后牙贵金属烤瓷桥中空桥体的制作

金属烤瓷桥是目前临床上最常见的修复体之一。由于贵金属合金组织相容性好、无毒性，性能稳定、不会对龈边缘进行染色，造成龈边缘发青、发暗，所以贵金属烤瓷在临床得到大量应用。临床上用贵金属烤瓷桥修复缺牙间隙较大或He龈距离较高的后牙时，用贵金属制作桥体基底，由于金属用量较大．很容易出现桥基底铸造缺陷，在瓷构筑烧结时会大大增加瓷泡的形成。若缺隙处制作成中空的桥基底，可有效地防止合金铸造收缩所形成的桥基底缩孔的发生，同时也减轻了烤瓷桥的重量和贵金属的使用量，减轻患者经济负担。     

前牙烤瓷桥崩瓷的修复

目的探讨前牙烤瓷桥崩瓷后,以桥体为基桩制作烤瓷冠修复的可行性. 方法去除桥体上唇舌侧残留瓷体,精密预备桥体,取模,常规烤瓷冠修复.结果 9例前牙桥体烤瓷冠修复,经过1～5年观察,疗效满意.结论前牙桥体崩瓷后烤瓷冠修复是一种切实可行的方法.     

口腔修复工艺学问答(九)

九、烤瓷与硬质冠桥树脂修复技术 147、烤瓷修复有几种、各有何工艺特点? (1)烤瓷全冠:是烤瓷修复的最初形式,先用纯的铂金箔作成坯,烧附烤瓷于其上,修复体制成后,再将铂箔剥去,完成烤瓷全冠。 (2)烤瓷—金属熔合全冠:是最广泛、实用的烤瓷复修技术,主要以高强度的金属与低熔烤瓷熔合,形成烤瓷—金属熔合全冠。其工艺特点是先铸造成冠     

牙周动力生物改形术在牙龈改形矫治中的应用

近几年我们运用非手术的牙周动力生物改形技术对 12例上前牙龈缘形态异常 ,不和谐影响前牙美观修复的患者进行金属烤瓷冠桥修复前的牙龈改形矫治 ,取得令人满意的临床疗效。材　料　和　方　法1　研究对象 :　安 Ⅰ、安 Ⅱ 、正常上唇笑线为中 ,高笑线的患者 2 0人 ,均要求金属烤瓷冠 (ＰＦＭＣ)或金属烤瓷桥 (ＰＦＭＢ)修复 ,对美观要求比较高 ,患者均无进行性的牙龈与牙周炎症症状伴发。年龄2 0～ 4 5岁 ,女性 14人 ,男性 6人 ,其中 13例为金属烤瓷冠修复治疗患者 ,7例为需金属烤瓷桥修复患者。2　材料和方法 :2 1　主要根据患者的意愿…     

中空式桥体在贵金属烤瓷桥修复中的应用

随着人们对口腔健康意识及美观要求的不断提高,在修复治疗时采用金合金烤瓷冠桥的患者逐年增多.据统计,我院2001年采用贵金属烤瓷冠修复的患者仅占5%,而到2005年则占40%.随着贵金属修复体的逐年增加,如何在保证义齿质量的同时适当降低材料成本是我们面临的一个实际问题.在日常加工义齿制作中,我们采用了中空(或镂空)桥体的方法改良贵金属烤瓷桥体蜡型的制作,即节约了成本,又满足了质量要求,现将该方法介绍如下.     

牙列重度磨损修复治疗36例报告

目的:探讨用金属烤瓷修复体修复牙列重度磨损伴牙列缺损病例进行重建的临床效果。方法:对36例重度磨损病例采用金属烤瓷冠桥进行重建修复治疗,治疗前、后测定咀嚼效率,并进行比较分析。结果:应用金属烤瓷冠桥进行重建修复有效地恢复了患者的关系及颌面垂直距离,原有的TMD症状得到改善或消失,咀嚼效率明显提高。结论:金属烤瓷修复体是牙列重度磨损后咬合重建的有效治疗方法。     

