老年缺牙患者口腔健康与牙缺失情况调查分析

目的：全面了解老年修复患者口腔组织特点,为老年人群的修复工作提供有针对性的基础性资料,进一步指导老年人的修复工作。方法：采用临床检查的方法,内容包括缺失牙情况、余留牙的健康状况、咬合状况等。结果：1.老年患者人均缺牙11.7颗,KennedyⅠ类、Ⅱ类占全部缺失类型的62.7%;2.缺失牙位最多的前三位牙齿分别为上颌第一磨牙、上颌第二磨牙、下颌第一磨牙;3.咬合牙对数平均为4.66对,咬合接触最多的牙位是尖牙,其次是侧切牙和切牙;4.19.7%的老年患者口腔卫生较差,55.6%的患者存在食物嵌塞,46.3%口腔中的牙齿需要进行治疗,指征失牙数平均为1.5颗。结论：1.老年缺牙患者缺牙数量多,咀嚼功能丧失较多;2.口腔卫生普遍不良;3.余留牙的健康状况较差;4.修复条件差,修复前需进行必要的调牙合。     

第一磨牙缺失对牙列和牙周组织的影响

通常认为牙齿缺失后如不及时修复会造成牙周组织及咬合的改变,第一磨牙缺失后的变化尤其典型,如两侧邻牙会向缺牙隙倾斜或移位,对(牙合)牙伸长,牙槽骨萎缩,牙周袋形成及垂直距离减少等。这些观察仅以临床经验为基础而缺乏实验证明,缺乏牙周和咬合变化的长期研究报告。本文研究了第一磨牙缺失对牙列和牙齿支持结构的影响及拔牙后缺牙间隙闭合的速度和程度。材料和方法:有上颌或下颌第一磨牙缺     

种植支抗压低上颌磨牙与下颌种植修复

目的:探讨片段弓技术联合部种植支抗压低上颌磨牙,为下颌牙缺失的种植修复提供足够的合间距离.方法:1)适应证:下颌后牙缺失伴上颌磨牙伸长而致的合间距离变小,使下颌种植义齿修复困难的成年患者.2)利用片段弓技术结合种植体支抗将上颌磨牙压低,获得上颌整齐的后牙区牙列及足够的种植修复空间.3)下颌缺牙区植入种植体,种植义齿修复.结果:17例下颌后牙缺失伴上颌磨牙伸长的病例,经片段弓联合种植支抗技术治疗后进行种植义齿修复,均达到理想的临床效果.讨论:下颌后牙长期缺失常常影响引起上颌磨牙伸长,导致下颌缺牙区的种植修复的间隙不够.利用片段弓技术联合种植支抗,将上颌伸长的磨牙压低,可以使缺牙区获得足够的种植空间,从而避免将伸长磨牙磨短或者杀髓,最终获得更好的功能及稳定的种植修复.结论:对下颌后牙区牙齿缺失伴上颌磨牙伸长病例,利用片段弓技术联合种植支抗来压低上颌磨牙,能获得更好的种植效果.     

先天性恒牙列缺失伴乳牙列重度磨耗的修复重建1例

先天缺牙是指牙胚在形成过程中未能发育和未能形成牙齿的先天性异常.根据缺牙数目可分为少数牙缺失、多数牙缺失和先天无牙[1].临床上,恒牙的先天缺失常伴有乳牙滞留,滞留乳牙长时间行使功能易出现重度磨耗,一方面导致乳牙牙髓暴露,引起牙髓炎、根尖周炎等;另一方面,垂直距离减低易引起咬合紊乱、颞下颔关节功能紊乱等,常需进行咬合重建修复.咬合重建是一种对全牙列进行整体改造以重新建立适当咬合关系的口腔修复方法,使咬合关系与颞下颌关节及咀嚼肌的功能协调一致,消除咬合系统形态和功能紊乱,最终恢复咬合系统正常的生理功能.2018年7月接诊一例罕见的全恒牙列先天缺失并伴有上颌乳牙列重度磨耗的病人,选择采用覆盖全口义齿和可摘局部义齿进行咬合重建修复,现对该病例的临床诊断与修复设计流程进行报道.     

成人二次矫正：一例上颌前突伴单侧上颌第一磨牙缺失病例

目的 探讨一例成人上颌前突伴单侧上颌第一磨牙缺失病例的临床治疗效果,该病例为二次矫正病例。材料与方法： 成年女性患者,主诉为牙齿前突、缺牙,有青少年时期正畸治疗史,上颌左侧第一磨牙缺失数年,间隙保持器维持,骨性II类,上颌前突,水平生长型,双牙弓前突,安氏二类亚类第一分类。通过拔除上颌右侧第一前磨牙、下颌左侧第一前磨牙、下颌右侧第一前磨牙,采用直丝弓矫治技术及自锁托槽矫治器,内收上下前牙,最终建立双侧尖牙中性关系,右侧磨牙中性关系,左侧磨牙完全近中关系。结果 患者在面型改善、功能检查、气道变化、稳定性、满意度、TMJ及牙周状况均获得了较好的结果。     

