263例患者固定修复后基牙情况5年临床观察

目的 探索固定义齿修复后基牙的发病规律.方法 随访观察263例行固定义齿修复的患者,修复5年来基牙的发病情况,分析患者年龄、修复体材料、修复时间与基牙发病的关系.结果 41岁以上年龄组患者修复后基牙发病明显高于40岁以下年龄组;基牙发病与修复体材料无关;修复后第1年基牙发病明显高于其后4年.结论 固定修复后有一定数量的基牙发生牙髓病和根尖周病,基牙发病与患者年龄及修复体戴用的时间有关,但与修复体材料无关.     

老年患者磁性附着体活动义齿修复的临床研究

目的：评价老年患者应用磁性附着体进行活动义齿修复的效果。方法：用89副Magfit磁性附着体为51例牙列大部缺损的老年患者进行义齿修复,并随访观察6个月-5年。结果：所有磁性附着体义齿在固位和稳定、咀嚼功能、语音功能、外观、舒适性、坚固性等随访指标上均获得较满意效果,仅21颗基牙出现龈缘炎,无继发龋或基牙松动、脱落。结论：磁性附着体义齿有利于保留老年患者余留牙根,减少牙槽骨吸收,提高义齿舒适性,有效改善了老年患者活动义齿修复效果。     

老年人196件三单位固定桥修复失败临床分析

目的:观察老年人三单位固定桥修复后的临床情况和对失败拆除原因的分析.方法:对近年来65岁以上老年人三单位固定桥修复进行5年至11年随诊观察,了解老年人固定义齿修复的特点,同时对该种固定义齿的失败拆除原因进行分析.结果:经过5年至11年临床观察,196件修复体修复后成功率为85.20%;失败拆除的原因主要是基牙牙周病,牙龈萎缩,食物嵌塞,修复体不密合,义齿脱落,义齿损坏,基牙继发性龋等.结论:结合老年人特点的短跨度固定义齿修复效果是肯定的,基牙牙周疾病是老年人固定桥失败拆除的主要原因.     

糖尿病患者义齿修复后龈沟液中白介素-1变化的实验研究

目的：探讨糖尿病患者戴用可摘局部义齿后龈沟液中白介素-1（IL-1）的变化,从而为临床上糖尿病患者义齿修复方式的选择提供依据。方法：对牙列缺损的糖尿病患者进行钴铬合金铸造支架式可摘局部义齿修复,在修复后六个月时分别采取基牙和非基牙区的龈沟液,用酶联免疫吸附法测定分析IL-1的表达水平。结果：可摘局部义齿修复后,糖尿病患者近缺隙侧基牙区龈沟液中IL-1的表达水平明显升高,而非基牙区则无明显改变。结论：糖尿病患者可摘局部义齿修复对基牙龈沟液中IL-1的表达水平有影响,从而为临床义齿修复提供了一定的理论依据。     

套筒冠覆盖义齿修复老年人牙列缺损的临床观察

目的 研究套筒冠覆盖义齿用于老年人牙列缺损的修复效果以及对基牙健康的影响.方法 对10例60岁以上曾做过普通可摘义齿修复的老年患者用套筒冠覆盖义齿进行修复,临床观察3～24个月.结果 余留牙的松动度有明显改善,咀嚼效率大大提高,患者对其使用的舒适度和美观度表示满意.结论 套筒冠覆盖义齿用于老年人牙列缺损的修复可显著改善义齿固位,提高咀嚼效率,保护基牙,具有良好的临床效果.     

