金属烤瓷翼板式粘接桥应用体会

金属烤瓷翼板式粘接桥是粘接式固定义齿修复的一种,由于该修复体的两侧固位体形似两个翼,故称为翼板式粘接桥.此种义齿主要适用于上下颌1—2个前牙缺失的修复.此设计是在3/4冠桥的基础上改良而成的.因其适应症与 3/4冠桥相同,但对基牙的预备切削较少,再加上用烤瓷牙方法来恢复缺失牙,有外形美观,耐磨损,抗老化,色泽光亮等优点,且不暴露金属,修复的效果较为理想,作者对这类症例经过5年的临床观察,现报告如下:     

前牙金瓷龈边缘和全瓷龈边缘烤瓷修复的美观效果观察

目的　比较前牙烤瓷修复时不同类型的龈边缘与义齿的美观状况。方法　 10 6名前牙要求烤瓷修复患者按不同的龈缘处理方法分为两组 :①唇颊侧金瓷龈边缘 ;②唇颊侧全瓷龈边缘。分别制作前牙烤瓷冠桥 ,戴入后观察 1年以上 ,并参照美国公共健康协会的修正标准 ,评估前牙烤瓷冠桥龈边缘的美观状况。结果　第一组义齿的龈边缘着色分级与第二组存在高度显著性差异 (P <0 .0 0 1) ;其余的分级结果如边缘完整性和继发龋等在两组间无差异。结论　提示唇颊侧纯瓷龈边缘的前牙烤瓷冠桥美观效果更佳。     

纤维增强树脂粘接桥修复老年缺失前牙的临床观察

目的:探讨纤维增强树脂粘接桥修复老年缺失前牙的临床效果。方法:选取48例前牙缺失的老年患者,行纤维增强树脂粘接桥修复缺失前牙,对义齿的固位、功能和使用情况进行30个月的随访临床观察。结果:1例修复体折裂,2例修复体脱粘接,其余45修复体均获得成功,患者咀嚼、容貌改善明显,达到预期对义齿功能和美观的要求。结论:纤维增强树脂粘接桥修复老年缺失前牙是一种大道至简的修复方案,适宜临床推广应用。     

22例粘结桥修复失败原因分析

马利兰粘结桥修复部分牙缺失是一种精密铸造而成的假牙,采用釉质粘接剂粘连在自体牙上,其优点:美观舒适和牙体色泽一致,无基托,就位方便,少磨牙,坚固耐用,病人乐意接受,是临床上较为理想的固定义齿修复方法,尤其适用前牙深覆盖和深覆患者.自1991年我科开展此方法修复部分牙缺失至今,笔者收集了22例粘结桥失败病例,对其失败原因作一分析.一般资料22例粘接桥修复失败均来自常州地区病员,其分类附表.附表　　　　　　　失　败　原　因失败原因例数%咬力过大941牙槽嵴粘膜损伤627操作不当523早接触29　　22例粘结桥修复失败病例中以咬力过…     

Super-Bond C&B粘接剂在改良式烤瓷粘接桥中的应用研究

近年来 ,随着新型粘接材料的研制成功 ,树脂粘接固定义齿修复已作为一种常规的修复方法被用于临床固定义齿修复中 ,特别是烤瓷粘接桥 ,它不仅磨牙量少 ,而且美观作用佳 ,深受患者的欢迎。Ｂａｒｒａｃｋ临床研究表明树脂粘接固定义齿修复 6年的成功率达到 93% ,且一些树脂粘接烤瓷使用寿命超过 10年以上。在本研究中 ,我们对来我院就诊的 14 8例患者制作了改良式烤瓷粘接桥 ,并采用新型的Ｓｕｐｅｒ -ｂｏｎｄ超强粘接剂进行修复体的粘接 ,取得了良好的临床效果。现介绍如下 :材　料　与　方　法1　临床资料 :　对我院修复科在 1999年 6月～…     