牙齿楔状缺损与侧方工作侧咬合接触关系的调查

目的　研究牙颈部楔状缺损与牙齿咬合接触的关系。方法　选取 12 3名中年机关干部。用 0 .0 2mm厚的超薄咬合纸 ,临床检查侧方运动工作侧上颌尖牙、第一、二前磨牙、第一磨牙颊尖各斜面上及咀嚼循环各个时期中的牙齿咬合接触情况 ;评估接触程度。结果　患楔状缺损牙齿咬合接触程度明显高于未患楔状缺损牙。上颌尖牙和前磨牙楔状缺损患牙在远中 (上第一磨牙的近、远中 )斜面上咬合接触程度高于未患牙 ,患牙在咀嚼侧方运动循环的中、末 (上第一磨牙在初、中或末 )期咬合接触程度增加。结论　牙颈部楔状缺损的发生与牙齿的咬合接触程度加重有关。     

牙齿楔状缺损与侧方he工作侧咬合接触关系的调查

目的 研究牙颈部楔状缺损与牙齿咬合接触的关系。方法 选取123名中年机关干部。用O．02mm厚的超薄咬合纸，临床检查侧方运动工作侧上颌尖牙、第一、二前磨牙、第一磨牙颊尖各斜面上及咀嚼循环各个时期中的牙齿咬合接触情况；评估接触程度。结果 患楔状缺损牙齿咬合接触程度明显高于未患楔状缺损牙。上颌尖牙和前磨牙楔状缺损患牙在远中(上第一磨牙的近、远中)斜面上咬合接触程度高于未患牙，患牙在咀嚼侧方运动循环的中、末(上第一磨牙在初、中或末)期咬合接触程度增加。结论 牙颈部楔状缺损的发生与牙齿的咬合接触程度加重有关。     

牙齿楔状缺损与侧方工作侧咬合接触关系的调查

目的研究牙颈部楔状缺损与牙齿咬合接触的关系.方法选取123名中年机关干部.用0.02mm厚的超薄咬合纸,临床检查侧方运动工作侧上颌尖牙、第一、二前磨牙、第一磨牙颊尖各斜面上及咀嚼循环各个时期中的牙齿咬合接触情况;评估接触程度.结果患楔状缺损牙齿咬合接触程度明显高于未患楔状缺损牙.上颌尖牙和前磨牙楔状缺损患牙在远中(上第一磨牙的近、远中)斜面上咬合接触程度高于未患牙,患牙在咀嚼侧方运动循环的中、末(上第一磨牙在初、中或末)期咬合接触程度增加.结论牙颈部楔状缺损的发生与牙齿的咬合接触程度加重有关.     

自体牙移植15例的临床疗效

对下颌磨牙缺失、上颌尖牙阻生 ,且不愿进行义齿修复或正畸治疗的患者 ,近几年我们采用自体阻生牙 38、4 8、13、2 3进行异位移植 ,经 3年临床观察 ,效果较好 ,现报告如下。1　材料和方法1.1　病例选择共 15例 ,其中男 11例 ,女 4例 ,年龄 18～ 37岁。下颌磨牙残冠或残根无法修复者 :4 7为 2例 ,4 6为 5例 ,36为 3例。上颌乳尖牙滞留 6 3为 4例 ,5 3为 1例。1.2　自体牙选择下颌磨牙 (38、4 8)和上颌尖牙 (13、2 3)阻生不能正常位萌出者 ,拍Ｘ线片证实牙体、牙根正常 ,牙囊完整。1.3　方法1.3.1　局麻下拔除选好的自体牙后 ,在尽量保护牙周…     

牙齿楔状缺损与侧方(牙合)工作侧咬合接触关系的调查

目的研究牙颈部楔状缺损与牙齿咬合接触的关系.方法选取123名中年机关干部.用0.02mm厚的超薄咬合纸,临床检查侧方运动工作侧上颌尖牙、第一、二前磨牙、第一磨牙颊尖各斜面上及咀嚼循环各个时期中的牙齿咬合接触情况;评估接触程度.结果患楔状缺损牙齿咬合接触程度明显高于未患楔状缺损牙.上颌尖牙和前磨牙楔状缺损患牙在远中(上第一磨牙的近、远中)斜面上咬合接触程度高于未患牙,患牙在咀嚼侧方运动循环的中、末(上第一磨牙在初、中或末)期咬合接触程度增加.结论牙颈部楔状缺损的发生与牙齿的咬合接触程度加重有关.     