球帽式附着体用于老年游离端缺牙修复的临床研究

目的：观察球帽式附着体用于老年游离端缺牙病例修复的临床效果。方法：以球帽式附着体作为固位体,对46例老年游离端缺牙病例进行可摘局部义齿修复,随访0．5～4年,对患者主诉、基牙情况、活动义齿及附着体使用情况进行观察。结果：义齿佩戴舒适,美观,固位力好,取戴方便,咀嚼功能恢复良好。1例基牙出现牙髓炎症状;3例附着体帽部脱落重粘。结论：球帽式附着体适用于老年游离端缺牙病例的修复治疗,能够获得良好的临床疗效。     

下颌第二磨牙缺失单端固定义齿修复的临床观察

目的：观察下颌第二磨牙缺失单端固定义齿修复的临床效果。方法：对以下颌第二前磨牙和第一磨牙为基牙，以单端固定义齿修复下颌第二磨牙缺失的25例患者进行临床和放射检查。结果：所修复的25例病例中有2例失败于固位力不足，1例失败于基牙折裂。其它均使用良好。结论：只要桥体设计合理，基牙牙体及牙周状况好，可以单端固定义齿的形式修复缺失的下颌第二磨牙。     

固定义齿修复对牙周炎基牙的保护作用

目的：观察松动基牙固定修复的临床疗效。方法：随访 １９９４—１９９８年间 １３４例基牙松动 Ⅱ°左右采用金属烤瓷全冠、Ｎｉ—Ｃｒ合金铸造全冠修复的固定桥１５６件的患者，以义齿恢复功能和基牙健康状况作为评价指标。结果：１～２年义齿功能良好率为９５％，基牙健康率为９２％，３～４年义齿功能良好率为９０％，基牙健康率为８１％。结论：固定义齿修复既有利于保护牙周炎基牙健康，也有利于恢复咀嚼功能。     

老年患者后牙残根残冠的保存与修复治疗

目的:研究老年患者后牙残根残冠行桩核全冠修复的效果.方法:对103例60岁以上老人的174颗后牙残根残冠进行根充治疗,制作桩核后行金瓷或金属全冠修复,对修复体的卫生、使用情况及基牙牙周健康状况进行为期5年的随访观察.结果:发现3颗全冠和2颗桩核脱落,6颗基牙因松动拔除,13颗基牙出现较重的牙周炎症,4颗基牙发生根面龋,另有4颗基牙动度明显增加,93%的义齿使用良好.结论:后牙桩核全冠修复,不仅能恢复口腔功能,可促进老年患者的健康.但口腔卫生至关重要.     

老年人全牙列固定义齿修复

为老年人保存经治疗的残根制备桩核，珉春它基牙共同设计、制作全牙列固定义齿，为１１例老年患者应用该技术进行了修复。经０．５－２．５年的随诊观察，获得满意的修复效果，此种义齿咀嚼功能好、舒适，使用方便、美观。该项修复技术和特点为大跨度固定义齿至全牙列，在基牙及桥体的设计上不同于常规固定义齿的设计。     

老年人牙缺失临床修复治疗的分析

目的了解老年修复患者的口腔情况及修复特点。方法对1 166例60岁以上老年人牙缺失患者作修复治疗,分析缺牙及修复情况。结果1 166例患者平均缺牙10.25颗。牙缺失数上领>下领,磨牙>双尖牙>切牙>尖牙。1 166例患者中1 120例作可摘义齿修复,其中游离端缺失约占58%0 46例作固定义齿修复。结论老年修复患者具有缺牙数目多,游离端缺失多,余牙磨耗严重,食物嵌塞多,余留牙松动及残根多等特点;修复以可摘义齿为主,可适当行固定义齿修复。修复治疗时尽量发挥尖牙、已治疗的残根及健康第三磨牙的作用。     

A 5-year longitudinal study of cantilevered fixed partial dentures compared with removable partial dentures in a geriatric population

Prosthesis function and dental conditions were observed for 5 years in 27 elderly patients treated with mandibular cantilevered fixed partial dentures (FPDs) and in 26 elderly patients treated with distal-extension removal partial dentures (RPDs). All patients were treated with a complete upper denture. The patients were assigned randomly into two treatment groups that had the same composition with regard to sex, age, and distribution of teeth. The patients were under supervised oral hygiene and prosthodontic care. Clinical examination of prostheses, masticatory system, periodontal status, and caries was carried out yearly. Oral hygiene was good, and the periodontal status was maintained in both groups. Caries was observed six times more frequently in the RPD group than in the group with fixed restorations, however. Occlusal and functional conditions deteriorated in the RPD group only. Eight of 42 fixed partial dentures (19%) failed; of these, six were recemented with composite resin. Generally the need for dental and prosthetic follow-up treatment was more pronounced in the RPD group than in the FPD group.     