920例烤瓷熔附金属修复体的长期疗效观察

目的:对烤瓷熔附金属修复体的长期临床疗效进行评价。方法:追踪观察自1995年1月以来诊治的920例烤瓷熔附金属冠桥修复病例,以修复体的状况、基牙的健康情况、牙周组织的状况等几个方面作为评价指标,分析修复体的临床成功率和失败原因。结果:在观察期间发现失败病例74例,其中前牙冠36例,46个冠;后牙冠失败18例,22个冠;前牙桥失败12例,后牙桥8例,占总病例数的8.04%。其中单个冠的失败率为4.84%,固定桥失败率为8.77%。失败修复体数占总修复体数的5.39%。结论:烤瓷熔附金属修复体是目前较为理想的修复方式。为进一步提高修复成功率,在临床和技工操作当中应严格按照标准的操作程序进行操作。     

金属翼板树脂粘接固定义齿的临床应用

金属翼板树脂粘接固定义齿是以铸造金属为支架,金属翼板为固位体,烤瓷熔附金属为桥体的粘接固定桥,是目前应用最多的一种粘接桥修复方法。其主要缺点是远期留存率较低,最常见的失败原因是脱胶,具体表现为脱落或松动,脱落率高成为限制发展的主要因素。影响其成功率的因素众多,本文就病例选择、固位体设计和连接体三个方面对粘接桥的影响作一综述,以供临床参考。     

口腔修复学——冠桥

IPS-Empress全瓷冠临床观察，套筒冠义齿修复上颌多数牙缺失4例报告，IPS-Empress瓷贴面修复前牙间隙2年的临床评价，计算机辅助设计中调控牙冠咬合面三维构型的模拟算法，烤瓷冠桩复合体三维有限元模型的建立，下颌第二磨牙缺失单端固定义齿修复的临床观察     

双侧后牙游离缺失及前牙重度磨耗的咬合重建修复

目的探讨固定义齿与水平球帽式附着体在双侧后牙游离缺失及前牙重度磨耗咬合重建中的应用效果。方法双侧后牙游离缺失及前牙重度磨耗患者10例,经过完善的基础治疗,使用垫式可摘义齿3个月,经过咬合重建的适应期,采用前牙金属烤瓷冠固定义齿及后牙水平球帽附着体可摘义齿进行咬合重建修复。结果对10例患者临床随访6个月至3年,8例患者对外貌及义齿功能满意,2例基本满意,无不满意。结论对于双侧后牙游离缺失及前牙重度磨耗的患者,行前牙金属烤瓷冠固定义齿及后牙水平球帽式附着体义齿咬合重建修复,具有良好的临床应用价值,其中正确的颌位关系是修复成功的必要条件。     

联冠固定松动基牙后可摘义齿修复肯氏Ⅰ类牙列缺损的临床疗效观察

目的:分别用烤瓷联冠固定基牙和连续高位卡环稳定基牙,利用可摘局部义齿(removable partialdenture,RPD)修复双侧磨牙缺失,比较两者间的临床疗效。方法:选取肯氏Ⅰ类牙列缺损近缺失端基牙I-II度松动病例40例,在进行完善的牙周基础治疗后,分别采用烤瓷联冠固定基牙和连续高位卡环稳定基牙,行可摘局部义齿修复。术后复查,随访1-5年,通过比较患者的主观感受和临床检查结果进行疗效评价。结果:烤瓷联冠组5年临床成功率高于连续高位卡环组,两组患者的满意率、牙周菌斑指数、牙周袋探诊深度、临床附着水平、探诊后出血指数、牙槽骨支持指数差异有统计学意义(P<0.05)。结论:对肯氏I类牙列缺损伴前磨牙松动的患牙,经完善的牙周治疗后,烤瓷联冠固定松动基牙后行可摘局部义齿修复可获得较好的疗效。     

