MK1冠外被动制锁式附着体义齿的临床应用

目的 探讨MK1附着体义齿修复远中游离缺失的临床效果.方法 33例双侧或单侧远中游离端牙缺失患者行MK1附着体义齿修复,随访2个月～2年.结果 1例修复2年时出现咀嚼痛,检查发现缺牙区牙槽骨吸收,重衬可摘义齿后症状消失.1例锁轴脱落,重配卡簧.其余患者反映义齿固位良好,异物感小.结论 MK1附着体义齿适宜修复远中游离端牙缺失.     

MK1附着体在老年患者单侧远中游离缺失修复中的临床应用

目的：评价MK1附着体修复老年患者单侧远中游离缺失的临床效果。方法：采用MK1附着体为23例单侧后牙游离缺失的老年患者进行修复治疗,经过8-44个月的随访,从主观感受、临床及X线检查评价修复效果。结果：所有患者对MK1附着体义齿的美观舒适性、固位力、咀嚼效能均感到满意;21例患者认为其摘戴方便。经配对t检验,MKl附着体义齿与原可摘义齿相比在美观舒适性、固位力、咀嚼效能方面均有明显优势（P〈0．05）;而在摘戴方面基本没有差别妒〉0．05）。2例患者出现了牙龈炎症,牙周治疗后炎症消失。3例患者进行了义齿可摘部分的重衬,其余患者基牙及缺牙区牙槽嵴无异常。结论：MK1附着体义齿稳定及固位性能良好,是一种较理想的修复老年患者单侧后牙游离缺失的修复体。     

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。     

套筒冠义齿修复老年人多数牙缺失的体会

老年人多数牙缺失,大多存在余留牙咬合关系不协调,邻牙向缺牙侧倾斜,对颌牙伸长,余留牙出现松动,部分残根存留等情况,传统的可摘局部义齿修复效果不甚理想.自2001年以来,我科应用套筒冠义齿修复老年患者缺牙,取得了较好的临床效果.     

后牙残根核桩修复的临床与体会

随着人口老龄化发展,牙列的保存修复治疗日趋重要,残根残冠的核桩修复已成为主要趋势。但由于操作上的困难,后牙残根、残冠的保存治疗与修复受到限制,常被拔除,造成可利用的基牙减少甚至游离端缺牙,影响义齿的修复效果。作者在临床上对一部分后牙的残根、残冠行铸造核桩修复,再进行冠或固定义齿修复,取得了比较满意的效果,现予以报告,供同道们参考。１ 拟保留残根的用途 后牙残根可根据其功能分成三类： 当全牙列缺失,行全口义齿修复,保留残根可作磁性附着体、机械式附着体修复,或作覆盖基牙,对减轻牙槽嵴粘膜受力,保护软组…     

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。     

游离端缺牙患者义齿修复前后咀嚼运动时脑血流的变化研究

目的：探讨游离端缺牙患者可摘局部义齿修复前后咀嚼运动不同时段脑血流变化。方法：从临床选择双侧游离端缺牙患者16例,应用经颅多普勒超声探测仪,记录其咀嚼前、咀嚼5min和咀嚼10min三个时段的大脑中动脉脑血流数值,在患者可摘局部义齿修复1个月后,再分别测量其三个时段的脑血流数值,比较修复前后咀嚼运动不同时段脑血流流速的变化。结果：患者修复前后配对t检验结果显示：游离端缺牙患者修复前、后咀嚼5min的Vs、Vd、Vm值均有显著差异（P〈0．05）,修复前、后咀嚼10min的Vd、Vm值有显著差异（P〈0．05）。结论：可摘局部义齿的修复恢复了游离端缺牙患者的咀嚼功能,脑部供血量有所增加,咀嚼运动具有促使老年人脑血流量增加的趋势。     