金属固定桥中空式桥体的设计与应用

目的 研究中空式桥体的制作方法及在金属固定桥中的应用,并与传统固定桥制作方法进行分析比较.方法 滴蜡法制作形状体积重量相同的下颌第一磨牙桥体蜡型10个,随机分成实验组和常规组,将实验组桥体蜡型舌侧开孔并修整成中空式.包埋铸造完成后观察铸件表面缩孔数量,并依次称重,结合制作过程进行分析.结果 使用中空式桥体的制作方法可以减少铸件的缩孔.中空式组重量低于常规方法组,减轻铸件重量约15％～17％,差异有统计学意义(P＜0.05).结论 使用中空式桥体的制作方法可以减少因铸件过厚而产生的铸造缺陷,减轻铸件重量.     

船底式桥体设计在牙周病患者后牙烤瓷桥修复中的应用

目的研究船底式桥体设计对牙周病患者后牙烤瓷桥修复效果的影响。方法对30例后牙单个缺失的牙周病患者进行烤瓷桥修复,桥体龈端形态设计为船底式桥体,并于修复后1、3、6个月复诊,检查修复体的口腔舒适度,桥体龈缘和牙龈乳头红肿、炎症情况及食物滞留情况。结果患者戴用后均无明显的口腔不适感。修复后1个月复诊仅一例患者出现食物滞留和牙龈乳头轻度炎症,并且在随后的复诊中未见桥体龈缘和牙龈乳头的炎症和红肿及食物滞留。结论船底式桥体是牙周病患者后牙烤瓷桥修复的理想桥体设计方式。     

679例1463个金属烤瓷牙修复体会

金属烤瓷是口腔修复中一种较好的修复技术,以其色泽近似天然牙,有良好的理化特性而深受广大患者的欢迎。目前在国内已逐步开展。我院开展该项技术以来,先后为679例牙体缺损及牙列缺损的患者,采用金属烤瓷冠、桥进行了修复,取得了较好的效果,现小结于下:     

二种材料的固定桥临床疗效分析

我们对27名患者分别用金属塑料联合固定桥和金属烤瓷固定桥修复，经过1—4年随访分析，认为金属烤瓷修复效果优于金塑联合修复。临床资料和方法27名患者中，男15例，女12例，年龄最大57岁，最小25岁，平均32.5岁，其中18例做金塑联合修复，9例做金属烤瓷固定桥修复。随访发现，做金塑联合修复的患者中，1例修复体脱落，缺牙区牙槽嵴粘轻度红肿，5例患者桥体颊面舌面龈缘有轻中度牙石附着，其余12例，边缘有食物残渣滞留，且无炎症反应。采用金属烤瓷修复体的患者中，均无上述不良现象存在，口腔卫生良好。讨论金塑固定桥中常用热固塑料，该…     

Charter刷牙法对桥体下牙槽嵴黏膜健康的影响

目的：评价Charter刷牙法局部口腔卫生维护对Co-Cr合金、Vita95瓷两种材料桥体下牙槽嵴黏膜健康的影响。方法：采用随机分组对照试验，要求实验组每天采用Charter刷牙法对桥体进行局部卫生维护，评价并分析实验组和对照组3个月后桥体下牙槽嵴黏膜炎症状况的差异。结果：实验组的炎症程度明显低于对照组，统计学相差显著。烤瓷和金属材料之间比较，在对照组两者对牙槽黏膜的影响有显著差异。结论：局部口腔卫生维护有利于保持桥体下黏膜的健康，而不同桥体材料对黏膜健康的影响在短期内并不显著。     

Cantilever bridges--a cross-sectional study

Life expectancy and functional performance of the cantilever bridges is determined by the length of the cantilever pontic(s) and by the number and localisation of the abutment teeth. No overall epidemiological survey covering this topic was found in the literature. 529 distally cantilevered bridges were evaluated by the authors. There were 310 upper and lower cases. The following parameters were recorded: length of the cantilever part (number of units), the relationship of the cantilevered pontics and the bridge, and the position of the fixed restoration in the dental arch. Previously the cantilevered bridge design was not accepted in Hungary but in spite of this fact a large number of distally cantilevered bridges were made in the country. Most of the examined cantilever bridges are properly designed: two abutments are supporting one pontic (342 cases, 65.56%). However some of the solutions are too risky: one abutment, one cantilevered pontic (110 cases, 20.45%), or two abutments, two cantilevered pontics (53 cases, 9.85%).     