微型固位钉式无冠粘结固定义齿的临床应用研究

目的 :评价微型固位钉和金属翼板辅助固位的树脂粘结固定义齿修复单个中间缺失的前牙或前磨牙临床效果。方法 :对 2 1例单个上颌前牙或前磨牙中间缺失患者进行无冠粘结固定义齿 (crownlessbridgeworks ,CBW )系统修复 ,在修复后即刻、1个月及 2年后对修复体的固位、边缘密合性、美观、口腔卫生状况、牙体牙周健康等项目进行评价。同时 ,对 2 0例单个中间牙缺失患者采用传统的 3单位全冠固位固定义齿方法修复并给以同期评价。 2组患者各评价项目的满意率之间采用卡方检验进行统计学比较。结果 :2年后 ,2组固定桥修复均无脱落。所有临床评价项目均为满意或可接受 ,无继发龋发生。 2组之间各项目的Fisher精确校正或连续校正卡方检验没有统计学上的显著性差异 (P >0 .0 5 )。结论 :CBW树脂粘结固定修复法具有磨除牙体组织少、无需麻醉、对牙体牙周组织影响小、易于掌握等优点。在本研究所观察的时间限度内 ,可作为传统固定修复的替代方法来修复中间缺失的单个前牙或前磨牙 ,能达到较好的临床效果     

Replacing an anterior metal-ceramic restoration with an all-ceramic resin-bonded fixed partial denture: a case report

Since the first resin-bonded fixed partial denture was described, this adhesive technique for splinting mobile teeth has developed into a conservative method for replacing missing teeth. Heat-pressed all-ceramic materials have been introduced for the fabrication of 3-unit fixed partial dentures in the anterior and premolar region. This clinical report describes the replacement of a conventional partial coverage metal-ceramic resin-bonded fixed partial denture with an all-ceramic resin-bonded fixed partial denture in the anterior maxillary area.     

Glass-fiber reinforced composite in management of avulsed central incisor: a case report

Reimplantation failure of avulsed anterior tooth in an adolescent patient requires removal of the failed tooth and consideration of restorative options. These options may include a removable partial denture, conventional 3-unit fixed partial denture, implant, or a resin-bonded appliance with a metal substructure (Maryland bridge). The glass-fiber reinforced composite material (everSTICK, StickTech Ltd, Turku, Finland) offers a restorative solution that is conservative and esthetic when compared to other restorations. Advantages include reduction of cost compared to conventional bridges, saving of time, elimination of second visit, ease of application, absence of metal allergy, ease of cleaning, and naturalness of feel. Its limitations include occlusal factors, and the presence of unsuitable abutment teeth. Another traditional contraindication is the presence of diastemas, which may limit the potential esthetic gains. This case of an 11-year-old girl, addresses the indications, preparation guidelines, and restorative procedures for an everSTICK bridge.     

Anterior maxillary resin-bonded fixed partial denture to preserve occlusal surface area for anterior guidance. A clinical report

One of the problems with anterior maxillary resin-bonded fixed partial dentures is anterior-guided occlusion. An anterior maxillary resin-bonded fixed partial denture was fabricated. The reduction of the lingual surface of the abutment was restricted to the nonocclusal surface area for anterior guidance. The patient's original mandibular movement did not change after the denture was seated. The denture has been functioning satisfactorily without any problems for more than 72 months. This article emphasizes the concept of fabricating an anterior maxillary resin-bonded fixed partial denture without reduction of the occlusal surface area for anterior guidance.     

切牙单端铸瓷粘接桥的临床应用初探

目的 探索切牙单端铸瓷粘接桥的治疗方法,观察其临床效果,以期为单端粘接桥的临床应用提供参考.方法 选择单颗切牙缺失病例10例,制作舌侧翼板固位的单端铸瓷粘接桥,共制作10件粘接桥,分别于修复后2周、1年、2年复查,复查内容包括:修复体折裂情况、边缘适合性、继发龋、颜色匹配性.结果 10例患者平均观察14.7个月.10件单端铸瓷粘接桥均无支架及饰瓷折断、裂纹,无松动;10颗基牙和固位体边缘密合,无边缘着色,无继发龋;7例修复体颜色匹配为A级,3例修复体颜色匹配为B级.结论 单端铸瓷粘接桥可修复单颗切牙缺失,牙体组织磨除量小,短期内临床效果良好,但其强度及粘接效果能否满足临床要求尚需进一步观察.     