种植体与天然牙联合修复后牙游离缺失53例

目的:采用种植-天然牙联合修复后牙游离缺失。方法:对53例患者共106颗第二磨牙游离缺失应用种植牙与天然牙联合修复游离缺失牙齿。结果:自1999年5月～2005年6月,共完成53例106枚种植一天然牙联合义齿修复。随访观察2～6年,平均随访期3年6个月。种植体的稳定性良好,患者主观满意者达98%。X线检查见种植体与骨组织结合紧密。无修复失败病例。结论:种植义齿逐渐成为后牙游离端缺失的首选修复方式。用种植义齿修复游离端缺失,既克服了可摘局部义齿对基牙及软组织的损伤,又满足了患者用固定义齿修复的要求,易于临床推广应用。     

外胚层发育不全患者牙列缺损修复1例及文献回顾

目的 探讨外胚层发育不全患者先天缺牙的治疗方案,为临床提供参考。方法 报道1例面中份凹陷,颏部前突,面下1/3发育不足的外胚层发育不全患者,患者上颌多颗牙先天缺失,余留牙为畸形牙,下颌牙列先天缺失,牙弓较小,上下牙槽骨发育不良。通过上颌可摘局部义齿、下颌在数字化导板辅助下进行前牙区种植,杆卡式种植覆盖义齿对其进行治疗,并对其治疗方案进行文献回顾。结果 患者佩戴义齿后固位及稳定佳,咬合关系良好,患者面部外形恢复较好,上下唇饱满,面下1/3与面中1/3基本相等,恢复了咀嚼功能。文献回顾结果表明,先天缺牙的外胚层发育不全患者的口内情况通常比较复杂,修复困难,对此类患者常见的修复方式包括固定桥、可摘局部义齿、全口义齿、覆盖义齿和种植义齿,需要根据患者口内实际情况选择不同的治疗方案。目前,对于外胚层发育不全患者先天缺牙的治疗尚未达成共识,有学者建议缺牙少的患者优先选择固定修复,缺牙多的患者选择可摘义齿或种植覆盖义齿修复,未成年患者优先选择活动修复,待颌骨发育完成后视情况更换永久固定修复。结论 对于外胚层发育不全先天缺牙的患者,应该充分考虑各方面因素,以修复为导向个性化制定可行的修复方案。     

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目的评价球帽式附着体修复游离端缺失牙的临床效果。方法选择2010年5月至2012年5月就诊于中国医科大学口腔医学院修复科的KennedyⅠ、Ⅱ类牙列缺损患者18例，对可保留的残根残冠进行完善的根管治疗后，使用球帽式附着体作为固位体进行义齿修复，并对其使用效果进行6个月至2年的临床随访观察。结果球帽式附着体用于游离端缺失牙修复后，基牙基本未受到损害，有2例基牙患有牙龈炎，患者对义齿美观、舒适、固位、稳固和咀嚼性能等方面均比较满意。结论球帽式附着体可以改善可摘局部义齿修复后的美观及功能，且有利于基牙的保护。     

1197例老年修复病例的临床分析

目的:了解老年修复患者口腔情况和修复状况。材料和方法:调查1197例老年修复治疗的病例,将每一病例的缺牙和修复情况输入计算机,统计分析。结果:本组老年人平均缺失牙齿9.10颗,缺失最多的前3位牙齿足正颌第—磨牙、上颌第二磨牙和下颌第一磨牙;余留最多的前3位牙齿足下颌尖牙、下颌第一双尖牙和上颌尖牙。19.51％的病例颌骨间无咬合接触关系,19.51％的病例修复时需咬合重建或咬合抬高;21.84％的病例修复前存在食物嵌塞。结论:活动义齿是目前老年修复治疗的主要方法。咬合重建以及防治食物嵌塞、颞下颌关节病是老年修复的特点。结果提示:应重视老年修复中牙体、牙周与颞下颌关节、咀嚼肌的保健与修复治疗间的相互联系与相互作用。     

Influence of mandibular free-end partial edentulism on the force exerted on maxillary anterior teeth

