太极扣附着体义齿修复后基牙牙槽骨高度的变化

目的:研究太极扣附着体在肯氏Ⅱ型牙列缺损修复中其远中基牙近、远中牙槽骨高度的变化。方法:对21例完成太极扣附着体修复的肯氏Ⅱ型牙列缺损患者,分别于修复完成当天、修复后1、3和6个月拍摄数字全景片,测量远中基牙近、远中牙槽骨嵴顶至根尖点的垂直距离,观察和比较修复前、后远中基牙牙槽骨高度的变化。采用SPSS16.0软件包对数据进行配对t检验。结果:太极扣附着体义齿修复完成当天、修复后1、3和6个月时,远中基牙的近中及远中牙槽骨高度均无明显降低(P>0.05)。结论:数字全景片观察显示,太极扣附着体义齿在肯氏Ⅱ型牙列缺损修复半年后,其远中基牙牙槽骨高度无明显变化,太极扣附着体在游离端义齿修复中有利于基牙的健康和稳定。     

冠外附着体义齿修复后基牙牙周状况的临床研究

目的评价冠外附着体义齿修复后基牙牙周的健康状况。方法选择20例下颌牙列末端游离缺损的患者,每个患者分别在附着体义齿修复前,修复后1个月、6个月和1年,4个不同时期测定远中基牙的牙龈指数和菌斑指数,并在附着体义齿修复前和修复1年后拍摄数码全口牙位曲面体层片,比较修复前后远中基牙的牙槽骨高度。结果修复前和修复1个月、6个月、1年后不同时期远中基牙菌斑指数的差异均无统计学意义;修复后1个月、6个月远中基牙牙龈指数和修复前的差异无统计学意义,修复1年后远中基牙的牙龈指数高于修复前（P<0.05）。同一个体修复前和修复1年后远中基牙远中侧的平均牙槽骨高度的差异无统计学意义（P>0.05）。结论冠外附着体义齿修复游离缺损时应注意维护基牙的牙周健康。     

不同基牙牙周状况下双侧游离缺损冠外附着体义齿的三维有限元分析

目的：探讨不同基牙牙周状况下,下颌后牙双侧游离缺损冠外附着体义齿支持组织的应力分布情况。方法：建赢下颌双侧67游离缺损冠外附着体义齿修复时基牙牙周健康和基牙牙周吸收的三维有限元模型,分析垂直载荷下基牙牙周状况不同时,基牙牙周组织及缺牙区牙槽嵴的VonMises应力分布。结果：与牙周健康的模型相比,当第二双尖牙牙周吸收1／3时,远中基牙牙周膜和牙槽骨的最大应力值均增加了两倍多;当第一和第二双尖牙牙周均吸收l／3时,远中基牙牙周膜和牙槽骨的最大应力值是基牙健康时的四到五倍。随着牙周吸收的基牙数目的增加,缺牙区牙嵴的最大应力值增加了47％。增加基牙数目可显著降低远中基牙的牙周组织和缺牙区牙嵴的应力,使义齿支持组织的应力分布更为均匀。结论：冠外附着体义齿修复下颌双侧后牙游离缺损时,若两侧只有第二双尖牙牙周吸收1／3时,修复设计时可考虑增加基牙数目,若第一和第二双尖牙牙周均有吸收则不建议再选作附着体义齿基牙。     

Dalbo附着体义齿修复老年人牙列远中游离缺失的临床观察

目的:研究Dalbo附着体义齿修复老年牙列远中游离端缺失的临床效果。方法:选择24例牙列远中游离端缺失的老年患者制作28件Dalbo附着体义齿,进行6个月-2.5年的随访,从患者主观感受,临床检查基牙情况、附着体固位稳定等方面评价修复效果。结果:Dalbo附着体义齿美观、舒适、稳固、咀嚼有力,基牙健康。2例患者附着体连接臂下方粘膜充血,水肿;1例基牙烤瓷冠崩瓷,1例患者缺牙区牙槽骨吸收,经找出原因对症处理后,义齿重新正常使用。结论:Dalbo附着体义齿修复老年人牙列远中游离端缺失,效果优良。     

