计算机图像处理技术在前牙美学修复中的应用

目的探讨用计算机图像处理技术为患者制作美观的、符合个性特征的前牙修复体的过程。方法对13例需行前牙美学修复的患者拍摄修复治疗前及治疗中前牙图像，获取患者牙齿与周围软组织的美学信息，包括天然牙的形态、颜色、半透明度、个性特征，以及下颌息止位时和微笑时牙齿的切缘位置、龈缘位置等。分析美学信息资料后行美学修复设计，应用Photoshop 8.0软件制作修复预期效果图，指导技师制作修复体。结果完成13例患者的前牙美学修复，临床美学修复效果良好。结论将计算机图像处理技术应用于前牙美学修复设计，有助于医师和技师为患者制作美观的、符合个性特征的修复体。     

前牙种植冠修复对口腔美观心理社会影响关系的研究

目的:探讨前牙种植冠修复后对患者的牙齿美观心理社会的影响,为前牙种植的重要性提供理论依据。方法:本研究选择在医院就诊的115例前牙种植治疗患者,在种植前和种植冠修复后6个月完成前牙美观心理社会量表(PIDAQ)的填写。冠修复6个月时,患者完成与种植前相比的口腔美学程度满意度的自我评估。结果:106例患者完成PIDAQ量表研究,此量表和口腔美学程度的自我评估密切相关。冠修复6个月后,与冠修复前,社会影响和美学态度下降,而牙齿自信分值明显升高。性别和教育水平明显影响到PIDAQ分值。结论:前牙种植修复明显影响患者的牙齿美学观点,能明显改善患者牙齿美观方面的负面影响。性别和教育水平和这种改善程度相关。PIDAQ能被用来评估前牙区种植对患者的心理社会影响。     

无托槽隐形矫治联合修复治疗在前牙美学修复中应用的临床效果研究

 目的　通过比较无托槽隐形矫治联合修复治疗与常规修复治疗在前牙美学修复中应用的临床效果,探讨无托槽隐形矫治在修复治疗中的临床应用价值。方法　选取2018年11月至2019年12月于中国医科大学附属口腔医院拟行前牙美学修复患者36例,随机分为研究组和对照组,每组18例。研究组患者先采用无托槽隐形矫治器对牙齿进行空间管理后,再进行修复治疗;对照组患者直接进行常规修复治疗。根据Kay牙齿美学分类标准,分别对治疗前后两组牙齿美学效果进行评价;根据Ryge评价标准改编的评分系统,对两组修复体美观性进行评分;由患者本人采用视觉模拟评分法对最终的修复效果进行满意度评分。结果　（1）治疗前两组患者牙齿美学分类主要为Ⅱ类和Ⅲ类,其差异无统计学意义（Z = -0.163,P > 0.05）。治疗后两组患者牙齿美学分类的分布不同,研究组牙齿美学效果优于对照组,差异有统计学意义（Z = -3.670,P < 0.05）。（2）研究组修复体美观性评分为（1.278 ± 0.286）分,低于对照组［（2.340 ± 0.808）分］,其差异有统计学意义（t = -5.223,P < 0.05）。（3）在修复体形态、与邻牙协调程度方面,研究组患者满意度高于对照组,差异有统计学意义（均P < 0.05）;在修复体颜色方面,两组患者满意度评分比较,差异无统计学意义（P > 0.05）。结论　无托槽隐形矫治联合修复治疗在前牙美学修复中应用,可达到更理想的美学效果。无托槽矫治在前牙美学修复治疗中具有较高的应用价值。     

无托槽隐形矫治联合修复治疗在前牙美学修复中应用的临床效果研究

目的　通过比较无托槽隐形矫治联合修复治疗与常规修复治疗在前牙美学修复中应用的临床效果,探讨无托槽隐形矫治在修复治疗中的临床应用价值。方法　选取2018年11月至2019年12月于中国医科大学附属口腔医院拟行前牙美学修复患者36例,随机分为研究组和对照组,每组18例。研究组患者先采用无托槽隐形矫治器对牙齿进行空间管理后,再进行修复治疗;对照组患者直接进行常规修复治疗。根据Kay牙齿美学分类标准,分别对治疗前后两组牙齿美学效果进行评价;根据Ryge评价标准改编的评分系统,对两组修复体美观性进行评分;由患者本人采用视觉模拟评分法对最终的修复效果进行满意度评分。结果　（1）治疗前两组患者牙齿美学分类主要为Ⅱ类和Ⅲ类,其差异无统计学意义（Z = -0.163,P > 0.05）。治疗后两组患者牙齿美学分类的分布不同,研究组牙齿美学效果优于对照组,差异有统计学意义（Z = -3.670,P < 0.05）。（2）研究组修复体美观性评分为（1.278 ± 0.286）分,低于对照组［（2.340 ± 0.808）分］,其差异有统计学意义（t = -5.223,P < 0.05）。（3）在修复体形态、与邻牙协调程度方面,研究组患者满意度高于对照组,差异有统计学意义（均P < 0.05）;在修复体颜色方面,两组患者满意度评分比较,差异无统计学意义（P > 0.05）。结论　无托槽隐形矫治联合修复治疗在前牙美学修复中应用,可达到更理想的美学效果。无托槽矫治在前牙美学修复治疗中具有较高的应用价值。     