PurposeThe purpose of this study was to determine the influence of mandibular free-end partial edentulism and the wearing of removable partial dentures in the partially edentulous area on the force exerted on maxillary anterior teeth.MethodsA commercially available jaw model with exchangeable teeth was used. Seven experimental conditions of mandibular free-end edentulism were set up and a distal extension removable partial denture to replace missing posterior teeth was fabricated. Strain gauges were attached to the root surface of the maxillary left central incisor, canine, first premolar and first molar, and the force exerted on them was calculated based on the calibration coefficient. An occlusal load of 49 N was applied and the forces were compared with the Kruskal–Wallis test (P < 0.05).ResultsThe force exerted on the maxillary anterior teeth increased significantly as the number of remaining teeth decreased. The force exerted on the maxillary anterior teeth decreased significantly with use of a removable partial denture.ConclusionsWhen the number of remaining teeth decreases in mandibular free-end partial edentulism, the burden on the maxillary anterior teeth increases. Our findings suggest that for patients with mandibular free-end partial edentulism, wearing a removable partial denture is effective in preserving the remaining teeth by reducing excessive stress.     

Condition of prosthetic constructions and subjective needs for replacing missing teeth in a Finnish adult population

Prosthetic treatment needs were studied in a sample of 1600 adults distributed equally into cohorts aged 25, 35, 50 and 65 years. A total of 1275 subjects (80%) were clinically examined with respect to the condition and age of existing prosthetic constructions, subjective needs for replacing missing teeth and the frequency of oral mucosal lesions associated with the wearing of dentures. Approximately half of the removable dentures (56%) were objectively non-acceptable and one-third (36%) subjectively so. One in four of those subjects with missing anterior teeth and premolars, or with 0-2 remaining mandibular molars and one in five of those with 0-2 remaining maxillary molars expressed a need to have one or more of the missing teeth replaced. The replacement needs were slightly greater for missing anterior teeth and premolars than for molars. Subjective needs for replacing missing teeth were greatest at the age of 50 years. The condition of removable dentures according to objective assessment was poorest among those aged 65 years. A high frequency of mucosal lesions associated with old and non-acceptable removable dentures was observed.     

Cephalometric evaluation of maxillary complete, mandibular fixed-removable partial prosthesis:a 5-year longitudinal study

summary Lateral cephalometric films were obtained from 10 subjects treated with maxillary complete dentures opposed to bar-supported mandibular removable partial dentures. The amount of bone resorption was determined following a 5-year period of denture use. In the maxilla, slight resorption was observed; a considerable amount had taken place in the mandible. Comparing the results of previous studies with the present one, it is suggested that bar-supported mandibular free-end saddle partial denture design has beneficial effects in terms of reduced bone resorption.     

老年人夹板式可摘局部义齿设计体会

目的：总结老年牙列缺损患者采用夹板式可摘局部义齿修复的设计体会，供临床工作参考。方法：针对老年人口腔生理、解剖特点，对89例老年牙列缺损患者分别采用3种形式的夹板式可摘局部义齿修复，并作1—3年追踪复查。检查项目为患者主观感觉、牙周情况、咀嚼功能。结果：患者主观感觉满意度为：93．26％；牙周情况正常率为：92．13％；咀嚼功能良好率为：98．88％；修复效果满意。结论：对老年牙列缺损患者采用夹板式可摘局部义齿修复，可在恢复缺失牙功能的同时，又对余留牙起到分散[牙合]儿、减轻牙周组织负荷的作用，有利于牙周组织恢复健康。     

Mandibular implant-supported removable partial denture with distal extension: a systematic review