固定桥桥体龈底形态对接触区黏膜微生态影响的研究

目的探讨烤瓷桥桥体龈端不同形态设计对牙槽嵴顶黏膜微生态的影响。方法对60例磨牙烤瓷修复的患者采用常规细菌培养和计算机鉴定的方法进行检测。结果桥体龈端接触区细菌附着量和种类与牙体预备前相比,均有增多。其中,改良鞍式和改良盖嵴式桥体龈端接触区细菌附着量和细菌种类变化的差异有统计学意义(P<0.05);而舟底式桥体龈端接触区细菌附着数量和种类的变化,均无统计学意义(P>0.05)。戴用3个月后,各组链球菌和奈瑟菌的组成比例变化与牙体预备前相比,差异有统计学意义(P<0.05);其余各类细菌组成比例的变化无统计学意义(P>0.05)。结论从对桥体底黏膜微生态的影响考虑,烤瓷桥舟底式桥体优于改良鞍式和改良盖嵴式桥体,是值得临床推广应用的磨牙桥体设计。     

Influence of pontic material on alveolar mucosal conditions

The purpose of the present study was to investigate plaque accumulation and inflammatory changes in the mucosa beneath fixed bridge pontics of various materials, in patients cleaning the infrapontic space daily. Fixed bridges with a tight but non-compressive contact to the mucosa in the pontic area and with interchangeable test specimens placed in the pontic base were constructed for five patients. During 4-wk periods the following materials were tested: alloys with a high or a low gold content, silver-palladium, cobalt-chromium, nickel-chromium and also a dental porcelain or a composite restorative resin. Between the test periods a "sanitary pontic" was used to enable recovery of the alveolar mucosa. Clinical examinations including exudate measurements demonstrated that the alveolar mucosa remained healthy irrespective of the material used when the dental floss was used regularly. The amount of plaque on the test specimens of the seven dental materials showed no consistent differences. The composition of the bacterial deposits showed no regular pattern. This investigation has demonstrated that patients maintaining a high standard of oral hygiene are able to prevent the development of inflammatory changes in the alveolar mucosa in contact with fixed bridge pontics irrespective of the pontic material used.     

Influence of pontic material on alveolar mucosal conditions

Abstract – The purpose of the present study was to investigate plaque accumulation and inflammatory changes in the mucosa beneath fixed bridge pontics of various materials, in patients cleaning the infrapontic space daily. Fixed bridges with a tight but non-compressive contact to the mucosa in the pontic area and with interchangeable test specimens placed in the pontic base were constructed for five patients. During 4-wk periods the following materials were tested: alloys with a high or a low gold content, silver-palladium, cobalt-chromium, nickel-chromium and also a dental porcelain or a composite restorative resin. Between the test periods a "sanitary pontic" was used to enable recovery of the alveolar mucosa. Clinical examinations including exudate measurements demonstrated that the alveolar mucosa remained healthy irrespective of the material used when the dental floss was used regularly. The amount of plaque on the test specimens of the seven dental materials showed no consistent differences. The composition of the bacterial deposits showed no regular pattern. This investigation has demonstrated that patients maintaining a high standard of oral hygiene are able to prevent the development of inflammatory changes in the alveolar mucosa in contact with fixed bridge pontics irrespective of the pontic material used.     

Providing support for the pontic of natural tooth adhesive bridges: a clinical report

Resin bonded bridges have become established as a treatment option for replacing missing teeth. Their development can be traced to the work of Rochette who used a macro mechanically bonded metal framework to stabilize mobile teeth. Adaptations of Rochette's concept, using natural teeth as pontics, have been presented. The use of a natural tooth has aesthetic and psychological advantages for the patient. The high failure rate of natural tooth pontics may be explained by a lack of support for the tooth on the metal framework. A clinical report is presented to illustrate a previously unreported technique to improve pontic support.     