两种精密附着体的游离端基牙牙周指数的临床评价

目的通过对两种冠外精密附着体的游离端第一基牙牙周指数的测定,比较两种附着体的冠外部分对基牙牙周健康的影响。方法选择肯氏Ⅰ类缺失的患者24例,每组12例,分别使用MK1精密附着体和Snap精密附着体修复,并在修复前、戴用3个月、6个月和12个月共四个时间段测量游离端第一基牙的菌斑指数、牙龈指数和龈沟出血指数,评定基牙的牙周状况。结果两组精密附着体的游离端第一基牙的牙周指数在戴用各时间段均明显高于修复前,MK1精密附着体组的牙周指数略高于同时间段的Snap精密附着体组。结论冠外附着体对游离端基牙的牙周健康有一定影响,临床医生在选择附着体类型时需根据基牙的牙周情况综合考虑。     

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目的评价太极扣附着体用于牙列缺损修复的临床效果。方法选择2006年4月至2011年9月北京黄寺美容外科医院总装备部牙科中心拟行覆盖义齿修复的牙列缺损患者25例,对基牙进行完善的根管治疗和牙周治疗,制作以太极扣附着体为固位体的覆盖义齿。患者戴用义齿后每半年复诊1次,追踪随访,通过对口内、X线的检查和修复体的戴用情况评估患者的满意度。结果戴用义齿后随访1—4年,21例患者对义齿的美观性、稳固性、咀嚼功能及牙周健康均感到满意,4例患者出现牙龈炎和牙槽骨吸收问题。结论太极扣附着体覆盖义齿是一种美观、经济、固位稳定好的修复方式。     

三种固位体义齿修复Kennedy第一和第二类牙列缺损疗效观察

目的评价太极扣义齿、精密附着体义齿和卡环固位体义齿修复Kennedy第一类和第二类牙列缺损的临床效果。方法收集Kennedy第一类和第二类牙列缺损修复患者823例,随机选择其中太极扣义齿、精密附着体义齿和卡环固位体义齿修复患者各63例,电话联系随访复查,检查患者基牙牙周状况及义齿组织面下黏膜,通过问卷调查获取患者的主观评价,并将结果进行对比研究。结果患者对太极扣义齿、精密附着体义齿的主观评价高于对卡环固位体义齿的主观评价;在舒适度、美观方面太极扣义齿优于精密附着体义齿。戴用3种义齿患者的口腔检查结果差异无统计学意义。结论太极扣义齿比较适合修复Kennedy第一类和第二类牙列缺损。     

MK1精密附着体用于后牙游离缺失修复的效果观察

目的研究MK1精密附着体在后牙游离缺失修复中的疗效。方法采用MK1精密附着体为26例后牙游离缺失的患者进行修复治疗,经过8个月～4年的临床观察,从主观感受、临床检查、X线检查观察修复效果。结果24例患者认为附着体舒适、稳固、易适应、咀嚼有力、不影响美观、无明显食物嵌塞。临床检查及X线检查基牙无叩痛,无松动,牙龈无萎缩,义齿受力区牙槽嵴黏膜无红肿、压痛,义齿稳固无摆动。基牙无根尖周病变及牙槽骨吸收现象。2例患者戴用2年后义齿可摘部分近中的塑料牙面碎裂,改做金属面增加强度后,使用至今无破损。结论MK1精密附着体是一种较理想的修复后牙游离缺失的附着体。     

太极扣附着体在全口覆盖义齿修复中的临床应用

目的：评价太极扣附着体在全口覆盖义齿修复中的临床效果。方法：选择符合适应证的患者18例,男8例,女10例,年龄65-77岁。对基牙进行完善的根管治疗和牙周治疗,制作以太极扣覆盖义齿附着体为固位体的覆盖义齿。病人修复后定期复查,追踪随访,通过对患者满意度的调查和基牙牙周健康程度进行评估。结果：戴用义齿后进行1-4年的随访,患者对义齿的美观性、咀嚼功能、固位性、舒适度进行评价,总满意率为92．2％,经χ2检验,与戴牙后1个月比较无显著性差异（P〉0．05）。4例基牙出现不同程度的松动,牙周袋深度显著加深（P〈0．01）。所有义齿都在继续使用中。结论：在全口覆盖义齿修复中太极扣附着体义齿是一种美观、经济、固位稳定好的修复方式。     

Mini-SG附着体义齿修复双端游离缺失伴余留牙重度磨损的临床体会

目的：观察Mini-SG附着体义齿修复双端游离缺失伴余留牙重度磨损的临床效果。方法：对12例双端游离缺失伴余留牙重度磨损患者,应用Mini-SG附着体义齿进行修复。结果：经过6个月-5年的临床随访,Mini-SG附着体义齿稳定性能好,患者满意,基牙牙周组织健康。结论：Mini-SG附着体义齿是修复双端游离缺失伴余留牙重度磨损的较好方法,有利于基牙的牙周组织健康。     