Summary The aim of this article is to investigate patient satisfaction, survival rate of implants, and prosthetic complications or maintenance for rehabilitation with removable partial dentures associated with implants in mandibular Kennedy class I and II cases. A systematic literature review was conducted by three independent reviewers including articles published from January 1981 through September 2011. Medline and Cochrane Library electronic databases were used in addition to hand searching to assess clinical outcomes for mandibular implant-supported removable partial denture with distal extension. This review yielded 1751 records that were narrowed down to 5. The studies revealed implant survival rates ranging from 95% to 100% with one failure reported of 98 implants. The removable partial dentures associated with implant in mandibular free-end arches showed some complications and need of repair for relining, pitting of the healing abutment, replacement of resilient component of the attachment, damage in framework, screw loosening and damage in acrylic denture base. Patient satisfaction was evaluated through a five-point questionnaire, and results ranged between 4·12 and 5·0, considering 1 as the least favourable situation. The literature review showed increase in patient satisfaction and high survival rates of implants associated with mandibular removable partial dentures with distal extensions. However, some complications and need of prosthetic repair were reported. Although this treatment approach could represent a low-cost and beneficial rehabilitation for free-end mandibular ridges, the lack of controlled and randomised well-designed clinical trials suggests further studies with more representative samples to validate the outcomes of this treatment modality.     

Cantilever bridges or removable partial dentures in geriatric patients: a two-year study

The purpose of this study was to compare prosthetic, functional and occlusal conditions in twenty-seven patients treated with distally extending cantilever bridges and twenty-six patients treated with removable partial dentures (RPD) in the mandible. All patients had a complete upper denture. Mean age of the patients in both groups was about 69 years. The patients were under a supervised oral hygiene care throughout the 2-year study period. There were 6.9 +/- 1.7 mandibular teeth left in the bridge group and 7.5 +/- 1.7 in the RPD group and the mean number of posterior teeth (natural teeth/denture teeth/pontics) in occlusion was 4.1 +/- 1.1 and 7.3 +/- 1.4, respectively. During the study period signs and symptoms of mandibular dysfunction became significantly aggravated in the RPD group, P less than 0.05. A balanced occlusion in the muscular contact position was observed in 90% of the patients in the bridge group and in 76% of the RPD wearers. During the study period the need for dental or prosthetic treatment was negligible in the patients treated with bridges. In the RPD group, twenty-two teeth were restored with fillings due to caries and in eight patients major adjustments of the sublingual bar were necessary due to irritation of the oral mucosa. This study has shown that treatment with distally extending cantilever bridges in the mandible is a favourable alternative to treatment with removable partial dentures in elderly patients with a reduced dentition.     

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.     

Cleidocranial dysostosis--a prosthodontic problem

The general physical and dental findings of cleidocranial dysostosis were described. The diagnosis and treatment of two patients have been presented. Each patient had the classic dental and oral abnormalities of this disorder.The first patient was treated by extracting all of the erupted teeth and making complete maxillary and mandibular dentures. The second patient was treated by retaining all teeth but one and constructing an overlay maxillary denture and a mandibular removable partial denture. Both methods were successful, dramatically improving the patients' function, appearance, and morale.     

老年人可摘局部义齿折裂的设计因素

目的：分析老年人可摘局部义齿折裂的设计因素，旨在提高可摘局部义齿的设计水平和质量。方法：通过对临床上216例老年人可摘局部义齿折裂病例的观察，根据王征寿分类法归纳各类义齿折裂的常见类型，分析其中的薄弱环节和设计因素。结果：一类义齿咬合低时易发牛近远中向折裂；二类义齿咬合紧时常在游离端远中发生近远中向折裂，尤以上颌结节和磨牙后垫部位多见；三类和五类义齿的舌腭侧基托常在两个缺牙区之间尤其是靠近缺牙区的部位发牛与牙弓相交叉的折裂；四类义齿常发牛人工牙脱落或腭侧基托横折；人类义齿舌腭侧基托易发生纵折，折裂线常位于人工牙与基牙交界处。以上可摘局部义齿折裂的发生部有其设计与制作上的原冈，作者对此提出了相应的对策。结论：应特别注重义齿的抗折设计，这是提高可摘局部义齿修复质量的重要环节。