老年人牙缺失临床修复治疗的分析

目的了解老年修复患者的口腔情况及修复特点。方法对1 166例60岁以上老年人牙缺失患者作修复治疗,分析缺牙及修复情况。结果1 166例患者平均缺牙10.25颗。牙缺失数上领>下领,磨牙>双尖牙>切牙>尖牙。1 166例患者中1 120例作可摘义齿修复,其中游离端缺失约占58%0 46例作固定义齿修复。结论老年修复患者具有缺牙数目多,游离端缺失多,余牙磨耗严重,食物嵌塞多,余留牙松动及残根多等特点;修复以可摘义齿为主,可适当行固定义齿修复。修复治疗时尽量发挥尖牙、已治疗的残根及健康第三磨牙的作用。     

348例老年人活动义齿修复临床探讨

目的了解老年修复患者口腔情况,探讨老年人牙列缺失缺损后的修复特点.方法分析348例老年人牙列缺损缺失的情况,采取不同方法进行修复,并进行5年随访.结果老年人牙列缺失缺损在注意咬牙合重建、抬高咬合、防止食物嵌塞情况下进行活动义齿修复.结论 活动义齿是老年人修复治疗的主要方法,老年人活动义齿修复应注意咬合重建,防止食物嵌塞.     

老年人牙根纵折临床分析

目的:探讨老年人牙根纵折的原因、临床特征及治疗预防措施.方法:对59例老年患者62颗患牙的临床表现结合X线片进行临床研究.结果:老年人牙根纵折好发于下颌第一磨牙,其次是上颌第一磨牙,牙髓治疗后发病率高于未行牙髓治疗的患牙.牙根纵折牙均有明显的咬合创伤及牙槽骨吸收.结论:牙槽骨吸收和咬合创伤是老年人牙根纵折的主要原因.     

Upper cuspid replacement by a fixed partial denture

The replacement of a maxillary cuspid by a fixed prosthesis, though difficult, can be satisfactorily achieved. A careful evaluation of the case and the reason for loss will help in determining the treatment plan.The use of a fixed prosthesis employing the first and second bicuspids as abutments with the cuspid pontic attached as a cantilever is suggested where the maxillary cuspid has been lost as a result of impaction or malposition or is congenitally missing.     

Transmigration of impacted mandibular cuspids

Transmigration of impacted mandibular cuspid is a rare finding. A cuspid is classified as "transmigrated" when more than half of its length has passed the mid-line. 13 cases of transmigration of impacted mandibular cuspids are presented, 3 of which occurred in pairs, raising the total number of teeth to 16. Radiographs showed positions ranging from a vertical impaction, to a cuspid having crossed the mid-line completely, reaching the first molar area of the opposite side.     

Replacement of a mandibular implant-fixed prosthesis with an implant-supported overdenture to improve maintenance and care

PatientsA 69-year-old woman presented to the Osaka University Dental Hospital. She had two chief complaints, (a) food accumulation under the lower teeth and (b) poor maxillary denture retention while eating. On clinical examination the patient presented with a maxillary complete denture and fixed mandibular implant prosthesis. For preventing food accumulation under the fixed implant prosthesis and to keep the maxillary denture stable by providing posterior occlusal contact for bilaterally balanced occlusion, the use of a mandibular implant-supported overdenture with self-adjusting magnetic attachments provided a prosthetic solution for this patient. After provided the new dentures, the patient was pleased and was comfortable with the aesthetic, stability and retention of the dentures. There were no discernable clinical or radiographic changes after 1 year of use.DiscussionTo prevent food accumulation beneath the fixed implant prosthesis and maintain the stability of the maxillary denture by providing posterior occlusal contact for bilaterally balanced occlusion, a mandibular implant-retained overdenture with magnetic attachments was used to provide a prosthetic solution for this patient.ConclusionIn this clinical case, an implant-fixed prosthesis in the edentulous mandibular region was replaced into an implant-supported overdenture with considerations for (a) preventing the food accumulation beneath the lower prosthesis, (b) achieving the proper occlusion in the posterior part for maxillary denture stability and (c) ease of maintenance and care for the prostheses.     

Total impaction of deciduous maxillary molars: two case reports

AIM: The purpose of this report is to present two cases of totally impacted maxillary deciduous molars, considered a rarity in dental practice. BACKGROUND: Primary tooth impaction is quite rare during the development of primary dentition. Various factors contribute to the impaction of a deciduous tooth, including anklyosis, congenitally missing permanent teeth, defects in the periodontal membrane, trauma, injury of the periodontal ligament, precocious eruption of the first permanent molar, defective eruptive force, or a combination of these factors. REPORTS: Case #1: An 18-year-old male presented with a complaint of spontaneous repetitious pain in the maxillary right premolar region. The maxillary right second premolar was clinically absent. Panoramic and periapical radiographs revealed an impacted second premolar close to the inferior wall of the maxillary sinus and an impacted deciduous molar deeply embedded in bone within the maxillary sinus. Case #2: A 14-year-old girl presented with a complaint of crowding of the maxillary teeth. The maxillary right second premolar and the maxillary permanent canines were clinically absent. A panoramic radiograph revealed an impacted maxillary right second premolar and an impacted deciduous molar embedded within bone close to the inferior wall of the maxillary sinus. SUMMARY: The total impactation of deciduous teeth is a rare condition, and few cases have been reported in the literature. The condition generally affects the mandibular second deciduous molar and the maxillary first deciduous least often. In this paper, two cases of totally impacted maxillary deciduous molars are reported.