小基托舌侧卡环可摘局部义齿63例

可摘局部义齿至今仍是牙列缺损的主要修复方法。传统的可摘局部义齿通常舌腭侧的基托较宽厚、固位卡环置于基牙唇颊侧[1]。当今人们崇尚自然美,尤其是那些单纯前牙缺失且缺牙数较少的青年患者往往不能接受上述传统可摘局部义齿。为此,笔者设计了小基托舌侧卡环可摘局部义?..     

可摘局部义齿的折裂因素及预防措施分析

可摘局部义齿是临床牙列缺损的修复中缺牙数目多时常采用的修复方式,但在实际使用中经常发生折裂,从而影响患者的正常生活。为此有学者做过调查,分析可摘局部义齿折裂的原因并进行统计分析,从而提出了一系列的预防措施。1可摘局部义齿折裂的因素分析根据王征寿分类法可将可摘局部义齿折裂的因素分为以下六类：     

个别前牙缺失无基托可摘义齿修复

常规的可摘局部义齿修复 ,有时往往因个别前牙缺失、也要带有一大块基托在舌 (腭 )侧 ,因异物感、影响发音 ,令部分患者很难适应。自 1992年起笔者采用无托可摘义齿修复个别前牙缺失。现将体会总结如下 :临床资料1.制作方法1.1　基牙要求牢固、在牙列中位置正常、临床牙冠不能过短 ,除过度磨耗咬合较紧外 ,一般不受牙合关系限制。1.2　基牙切 (舌 )支托凹预备 ,在缺隙两侧基牙的近中、远中边缘嵴、大约牙冠舌 (腭 )面切 1/3与中 1/3交界处 ,形成切支托凹。支托凹不宜过深过宽、以容纳 0 .8～ 0 .9钢丝为宜 ,咬合无障碍即可。1.3　常规制取模…     

弹性树脂结合铸造支架可摘义齿修复牙周病患者缺牙的临床评价

目的：探讨弹性树脂与铸造支架联合修复牙周病患者缺牙的临床效果。方法：采用弹性树脂做唇（颊）侧基托及前牙、前磨牙唇（颊）侧固位体,后牙及舌（腭）侧采用铸造支架,设计联合可摘局部义齿,修复28例牙周病缺牙患者,共35件修复体,戴用1年后进行临床评价。结果：弹性树脂结合铸造支架可摘义齿在美观舒适性、固位力、咀嚼功能、食物嵌塞、基牙情况等方面较传统义齿有明显改善。结论：将弹性树脂与铸造支架结合起来修复牙周病缺牙,能很好的解决其美观和功能的问题,是一种较好的修复方法。     

唇颊侧基板的义齿修复余留牙舌腭侧倒凹大的患者

唇颊侧基板的义齿修复余留牙舌腭侧倒凹大的患者王峰郭航（北京海军总医院口腔科）～～～～～～～～～～～～～～～～～～～～常规可摘局部义齿修复，舌腭侧基托面积常较大，起固位及连接义齿各部件成一整体的作用。但这种义齿对于某些余留牙舌腭侧倒凹较大的患者，就存在...     

单个上切牙新型可摘义齿——四突义齿

单个上切牙缺失,我们设计一种新型可摘义齿,即腭侧无基托,唇侧无卡环。此种修复体在人造牙切端舌侧近远中有两个支托(图1),在人造牙唇侧近远中邻间隙内有两个 Ⅰ型卡(图3),故名四(?)义齿。四(?)义齿适于单个上切牙缺失,基牙健康,有一定倒凹的病例。     

金属基托舌侧预留网的技工制作

在临床工作中,选择金属基托可摘局部义齿修复缺失牙的一些患者,如果当余留牙健康状况不稳定,戴用义齿一段时间后可能发生新的天然牙缺失。传统加牙修理方法采用在金属基托上加焊,形成与树脂人工牙的连接。义齿设计为金属基托制作舌侧预留网可以更好的解决这个问题,当患者发生新的天然牙缺失,同时旧义齿使用良好的情况下,可借助舌侧预留网使树脂与金属基托相连,     

可摘义齿损坏后立即修理

近一年来,我们对203例因各种不同原因造成的216件可摘义齿损坏进行了立即修理,其中义齿基托折断或折裂155件;人工牙脱落、折断或磨损34件;卡环或支托折断15件;牙齿拔除后需要增补人工牙12件。修理方法一、基托折断或折裂的立即修理义齿基托折断或折裂的主要原因是由于基托组织面不贴合形成支点所造成。修理前必须检查义齿基托折断面拼对是否完好,拼对无法复原者不能修理。拼对复原后仍有小部残缺者也可修理。1.首先洗净义齿,用酒精棉球擦洗基托断面,去脂去污。     