应用前牙美学评估表对前牙美学修复患者满意度影响研究

目的    探讨应用前牙美学评估表对前牙美学患者满意度的影响。方法    选取2014年11月至2016年5月于第四军医大学附属口腔医院修复科进行上前牙全瓷修复的患者60例,随机分为A、B两组,每组30例。A组应用现代前牙美学修复的方法进行修复,B组则应用现代前牙美学修复结合前牙美学评估表的方法进行修复。修复两周后预约患者复诊,进行满意度评价。每项内容采用视觉模拟评分法（VAS）进行量化。结果    两组患者前牙美学修复后在牙齿排列效果、牙齿形态轮廓、牙齿长宽比例、牙齿颜色情况、发音情况、微笑效果及整体满意情况等方面的差异均有统计学意义（P < 0.05）。结论    对于需要进行前牙美学修复的患者,应用现代前牙美学修复结合前牙美学评估表的方法,可以提高患者对于美学修复效果的满意度。     

牙龈瓷在红色美学修复中的应用技巧-附病例报告

目的：研究修复治疗中对于红色美学缺陷的修复技巧及修复效果。方法：通过使用牙龈瓷补偿前牙美学区软硬组织严重缺失的固定修复病例,结合有关临床和工艺制作的文献资料,对其修复设计方案、修复体设计以及制作过程进行讨论。结果：修复治疗效果得到患者及医生的一致满意。结论：对于红色美学缺陷的患者,有技巧地运用修复技术可以达到良好的美学修复效果。     

前牙全瓷美学修复

医学上美的实现不仅仅是满足患者关注较多的外在的形式美,更要注意患者的功能健康。牙齿美学修复具有生理学、心理学及社会学的意义。临床上应从适应症、美学设计、临床软硬组织处理、修复材料选择、义齿制作、最终完成几方面考虑。美学修复前的准备包括检查患者口腔状况,取全口模型,了解患者文化水平、职业、审美及预达到的美学修复期望,为患者进行美学设计,包括牙齿的色泽、形态、排列、协调性、患者个性化审美等方面。前牙美学修复中常见问题及处理原则:1.牙列不齐的年轻患者,首先应采用正畸方法排齐牙列,再美学修复治疗。2.对于多数牙体缺损或需要做临床冠延长的患者,应先制作诊断性蜡型。然后制作树脂罩面,以便在口内更加准确地判断前牙的外形,以及上下牙齿间的覆颌覆盖关系。3.对于牙龈附着较低的患者,需进行膜龈外科手术,修整牙槽骨和附丽过低的牙龈组织,并制作暂时性修复体,以维护牙龈组织的健康。4.对于单纯性牙齿着色的患者,应先进行必要的基础治疗,如牙齿洁治,以去除表面污垢。5.对于四环素牙以及其他变色牙,应先进行漂白、脱色治疗,根据脱色治疗情况确定美学修复治疗方案。     

DSD在前牙美学修复中的应用要点与临床效果探究

目的利用数字化微笑设计(digital smile design,简称DSD)按照颌面口腔美学原理,通过计算机模拟分析设计软件,使牙齿的形态和排列在虚拟的状态下得到艺术地表达。医疗团队和患者在治疗前即可对治疗结果有很好的评估和沟通,获得医患双方统一认可的治疗设计方案可以指导整个治疗流程,从而获得可预见的治疗效果。方法在2014年10月至2016年10月期间收治50例前牙变色、牙体缺损和牙列不齐的患者,在DSD设计指导下进行修复治疗,且分析其治疗效果。结果按照Kay牙齿美学改变分类来对结果进行美学评估,所有治疗均达到前期DSD设计要求。同时对患者进行治疗结果的满意度调查,全部患者对前牙外形排列均非常满意。有3例患者希望颜色更白亮,重新制作其满意的漂白色。功能咬合方面基本模仿了临时修复体外形,仅有少量需要调整。结论 DSD在前牙美学修复发挥着重要的作用,指导整个治疗流程,提高患者的满意度。     

