老年人复杂可摘局部义齿修复的体会

老年人缺失牙较多,时间较长,使口腔状况十分复杂,修复较为困难[1].笔者通过对各类复杂可摘义齿设计及制作方面谈几点体会.     

老年人牙列缺损可摘局部义齿修复设计回顾性研究

目的:总结老年人多数牙列缺损的临床修复体会,探讨老年患者可摘局部义齿的设计。方法:对276例老年多数牙列缺损患者分别设计牙合垫式、连续卡环式、连续卡环加牙合垫式可摘局部义齿,其中179例余留牙有残根、残冠患者,先作根管治疗,然后按以上形式设计覆盖式可摘义齿。对修复效果作戴修复体时及戴后3月、3年随访,标准分为好、差两个等级。结果:276例复查结果:满意度调查,好均为100%,(P>0.05)。咀嚼功能检查,戴后3月,好为100%,3年好为99.3%,(P>0.05)。基牙牙周情况检查,戴后3月,好为100%,3年好为97.1%,(P>0.05)。结论:对老年人多数牙列缺损患者,应根据患者口腔情况设计最佳个体修复方案,制作适合老年人生理特点的可摘局部义齿。     

可摘局部义齿

揲帽式和沟槽式附着体义齿的临床应用；种植修复Kennedy Ⅱ类牙列缺损38例临床报告；[编者按]     

可摘(牙合)垫式义齿修复老年人缺牙体会

我们自2000年～2003年可摘(牙合)垫式义齿用于老年人缺牙修复[1],收到了满意的效果,报道如下.     

可摘局部义齿修复1126例临床分析

目的：对1126例可摘局部义齿进行分析，为临床关于可摘局部义齿修复牙列缺损积累经验。方法：随机选取1126件义齿修复病例，分析牙齿缺损位置、数量与性别和年龄的关系及修复体的类型，并对采用新技术进行的特殊设计进行分析。结果：上颌牙缺失多于下颌，不同年龄组缺牙好发部位不同，青年组以前牙缺失为多，其他年龄组以后牙缺失为多。男女两组中平均失牙数随年龄增加而增加，但与性别无关，在各类可摘局部义齿设计中，第5类最多。结论：可摘局部义齿制作简便，适应症广，目前仍然在修复治疗中发挥着重要的作用。     

可摘局部义齿

整体铸造支架联合可摘隐形义齿修复牙周病患者缺牙；套筒冠覆盖义齿修复老年人牙列缺损的临床观察；黏接式套简冠可摘义齿的制作；成年人第一磨牙拔牙间隙变化的临床研究；键槽缓压式附着体义齿的临床应用     

可摘局部义齿

冠外附着体义齿修复游离端牙列缺损的临床应用;EDEC概念应用于牙列缺损修复的病例报告;     

可摘局部义齿

套筒冠可摘活动义齿修复后出现的问题及处理；上颌可摘局部义齿修复对辅音声学特征的影响；上颌肯氏Ⅰ类牙列缺损义齿修复对元音的影响；牙列缺损患者三维数字化牙颌模型数据库的建立。     

牙列缺损者可摘局部义齿修复前后咀嚼效能的调查

本文用吸光度法测定138例可摘局部义齿修复前后的咀嚼效能,并与正常(牙合)者的咀嚼效能相比较,观察分析各种类型牙列缺损者修复前后咀嚼效能的变化和可摘局部义齿的疗效,得出下述结论:牙列缺损后咀嚼效能的丧失及义齿修复后咀嚼效能的恢复、提高与缺牙的数目、部位、义齿的类型密切相关。     

可摘局部义齿

纳米非晶金刚石膜改善义齿基托表面变形链球菌黏附量的研究;可摘局部义齿基托表面形态对语音影响的分析;（牙合）面磨损伴牙列缺损殆重建修复效果探讨;改良式活动桥在个别后牙缺失修复中的应用体会     

夹板式义齿在牙周病修复治疗中的应用

目的：探讨夹板式可摘局部义齿在牙周病修复治疗中的疗效。方法：对67例患者应用铸造或弯制支架式可摘局部义齿，结合牙周病修复治疗的原则和方法，在修复缺失牙的同时固定松动牙。结果：经过修复后3年复查，有效率达92．5％。结论：夹板式可摘局部义齿是修复治疗牙周病较为理想的一种方法。     

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。     

Parallel bonded cast attachments for removable partial dentures

The original design of a semi-precision extra-coronal attachment for partial dentures is illustrated, and its fabrication in a cast non-precious bondable alloy is described. A step-by-step method is also described of bonding multiple attachments in parallel for the retention and support of removable partial dentures. Clinical cases are illustrated. The results of trials indicate that the method is clinically viable and, in selected cases, appears to offer distinct advantages over existing retention systems.     