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.     

Functional preprosthetic orthodontics and prosthetic reconstruction with resin-bonded fixed partial dentures

When a resin-bonded fixed partial denture is planned in the maxillary anterior region, special attention must be paid to occlusal diagnosis. Specific instrumental diagnosis is necessary to define the functionally important factors: the anterior teeth, the occlusal plane, the temporomandibular joint, and their three-dimensional relation. The optimal treatment in an anterior-guided occlusion is a complete integration of the retainers in the given tooth form without altering the original inclination of the palatal guiding surfaces of the anterior teeth. In many cases, preprosthetic orthodontics is indicated because of functional and esthetic reasons. The objective is to achieve an anterior tooth position that allows the retainers of a resin-bonded fixed partial denture to be incorporated with the designed inclination of the guiding surfaces, using noninvasive preparation techniques. Preprosthetic orthodontic treatment planning, possible problems, and limiting factors as well as the subsequent prosthetic reconstruction have been described in detail. The interdisciplinary treatment has to be planned individually for each patient, depending on the functional diagnosis and the clinical and anatomic situation.     

Two-year clinical trial of resin-bonded fixed partial dentures incorporating novel attachments

PURPOSE: This controlled clinical trial evaluated the clinical performance of a new resin-bonded fixed partial denture (FPD) system and compared the clinical performance with that of conventional FPDs. MATERIALS AND METHODS: Resin-bonded FPDs replaced 12 single anterior and 9 premolar missing teeth in 20 healthy patients. Conventional three-unit FPDs (metal-ceramic crowns or complete cast-metal crowns) replaced 10 single anterior and 10 single posterior missing teeth in 20 age-matched controls. Retention, marginal integrity, periodontal condition of the FPDs, esthetics and hygiene of pontics, and secondary caries were clinically evaluated immediately, 1 month, and 2 years after cementation. RESULTS: After 2 years, no failure was observed in the resin-bonded or conventional FPDs because of debonding from the abutment teeth. All clinical results evaluated for both groups were satisfactory or acceptable. No secondary caries was found in either group. Fisher's exact test and/or continuity-corrected chi-square test showed no significant differences of satisfactory rates between the resin-bonded and conventional FPDs for all variables evaluated. CONCLUSION: Short-term clinical results indicate that resin-bonded FPDs may be used as fixed prostheses to replace lost single anterior or premolar teeth with minimum preparation of abutment teeth. This restoration did not adversely influence pulpal or periodontal health. However, a 2-year clinical trial for a new FPD can only provide preliminary data, and longer term observations are clearly necessary.     

改良牙体预备的热压铸全瓷粘接桥2年临床观察研究

目的　观察临床中下颌前牙缺失2颗以内的患者,采用改良粘接桥牙体预备后,热压铸造全瓷粘接桥临床修复效果。方法　32位患者共制作32件双翼下前牙热压铸造全瓷粘接桥,修复后3个月、6个月、1年和2年观察修复体的完整性,基牙的继发龋,边缘着色。 结果　3个月和6个月内32例患者中未出现脱落和折断病例,1年内出现1例脱落患者,2年内出现2例脱落患者,但均通过处理后再次完成粘接继续使用,所有病例在2年的观察期内均未发生继发龋和边缘着色,其颜色与邻牙相协调。整体修复成功率为90.6%。 结论　下前牙2颗以内缺失患者,采用改良粘接桥牙体预备后,热压铸造全瓷粘接桥修复,可以取得较好的临床修复效果。