活动桥式义齿(牙合)支托位置的探讨

在牙列缺损的可摘局部义齿的修复中,活动桥式义齿(以下简称桥式义齿)常易出现以(牙合)支托为支点的旋转,其临床表现是:上颌义齿的颊侧基托或下颌义齿的舌侧基托压迫粘膜。对此目前临床上的解决方法主要有:1。     

个别前牙缺失改良可摘义齿修复

常规的可摘局部义齿修复，有时因个别前牙缺失，也要戴一块大基托在舌(腭)侧，这样就造成了患者异物感很强，部分患者甚至难以适应。近6年来，笔者采用改良可摘义齿修复个别前牙缺失，收到了良好的效果。     

Detection of improvement in the masticatory function from old to new removable partial dentures using mixing ability test

The aim of this study was to determine the sensitivity of the Mixing Ability Test to detect improvement of masticatory function in subjects on transition from old to new removable partial dentures. Thirty-two subjects (seven males, 25 females, mean age 65.0 years) with distal extension partially edentulous area in mandible and/or maxilla participated in the study. The following reasons were presented for replacing the old removable partial dentures with new ones: fracture and/or poor fitness of retainers, extraction of abutment teeth, poor fitness of denture base, severe wear of artificial teeth and request for metal base dentures. Masticatory function with old and new removable partial dentures after an adaptation period (mean 27.4 weeks) was evaluated by the Mixing Ability Test. Subjects were asked to masticate five two-coloured wax cubes with each removable partial denture. Mixing Ability Index was obtained from the colour mixture and shape of the masticated cubes. Wilcoxon signed-rank test was used to test the difference of Mixing Ability Indexes between old and new removable partial dentures. The mixing ability indexes with new removable partial dentures (mean+/- s.d.: 0.70+/- 0.68) was significantly higher (P<0.001) than those with old removable partial dentures (-0.11+/-1.13). The results suggest that the Mixing Ability Test was capable of detecting improvement in masticatory function with new removable partial dentures.     

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。     

Qualitative changes in dental plaque formation related to removable partial dentures

A study was performed on the microbial composition of dental plaque developing on fifteen abutment teeth in nine partially edentulous subjects. Bacteria were counted in samples of plaque which had formed on vestibular surfaces, and on proximal surfaces facing edentulous spaces, during a period when dentures were not worn, and then for a period when dentures were being worn. It was found that the presence of removable partial dentures favoured a proliferation of spiral organisms.     

Load transfer characteristics of unilateral distal extension removable partial dentures with polyacetal resin supporting components

Background:  To photoelastically examine load transfer by unilateral distal extension removable partial dentures with supporting and retentive components made of the lower stiffness polyacetal resins.
Methods:  A mandibular photoelastic model, with edentulous space distal to the right second premolar and missing the left first molar, was constructed to determine the load transmission characteristics of a unilateral distal extension base removable partial denture. Individual simulants were used for tooth structure, periodontal ligament, and alveolar bone. Three designs were fabricated: a major connector and clasps made from polyacetal resin, a metal framework as the major connector with polyacetal resin clasp and denture base, and a traditional metal framework I-bar removable partial denture. Simulated posterior bilateral and unilateral occlusal loads were applied to the removable partial dentures.
Results:  Under bilateral and left side unilateral loading, the highest stress was observed adjacent to the left side posterior teeth with the polyacetal removable partial denture. The lowest stress was seen with the traditional metal framework. Unilateral loads on the right edentulous region produced similar distributed stress under the denture base with all three designs but a somewhat higher intensity with the polyacetal framework.
Conclusions:  The polyacetal resin removable partial denture concentrated the highest stresses to the abutment and the bone. The traditional metal framework I-bar removable partial denture most equitably distributed force. The hybrid design that combined a metal framework and polyacetal clasp and denture base may be a viable alternative when aesthetics are of primary concern.     

Retainer design for unilateral extension base partial removable dental prosthesis by three-dimensional finite element analysis

PurposeThe purpose of this study was to evaluate the effect of differences in the retainer design on load on abutment teeth and displacement of the denture base in mandibular unilateral extension base partial removable dental prosthesis to determine the optimum design for a mechanically appropriate retainer.MethodsThree models were used. Each incorporating a removable denture with different designs of retainer positioned. In design A, Akers clasps were positioned over the first and second premolars. In design B, embrasure clasp was positioned over the first and second premolars. In design C, rest and back-action clasps were positioned over the first and second premolars, respectively. Loading on the occlusal surface of the dentures was performed in the vertical, oblique lingual and buccal directions. Load on the abutment teeth and displacement of the denture base were determined by the three-dimensional finite element method analysis.ResultsVertical and buccolingual load on the abutment teeth by lingual and buccal direction loading on the denture were smaller in designs B and C than in design A. However, the superioinferior and buccolingual displacement of the denture base by buccal direction loading on the denture were largest in design A. Superioinferior and buccolingual displacement of the denture base by the lingual direction loading on the denture were largest in design C.ConclusionsUnder the conditions set in this study, the stability of design A was greater than that of design B or C, but load on the abutment teeth was larger.     