Case report: a non-rigid connector for a resin bonded bridge

The use of rigid connectors between pontics and retainers is common for conventional bridges. Restoration of two missing teeth and an intermediate pier abutment with a rigid bridge is not an ideal treatment. In this report a resin bonded bridge with a non-rigid connector within the pontic distal to the pier abutment was constructed and remained in place without debonding for seven years.     

A retrospective clinical evaluation of resin-bonded bridges inserted at the Adelaide Dental Hospital

The clinical performance of resin-bonded Rochette and Maryland bridges inserted by various operators at the Adelaide Dental Hospital is reported. Thirty-four Rochette bridges (30 anterior, 4 posterior) and 228 Maryland bridges (150 anterior, 78 posterior) were assessed. Clinical data were compiled on types of bridge failure, factors influencing bridge retention, and the effects of the prostheses on abutment teeth and supporting tissues. The failure rate for Rochette bridges over 6 years was 75 per cent with a median survival of 2.14 years. Debonding occurred in 70 per cent of bridge failures. The failure rate for Maryland bridges over 5 years was 42 per cent with a median survival of 2.60 years. Pontic fracture (29 per cent) and debonding (20 per cent) were the main failures observed. Porcelain pontics performed significantly better than the processed hybrid resin pontics (P<0.01). The main reasons for debonding included occlusal stresses, non-retentive bridge designs and resin cement failure. A life-table analysis showed no significant difference in the overall cumulative survival rates between Rochette and Maryland bridges. Bridge design and the choice of pontic material and resin cement emerged as significant factors influencing the success rate of the bridges examined.     

Influence of oral hygiene on the mucosal conditions beneath bridge pontics

The purpose of the present study was to elucidate the relationship between the oral hygiene at the bridge pontic and the inflammatory changes in the adjacent mucosa. The study consisted of three 4-wk periods with different hygienic measures: 1) no oral hygiene around and beneath the pontic, 2) thorough hygiene using toothbrush and toothpicks and 3) thorough hygiene using a toothbrush and dental floss every day. The amount of accumulated bacterial deposits on the pontic and the inflammation in the pontic area were estimated using quantitative microbiologic tests, and clinical and histologic examinations. When dental floss had been used the mucosa was healthy while it showed mild or moderate inflammation after the other experimental periods. There was a high correlation between the amount of mucosal exudate and the inflammation in the mucosa as measured by a modified Gingival Index. Daily use of dental floss resulted in a significantly lower number of microorganisms per mm2 compared with the other hygienic measures. Histologic sections of the biopsies showed changes in form of parakeratosis with thinning or loss of stratum corneum. The investigations have demonstrated that insufficient oral hygiene is an important factor in the development of inflammatory changes in the oral mucosa beneath bridge pontics. Regular use of dental floss ought to be a part of the oral hygiene regimen in patients wearing fixed bridges.     

Influence of oral hygiene on the mucosal conditions beneath bridge pontics

Abstract – The purpose of the present study was to elucidate the relationship between the oral hygiene at the bridge pontic and the inflammatory changes in the adjacent mucosa. The study consisted of three 4-wk periods with different hygienic measures: 1) no oral hygiene around and beneath the pontic, 2) thorough hygiene using toothbrush and toothpicks and 3) thorough hygiene using a toothbrush and dental floss every day. The amount of accumulated bacterial deposits on the pontic and the inflammation in the pontic area were estimated using quantitative microbiologic tests, and clinical and histologic examinations. When dental floss had been used the mucosa was healthy while it showed mild or moderate inflammation after the other experimental periods. There was a high correlation between the amount of mucosal exudate and the inflammation in the mucosa as measured by a modified Gingival Index, Daily use of dental floss resulted in a significantly lower number of microorganisms per mm² compared with the other hygienic measures, Histologic sections of the biopsies showed changes in form of parakeratosis with thinning or loss of stratum corneum. The investigations have demonstrated that insufficient oral hygiene is an important factor in the development of inEammatory changes in the oral mucosa beneath bridge pontics. Regular use of dental floss ought to be a, part of the oral hygiene regimen in patients wearing fixed bridges.