老年人可摘局部义齿修复后对基牙牙周状况的影响

目的：研究老年人戴用可摘局部义齿对基牙牙周健康状况的影响。方法：对56例牙列缺失后的老年人行可摘局部义齿修复,3个月、12个月后复查并记录基牙与对侧同名牙的菌斑指数、牙龈指数、探诊出血指数、探诊深度等四项牙周指标。结果：患者戴用可摘局部义齿后基牙的四项牙周指标明显高于对照牙（P〈0．01）;老年患者戴用可摘局部义齿后的3个月内,基牙的牙周指数均明显升高（P〈0．01）,12个月时基牙的牙周状况趋于稳定状态。结论：老年人戴用可摘局部义齿可引起基牙的牙周指数增加。     

可摘局部义齿对Ⅱ型糖尿病患者基牙牙周状况的影响

目的研究可摘局部义齿对Ⅱ型糖尿病患者基牙的影响程度。方法选取口腔门诊就诊的Ⅱ型糖尿病患者60例,牙周非手术治疗后进行可摘局部义齿修复,研究基牙与其对侧同名牙于义齿修复前、修复后2周、3个月、6个月、12个月、24个月的菌斑指数、牙龈指数、探诊出血指数、探诊深度和临床附着丧失5项牙周指标。结果 1)Ⅱ型糖尿病患者戴用可摘局部义齿后基牙的牙周指标明显高于对照牙(P<0.01);2)Ⅱ型糖尿病患者戴用可摘局部义齿后的6个月内,基牙的牙周指标均明显升高(P<0.01);但随着戴用时间继续延长,基牙的牙周状况趋于稳定和缓解。结论戴用可摘局部义齿可引起Ⅱ型糖尿病患者基牙牙周指数的升高。     

Periodontal considerations in removable partial denture treatment: a review of the literature

PURPOSE: A critical review of the literature on the periodontal considerations in removable partial denture (RPD) treatment is presented. MATERIALS AND METHODS: A MEDLINE search was conducted for studies pertaining to the effects of RPDs on the periodontal tissues during the various phases of prosthetic treatment. The review included both in vivo and in vitro studies. RESULTS: The use of RPDs leads to detrimental qualitative and quantitative changes in plaque. There seems to be a lack of information regarding the effects of RPDs on the status of periodontally compromised abutments. A number of studies, mainly in vitro, have failed to agree on the ideal RPD design. Clinical trials have shown that if basic principles of RPD design are followed (rigid major connectors, simple design, proper base adaptation), periodontal health of the remaining dentition can be maintained. CONCLUSION: Removable partial dentures do not cause any adverse periodontal reactions, provided that preprosthetic periodontal health has been established and maintained with meticulous oral hygiene. Frequent hygiene recalls and prosthetic maintenance are essential tools to achieve a good long-term prognosis. More prospective clinical trials are needed on the effect of RPDs on the condition of periodontally involved abutment teeth.     

慢性牙周炎患者磁性附着体基牙牙周状况分析

目的 了解慢性牙周炎患者磁性附着体基牙的牙周状况。方法 选取2009年1月至2011年1月于中国医科大学附属口腔医院口腔修复门诊接受治疗的19例慢性牙周炎患者的45颗磁性附着体基牙作为研究对象,修复后随访观察3年,比较磁性附着体基牙在义齿修复前后的牙周袋探诊深度（PD）、牙齿松动度及义齿的稳定性状况。结果 磁性附着体基牙在口内3年的存留率达91.11%。磁性附着体基牙在义齿修复前及修复3年后的PD值分别为（2.17 ± 0.77）mm和（1.89 ± 0.67）mm,修复后较修复前的PD值减小,差异有统计学意义（P < 0.05）。部分基牙松动度在义齿修复3年后较修复前增大,可能与可摘局部义齿功能稳定性变差有关（P < 0.05）。结论 磁性附着体义齿对慢性牙周炎患者的弱基牙有保护作用。     

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目的了解慢性牙周炎患者磁性附着体基牙的牙周状况。方法选取2009年1月至2011年1月于中国医科大学附属口腔医院口腔修复门诊接受治疗的19例慢性牙周炎患者的45颗磁性附着体基牙作为研究对象,修复后随访观察3年,比较磁性附着体基牙在义齿修复前后的牙周袋探诊深度（PD）、牙齿松动度及义齿的稳定性状况。结果磁性附着体基牙在1：2内3年的存留率达91．11％。磁性附着体基牙在义齿修复前及修复3年后的PD值分别为（2．17±0．77）mm和（1．89±O．67）rnm,修复后较修复前的PD值减小,差异有统计学意义（P〈0．05）。部分基牙松动度在义齿修复3年后较修复前增大,可能与可摘局部义齿功能稳定性变差有关（P〈0．05）。结论磁性附着体义齿对慢性牙周炎患者的弱基牙有保护作用。     