复合树脂在前牙美容修复中的临床体会

[摘要] 目的 探讨前牙美观缺陷患者的有效治疗方法。方法 选择163例前牙美观缺陷患者(凡前牙形态异常、颜色改变、结构异常;无论先天获得的还是后天获得;影响牙齿美观的患者,这里统称为前牙美观缺陷患者),共计336颗患牙,复合树脂直接美容修复治疗。结果通过连续3年的临床观查,1年成功率96.79%2,年成功率92.97%,3年成功率90.52%,临床效果非常满意。结论 本组治疗结果显示,前牙美观缺陷的患者,通过复合树脂美容修复治疗,可获得立竿见影的美观效果,且长期效果稳定,是一种快捷、经济、安全的牙齿美容治疗理想方法。     

口腔数字化设计在唇腭裂患者前牙美学修复中的应用研究

目的 探讨口腔数字化设计技术在唇腭裂患者前牙美学修复中的应用效果.方法 选择裂隙区需要前牙美学修复的唇腭裂成年患者9例,获取患者口内前牙与周围软组织及面部的美学数字化信息,利用keynote及3shape软件进行美学修复分析设计,与患者沟通优化修复方案,生成3D诊断蜡型并打印树脂实体诊断模型,在口内制作树脂罩面指导医生...     

The Influence of Various Fluoride Exposures on the Prevalence of Esthetic Problems Resulting from Dental Fluorosis

Objectives : This study sought to determine the prevalence of esthetic problems due to dental fluorosis, and determine the relationship of different fluoride exposure histories to the occurrence of these problems. Methods : In 1993–94 2,715 children in grades 2 and 3 and 3,297 adolescents in grades 8 and 9 were examined by four dentists. Questionnaires detailing exposures to various fluoride technologies were collected from 3,022 of these study participants. Esthetic ratings of the participants' maxillary anterior teeth were made by the examiners, the participants themselves, and their parents using questionnaires designed for this purpose. Results : Data indicate that 46 percent of the participants had dental fluorosis. Only 40 percent had fluorosis on anterior maxillary teeth. The prevalence of esthetic problems ranged from about 1 percent to 4 percent, depending on how an esthetic problem was defined. Esthetic problems as defined by the participant were more prevalent for the "over 11'age group. Logistic regression results demonstrated significant associations between several of the classifications of esthetic problems and the use of fluoride supplements and dentifrices, and exposure to fluoridated water during the third year of life. Conclusion : Results suggest that the prevalence of esthetic problems is low in the communities surveyed, and that exposure to any number of fluoride technologies in the third year of life can increase a child's risk for this problem.     

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??Dental trauma is a common dental emergency disease. Teeth extraction would be requested in severely damaged cases. The missing teeth would be traditionally restored with a fixed or removed denture or dental implants 3-6 months later after teeth extraction. And the patients should tolerant with the inconvenient of teeth loss or conventional removable prosthesis during such a long periods. With the development of dental implantology??replacement of traumatized teeth with immediate implants and immediate loading became one of the options for management of severely traumatized dentitions. However??dental practitioners should recognize that immediate placement of dental implants in the maxillary anterior area still has strict indications and poses great challenges because of the high esthetic demands in this area. This review introduces the considerations and the applications of immediate implantation in severe dental trauma and two represented cases were presented.     

即刻种植在严重牙外伤中的应用

牙外伤是口腔急诊中的常见病和多发病,严重的牙外伤常常导致患牙不能保留而需要拔除。以往前牙缺失后采取传统的固定和活动义齿修复或者常规种植修复,通常需要3 ~ 6个月的等待,在这期间患者需要经受缺牙或佩戴活动临时修复体带来的不适。近年来,即刻种植技术迅速发展,不仅能更快地恢复缺失牙的形态和功能,同时能起到尽可能保存原有软硬组织的作用。但临床医生需要意识到,即刻种植在适应证上有较为严格的要求,同时因为牙外伤常发生在前牙美学区,需要考虑相应的美学风险。因此,特别是对于临床经验不足的医生而言,即刻种植手术是一项巨大的挑战。文章对即刻种植在牙外伤中的应用做一简单总结,并结合笔者临床经验分享即刻种植的一些技术要点和病例分析。     