老年人可摘局部义齿修复对基牙的影响

目的:分析研究老年人可摘局部义齿修复后对基牙的影响,探讨其原因及预防措施。方法:对95例牙列缺失后的老年人行冷弯卡环固位式可摘局部义齿修复,记录和比较戴可摘局部义齿后基牙和非基牙的龋坏率和缺失率,用χ2检验分析其结果有无差异,并对影响基牙的原因进行分析。结果:戴用可摘局部义齿5a后,基牙的患龋率(17.38%)显著高于非基牙(7.10%);因牙折、牙周病松动及龋坏无法保留而拔除的基牙缺失率(27.01%)也显著高于非基牙(7.79%)(P<0.01)。结论:冷弯卡环固位可摘局部义齿修复后在一定程度上可增加老年人基牙的患龋率和缺失率。     

Further aspects of design for distal extension removable partial dentures based on the Kennedy classification

A supplement to the Kennedy classification of partially edentulous arches for restoration with removable partial dentures has been suggested. Factors affecting denture design relating to the position of the abutment teeth, the symmetry of the edentulous distal extensions, the arch form and the cross-sectional shape of the residual ridges have been discussed and classified. An understanding of the movement of the denture bases in relation to the influence of these factors makes for a rational approach to removable partial denture design and the treatment of complications observed clinically in removable partial denture wearers.     

可摘局部义齿佩戴与口腔健康相关生活质量的关系

目的研究可摘局部义齿治疗前后老年修复患者的口腔健康相关生活质量,为可摘局部义齿治疗计划的制定提供参考。方法收集可摘局部义齿修复的老年牙列缺损患者154例,平均年龄为64.35岁,采用老年口腔健康评价指数(geriatric oral health assessment index,GOHAI)量表中文版进行问卷调查,对可摘局部义齿修复治疗前后的GOHAI得分进行统计学分析。结果可摘局部义齿修复后,患者GOHAI量表中生理功能(Z=-7.989)、心理功能维度(Z=-8.128)和总体得分(Z=-7.932)较治疗前明显升高,差异具有统计学意义(P<0.01)。结论可摘局部义齿修复通过改善患者的口腔生理功能和心理社会功能,可显著提高老年牙列缺损患者的口腔健康相关生活质量。     

Laboratory procedures for the one-clasp removable partial denture

The lateral rotational path of insertion for removable partial dentures in the Kennedy class II category is generally limited to situations where the dentulous side has been restored with fixed restorations that provide a lingual undercut. The rigid lingual plate is first inserted horizontally into the undercut, followed by a lateral rotation to seat the edentulous side. No alterations of properly designed fixed restorations are necessary. This article discusses the technical procedures in detail.     

A 5-year follow-up study on the prosthetic rehabilitation of the elderly in Helsinki, Finland

In 1990, 364 elderly (76-86 years) inhabitants of Helsinki, Finland, attended a dental and oral examination study that was conducted as part of the Helsinki Aging Study. In spring 1996, these subjects were recalled for a 5-year follow-up. Between the baseline and follow-up examinations, 114 (31%) subjects had deceased (86 women and 28 men), whereas 134 had either moved, were too ill, or refused to participate in the follow-up. Follow-up examination was conducted for 113 subjects (79 women and 34 men), with the participating rate being 46%. Five subjects became edentulous during the follow-up. Of the subjects, 61% had 1-32 teeth at follow-up. In these subjects, the mean number of teeth decreased from 14.9 (+/-8.3) to 13.5 (+/-8.6) (P < 0.0001). Prosthetic status changed in 40% of the elderly dentate people: 25% received new prostheses whereas 15% lost prostheses that were not replaced. New fixed partial dentures were made in five maxillae and in nine mandibles during the follow-up. Acrylic removable partial dentures (ARPD) were most frequently used: 35% of dentate subjects had an ARPD. Subjects with removable prostheses had higher levels of salivary microbes and higher root caries incidence than those with natural teeth. Furthermore, the presence of removable prostheses at baseline, together with the male gender, was clearly associated with tooth loss during follow-up. This study indicates that fixed rather than removable prostheses should be used in elderly patients. The need for a removable denture ought to be carefully considered.