Influence of bonded composite resin cingulum rest seats on abutment tooth periodontal tissues: a longitudinal prospective study

This study aimed to examine the longitudinal influence of bonded composite resin cingulum rest seats on abutment tooth periodontal tissues in removable partial dentures (RPDs). Twenty-eight patients with RPDs were enrolled in the study. Thirty-one cingulum rest seats were prepared for an anterior tooth using composite resin and a standardized method for each patient. Periodontal indices such as probing pocket depth (PD), bleeding on probing (BoP), and tooth mobility (TM) were measured at the time of denture insertion (baseline) and at least 3 months postinsertion (up to 8 years). Control data were obtained from the remaining nonprepared anterior teeth on the other side of the arch. None of the bonded resin rest seats failed, but slight abrasion was observed in 3 rest seats. No significant differences were found in terms of PD, BoP, and TM between baseline and postinsertion data for abutments with bonded resin rest seats and controls. It is suggested that bonded composite resin cingulum rest seats can be used longitudinally without damaging the periodontal tissues of abutment teeth.     

基牙数目对附着体式义齿基牙位移的影响

目的：探讨基牙数目对下颌单侧游离端MK-1附着体式义齿基牙位移的影响。方法：选用单基牙、双基牙和三基牙支持的MK-1附着体制作下颌单侧游离端MK-1附着体式义齿,在义齿侧上下牙列间放置食物片,咬合时用LB-72型高精度半导体激光位移测量仪,测量并计算出基牙在不同方向的位移量,并用随机方差分析法进行统计学分析。结果：单基牙组的近远中向、颊舌向、垂直向的位移、倾斜、扭转均大于双基牙组,差别有统计学意义（P〈0.05）。双基牙组的近远中向的位移大于三基牙组,差别有统计学意义（P〈0.05）,其余差别没有统计学意义（P〉0.05）。结论：单侧游离端MK-1附着体式义齿不宜设计单基牙,宜设计双基牙,如双基牙条件不理想时,可增加第三基牙。     

Periodontal considerations of the removable partial overdenture

1. An overdenture, whether complete or partial, is an excellent mode of treatment in the mutilated dentition for the preservation of the residual ridge. 2. Selection of patients for an overdenture should be based on past history of dental neglect, the status of the teeth and their periodontium, including present oral hygiene status, and patient motivation. The patients with a history of dental neglect, poor oral hygiene, and lack of motivation in having the teeth and the periodontium restored to health as well as strict compliance to a home-care regimen and recall schedule are not good candidates for treatment with an overdenture. 3. The choice of teeth or roots to serve as overdenture abutments must include their periodontal evaluation, which should consist of a detailed periodontal examination, diagnosis, prognosis, and treatment when this is indicated, including chemical protection (fluoride gel) and an oral hygiene regimen tailored to individual needs. 4. The knowledge and expertise in the selection and implementation of appropriate periodontal treatment modalities is of paramount importance in restoring optimum periodontal health to the overdenture abutments before overdenture fabrication. 5. The maintenance phase of the overdenture abutments as well as of the existing natural teeth is of critical importance in the preservation of health of these abutments and teeth. This maintenance phase should consist of periodic recalls based on individual needs; a detailed periodontal evaluation, including patient's motivation and status of oral hygiene and denture hygiene; and detection of caries. If necessary, appropriate periodontal and/or restorative therapy should be performed, and oral hygiene measures reinforced. This will ensure longevity of both abutment teeth or roots and of the existing natural teeth resulting in a long-term success of an overdenture. 6. Because there is evidence of high incidence of periodontal disease and dental caries in overdenture wearers, and because this evidence is attributed mainly to lack of motivation and compliance of adequate oral hygiene as well as to frequency of recall visits, patients should be made aware of the importance of their role in the maintenance phase of treatment and in the factors that lead to ultimate success of overdenture therapy. 7. With (a) proper selection of the patient and the abutment teeth, (b) adequate periodontal and restorative health and treatment to ensure optimum health prior to RPOD construction, (c) a well-designed home-care regimen and frequency of recalls, and (d) proper execution of maintenance care, changes for long-term success of overdenture therapy will be much improved.