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。     

Failures in the rehabilitation treatment with removable partial dentures

Abstract

Background. Despite being functional and having aesthetic benefits, the acceptance of patients regarding the use of removable partial dentures (RPDs) has been low. In part, this is due to the deleterious effects that causes discomfort to the patient. Success depends not only on the care expended by the patient, including daily care and oral hygiene, but also on common goals set by their professional and clinical staff, aiming beyond aesthetics, to incorporate issues of functionality and the well-being of patients. Methods and results. For rehabilitation treatment with RPDs to reach the desired level of success without damaging the support structure, all the steps (diagnose, cavity preparation, adaptation of the metal structures, functional of distal extension and posterior follow-up) in the rehabilitative treatment should be carefully developed. A literature review was carried out, searching through MEDLINE (PubMed) articles published between 1965 and December 2012 including clinical trials and reviews about the use of RPDs. Conclusions. This study describes factors that lead to failures and complications in oral rehabilitation through the use of RPDs and suggests possible solutions.     

A survey of treatment outcomes with removable partial dentures

The patient's satisfaction with removable partial denture (RPD) therapy has become an increasingly important factor in prosthetic treatment. This study examined patients' satisfaction with RPDs in relation to some socio-economic variables, patients' habits of wearing and cleaning RPDs, comfort of wearing RPDs and different RPDs characteristics. A questionnaire was devised for the purpose. Two hundred and five patients were required to assess satisfaction with RPDs. They graded RPDs, depending on the level of satisfaction, on scale ranging from 1 to 5. A dentist determined Kennedy classification, material and denture support, denture base shape, number of missing teeth and evaluated denture construction. Majority of the patients were satisfied with the prosthesis. The patients of a higher education level gave lower grades (P < 0.05) to aesthetics of maxillary RPDs. Almost half of the patients were wearing RPDs during the day. Most of the patients cleaned RPDs three times a day. A significant difference was found between the patients' grades for comfort of wearing mandibular RPDs and number of missing teeth and between hygiene of mandibular RPDs and habits of cleaning them. Majority of the patients treated with RPDs were satisfied with the prosthesis. Dissatisfaction was related to mastication, esthetics, number of missing teeth and maintenance of oral hygiene.     

垫式可摘局部义齿联合软牙合垫治疗颞下颌关节紊乱病的疗效观察

目的观察利用垫式可摘局部义齿联合软垫对垂直距离过低的颞下颌关节紊乱病患者进行治疗的临床疗效。方法选择16例垂直距离过低的颞下颌关节紊乱病患者对其采用垫式可摘局部义齿联合软垫的方法进行修复治疗,做3个月和半年的随访,用Fricton指数和临床症状评价效果。结果 16例患者在接受治疗后Fricton指数较治疗前有明显下降,半年较3个月下降更为明显,统计学分析显示治疗3个月和半年与治疗前比较各项数据差异均有显著性(P<0.05),治疗半年与3个月比较JP、MP、PI无统计学意义(P>0.05)。结论 垫式可摘局部义齿可以在修复牙列缺损、恢复垂直距离的同时联合软垫有效治疗颞下颌关节紊乱病。     

��ժ�ֲ���ݻ��ߵ��˸��������޸�����ȵ�������о�

目的    了解可摘局部义齿（removable partial denture,RPD）修复患者的基本情况以及人格特征,分析人格特征与修复满意度之间的关系。方法    2007年6月至2010年3月使用艾森克人格问卷及可摘局部义齿满意度调查表对盘锦市第一人民医院口腔科108例可摘局部义齿修复患者进行调查,采用统计学方法进行相关性分析。结果    对语言和咀嚼能力满意的患者所占比例较高,与其他分项比较,差异有统计学意义（P < 0.05）。N量表得分与固位稳定、舒适度及满意度问卷总分之间呈负相关（r = -0.31 ~ -0.24）,且以N得分 = 60为界,N得分> 60 和≤ 60两组之间差异具有统计学意义（P < 0.05）。结论    情绪稳定、性格乐观、自控性强的缺牙患者较神经敏感、情绪不稳、自控性差者容易接受可摘局部义齿修复,各项满意度较高。     

Caries and periodontal status in patients fitted with removable partial dentures

A 6-year follow-up study was carried out on 28 patients fitted with removable partial dentures. Prior to the prosthetic treatment all patients were given oral hygiene instruction and periodontal therapy where indicated. The removable partial dentures were carefully planned and designed. During the follow-up period the patients were examined at yearly intervals when remotivation, scalings, conservation and prosthetic adjustments were carried out as required. Patient cooperation was excellent and no significant deterioration of the periodontal status of the remaining teeth could be found. In addition the number of newly registered carious lesions was low. A certain degree of deterioration of occlusion, articulation, stability and clasp retention of the dentures fitted did occur, however.