of the categories, scales, and reporting methods, has created a body of literature that is extremely difficult to interpret meaningfully. In many cases, the insensitivity of the original Ryge methods leads to misinterpretation as good clinical performance. While there are many good features of the original system, it is now time to move on to a more contemporary one. The current review approaches this challenge in two ways: (1) a proposal for a modern clinical testing protocol for controlled clinical trials, and (2) an in-depth discussion of relevant clinical evaluation parameters, providing 84 references that are primarily related to issues or problems for clinical research trials. Together, these two parts offer a standard for the clinical testing of restorative materials/procedures and provide significant guidance for research teams in the design and conduct of contemporary clinical trials. Part 1 of the review considers the recruitment of subjects, restorations per subject, clinical events, validity versus bias, legal and regulatory aspects, rationales for clinical trial designs, guidelines for design, randomization, number of subjects, characteristics of participants, clinical assessment, standards and calibration, categories for assessment, criteria for evaluation, and supplemental documentation. Part 2 of the review considers categories of assessment for esthetic evaluation, functional assessment, biological responses to restorative materials, and statistical analysis of results. The overall review represents a considerable effort to include a range of clinical research interests over the past years. As part of the recognition of the importance of these suggestions, the review is being published simultaneously in identical form in both the Journal of Adhesive Dentistry and Clinical Oral Investigations. Additionally, an extended abstract will be published in the International Dental Journal, giving a link to the web full version. This should help to introduce these considerations more quickly to the scientific community.