The pier abutment: a review of the literature and a suggested mathematical model.

Many clinicians consider the prosthetic restoration of missing posterior teeth by means of a 5-unit fixed partial denture with a pier abutment a non-favorable situation. The present article assesses the validity of the pier abutment by means of a critical review of the literature and mathematical analysis of the forces generated within a fixed partial denture of this design. Few studies are available, and none substantiate the theory that the pier abutment serves as a fulcrum. A mathematical model suggests that debonding may occur in the anterior abutment, but not due to the teetering of the fixed partial denture around the pier abutment.     

连续多个牙缺失的正畸-固定义齿修复联合治疗

初步探讨连续多个牙缺失患者正畸-固定义齿修复联合治疗的方法与疗效.对12 例连续多个牙缺失患者,采用修复前正畸治疗将连续缺失转变为间隔缺失后,再作固定义齿修复.所有病例均获得了功能与美观的同步恢复、基牙健康、修复体稳定的治疗效果.运用正畸-固定义齿修复联合治疗连续多个牙缺失效果良好,丰富了临床修复方法,值得临床应用.     

Treatment of a juvenile patient with a maxillary all-ceramic resin-bonded fixed partial denture: a case report.

Treatment of juvenile patients with a missing maxillary incisor is difficult, because an implant cannot be placed until growth is completed. The other minimally invasive alternatives are also problematic: Removable dentures are rarely accepted by juvenile patients, and the conventional resin-bonded fixed partial denture often provides a poor esthetic result because the metal retainer causes the abutment teeth to lose their natural translucency and to become grayish. Moreover, the alveolar ridge defect makes it easy to identify the prosthesis in the pontic area. The present case report describes the prosthetic treatment of a juvenile patient who had lost a maxillary incisor to trauma. To avoid the disadvantages of conventional therapies, subepithelial connective tissue was grafted to reshape the alveolar ridge. The space was closed with an all-ceramic resin-bonded fixed partial denture.     

Periodontal and Prosthetic Conditions in Patients Treated with Removable Partial Dentures and Artificial Crowns: A Longitudinal Two-Year Study

In the present longitudinal study the periodontal and prosthetic conditions in 30 patients treated with removable partial dentures and artificial crowns were followed over a period of 2 years. The patients were given individual instructions in oral and denture hygiene and adequate periodontal treatment before the prosthetic therapy was started. The removable partial dentures were carefully planned and designed. The patients were regularly checked, and necessary instructions, scaling and prosthetic corrections were undertaken. The patients cooperated excellently and no significant deterioration was found in the clinical periodontal status of the remaining teeth. Only a few carious lesions were registered. The present study does not support the opinion that a removable partial denture per se will cause periodontal and carious lesions. When teeth with artificial crowns were examined regarding the position of the crown margins it was found that clinically observable gingival inflammations tended to be greatest when the crown margins were subgingivally located. Some deterioration of the removable partial denture occurred during the two-year follow-up concerning preferably occlusion, articulation, stability and clasp retention.     

Tooth-related risk factors for tooth loss in community-dwelling elderly people

Hirotomi T, Yoshihara A, Ogawa H, Miyazaki H. Tooth‐related risk factors for tooth loss in community‐dwelling elderly people. Community Dent Oral Epidemiol 2012; 40: 154–163. © 2011 John Wiley & Sons A/S Abstract – Objective: To appropriately explore risk factors for tooth loss operating at the tooth‐level, subject‐related factors and a hierarchical data structure have to be considered. The purpose of this study was to evaluate tooth‐related and subject‐related risk factors affecting tooth loss. Methods: A 10‐year longitudinal survey was carried out on 286 elderly subjects. At baseline, the prosthodontic status and abutment function of the 5574 teeth were recorded. Tooth loss was defined as the main outcome variable, and a multilevel logistic regression model considering subject and tooth levels was applied. Results: Tooth loss was found in 75% of subjects and most frequently in molars. A multivariable, multilevel logistic regression revealed that the following tooth‐related variables were significantly related to tooth loss over 10 years: maxillary teeth, multirooted teeth, single crowns, abutment teeth for a fixed/removable partial denture (FPD/RPD), and periodontally involved teeth. Among them, single crowns, abutment teeth for an FPD, and teeth with severe periodontal disease at baseline had the highest odds of 5.1, 6.0, and 7.1, respectively. Conclusions: The findings of this study suggest that tooth loss is the result of complex interactions of tooth‐related factors. Several tooth‐related variables including multirooted teeth, abutments, and single crowns were found to be possible risk factors for tooth loss. Thus, these findings confirm and underline the potential benefit of minimizing prosthetic treatment of molars.     