前牙种植义齿修复美学效果评价及其影响因素分析

目的探讨前牙种植义齿修复美学效果评价及其影响因素分析。方法选择2009年4月—2010年12月在我院接受前牙种植固定修复的134例患者,随访种植义齿情况,且通过视觉模拟评分法(VAS)和种植牙冠美学指数(ICAI)评价修复体的美学效果并分析其影响因素。结果术后回访,种植体成功率98.26%,患者VAS评分为(89.21±3.12)分,医生ICAI总评分为(1.81±0.11)分,说明种植义齿美学效果令人满意。种植方法、种植体周围软组织处理方法和骨吸收与修复美学效果成正相关(P<0.05);采用切开翻瓣方法与修复美学效果成负相关(P<0.05)。结论影响种植义齿美学效果的因素较多,在修复过程中不但需根据患者自身状况选择适宜的手术方法,而且需加强医患沟通,及时纠正影响美学效果的因素,从而提高患者对种植义齿美学效果的满意度。     

Multidisciplinary treatment approach for crown fracture and crown-root fracture – a case report

Abstract –  The increased incidence of traumatic injuries to anterior teeth is a consequence of leisure activities, where the most common injuries are crown fractures. Treatment of the dental trauma is complex and requires a comprehensive and accurate diagnostic and treatment plan. It is also important to consider the biological, functional, esthetic and economic aspects, as well as the patient's desire. The purpose of this article is to report a case that shows the multidisciplinary approach required to successfully manage the rehabilitation of a maxillary central incisor with a complex crown fracture and a maxillary lateral incisor, that at first presented an oblique crown-root fracture, and after the orthodontic extrusion, suffered a more apical new crown-root fracture.     

Predictable esthetic treatment of fractured anterior teeth: a clinical report

Dental fractures of the permanent maxillary anterior teeth are relatively frequent accidents during childhood. Placement of direct composite restorations allows clinicians a conservative method of restoring fractured anterior teeth to the original shape and color. A methodical protocol for the restoration of a fractured maxillary left central incisor of a 7-year-old girl is presented. As a temporary treatment, pulpal protection and the use of an acetate crown with glass-ionomer cement were performed. As a definitive treatment, diagnostic waxing and a silicone matrix formed the basis for successful reconstruction of the fractured tooth with composite resin. After finishing and polishing, an esthetic and natural-looking restoration was achieved, which completely satisfied the functional and esthetic expectation of the patient and dental team.     

Anterior esthetic rehabilitation on teeth and dental implants optimized with Procera technology: a case report

With the latest developments of the Procera® system, all-ceramic crowns have become an attractive solution to provide functional and esthetic rehabilitation on teeth and dental implants. The Procera AllCeram crown and Procera Abutment embrace the concept of computer-assisted design and computer-assisted machining (CAD/CAM) and can be used together for optimal esthetic result. The purpose of this case report was to illustrate the advantages of these new components for complex anterior rehabilitation. Three natural teeth and a Procera Abutment were restored using four Procera AllCeram crowns. Treatment planning and esthetic benefits are discussed.
CLINICAL SIGNIFICANCE
For complex anterior rehabilitations, the Procera system fulfills both functional and esthetic objectives, providing a new way in the field of esthetic and restorative dentistry. Nevertheless, planning and preparation stages are decisive for successful treatment.     

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口腔医生近年来对于口腔临床美学治疗理想境界的追求被概括为"红白美学",其中"白"是指天然牙齿或天然牙齿的仿真修复体;"红"则代表由牙龈乳头、附着龈和牙槽黏膜等软组织。本文将着重就口腔临床美学治疗中涉及到的牙周领域的"红色"问题及牙周治疗技术进行介绍。     

Considerations for planning esthetic treatment with veneers involving no or minimal preparation

BACKGROUND: Recently, some manufacturers, dental laboratories and practitioners have been marketing their "no-preparation" porcelain veneer systems as ones that will achieve results the same as or better than those seen with traditional veneers accomplished with tooth reduction. This case report describes case selection and esthetic treatment planning considerations for veneers involving no or minimal preparation. CASE DESCRIPTION: A 30-year-old woman with erosion on the facial surfaces of her maxillary teeth sought treatment for esthetic improvement of her smile. The author evaluated the patient's goals, midline position and cant, lip position and fullness, color, incisal edge position, desired tooth contours and occlusion. Once the author determined the ideal final position of the teeth and compared it with their current position, he decided that the patient was a perfect candidate for no-preparation veneers. CLINICAL IMPLICATIONS: To optimize the outcome, dentists should perform a complete esthetic examination before selecting and planning treatment for patients receiving porcelain veneers involving no or minimal preparation.