玻璃纤维强化复合树脂前牙粘结桥临床应用初探

目的 :探讨前牙玻璃纤维强化复合树脂粘结桥 (GFRC RBFPD)修复方法和评价短期临床效果。方法 :收集修复门诊 3 0名前牙缺失病例 ,缺失 1颗牙者 2 7例 ,缺失 2颗牙者 3例。其中基牙不需牙体预备的 16例 ,少量牙体预备的 14例。采用STICK预浸透玻璃纤维强化的Sinfony复合树脂制作粘结桥。应用All Bond 2树脂粘结材料粘结修复体。临床进行定期检查 ,全面评价使用效果。结果 :2 6例 6个月后临床复查 ,2 3例 (88.5 % )GFRC RBFPD不松动 ,修复体完好 ,无折断、缺损或过度磨耗 ,无明显着色 ,固位体边缘与粘结剂界面临床观察结合良好。 2例 (7.7% )在使用中出现脱粘 ,1例 (3 .8% )折断。 2 4例 18个月后临床复查 ,其中 3例 (12 .5 % )脱粘 ,3例 (12 .5 % )折断 ;基牙的探诊出血与对照牙比较均有显著性差别 (P <0 .0 5 )。结论 :GFRC RBFPD是一种微介入、无金属的固定修复方法 ,向患者提供了传统固定桥以外另一种固定修复方式。其支架强度和粘结强度需进一步提高 ,临床应用效果应长期观察。     

老年人牙列缺损可摘局部义齿修复设计回顾性研究

目的:总结老年人多数牙列缺损的临床修复体会,探讨老年患者可摘局部义齿的设计。方法:对276例老年多数牙列缺损患者分别设计牙合垫式、连续卡环式、连续卡环加牙合垫式可摘局部义齿,其中179例余留牙有残根、残冠患者,先作根管治疗,然后按以上形式设计覆盖式可摘义齿。对修复效果作戴修复体时及戴后3月、3年随访,标准分为好、差两个等级。结果:276例复查结果:满意度调查,好均为100%,(P>0.05)。咀嚼功能检查,戴后3月,好为100%,3年好为99.3%,(P>0.05)。基牙牙周情况检查,戴后3月,好为100%,3年好为97.1%,(P>0.05)。结论:对老年人多数牙列缺损患者,应根据患者口腔情况设计最佳个体修复方案,制作适合老年人生理特点的可摘局部义齿。     

Orthodontic and prosthetic rehabilitation of unilateral free-end edentulous space

Most patients prefer fixed dentures, even in the presence of uni and bilateral free-end saddle. The most suitable treatment for this is an implant or implant-supported prosthetic restoration. A combined prosthetic and orthodontic treatment with distalization of a posterior tooth towards the edentulous region is an alternative approach. This study involved a 34.3 year old female patient who had a free-end edentulous space on the left mandibula and missing 1st and 3rd molars on the right mandibula. The patient was offered both a removable partial denture and implant treatment options. A detailed explanation of her situation and suitable treatments were given but she refused both options. Therefore, an alternative combined treatment involving prosthodontic and orthodontic disciplines was performed. The second premolar tooth was distalized orthodontically and used as a distal bridge abutment. After 65 months, prosthetic restoration was functional and abutment teeth and periodontium were pathology free, and the patient was satisfied with the results.