牙列重度磨耗伴缺损的可摘局部义齿重建修复

目的：探讨应用可摘局部义齿一次性咬合重建修复牙列重度磨耗伴缺损的可行性.方法：对17例牙列重度磨耗伴缺损的患者采用（耠）垫式可摘局部义齿行一次性咬合重建,治疗后1个月、3个月和6个月复诊,调查患者主观感觉、咀嚼效果、义齿稳定性;以及是否有颞颌关节不适.结果：患者咬合升高1.5mm-2.5mm.随访6个月,患者无不适,咀嚼功能改善明显,对义齿的美观和功能都满意.结论：对于牙列重度磨耗伴缺损的病例可以尝试应用可摘局部义齿进行一次性咬合重建修复.     

牙列重度磨耗伴缺损老年患者两种咬合重建治疗的效果比较

目的:观察牙列重度磨耗伴缺损的老年患者分别采用垫式可摘局部义齿与固定义齿进行咬合重建治疗的效果,并进行对比研究。方法:24例牙列重度磨耗伴缺损的老年男性患者,分别采用垫式可摘局部义齿与固定义齿进行咬合重建治疗,其中垫式可摘局部义齿咬合重建组15例,固定义齿咬合重建组9例,并分别对患者治疗前后的自我感觉(美观、舒适)、临床表现、咀嚼效率、颞下颌关节紊乱病临床症状的变化等指标进行评估及分析。结果:垫式可摘局部义齿与固定义齿咬合重建治疗后,患者均主观感觉良好、临床症状改善、咀嚼效率增加,差异显著(P<0.01)。固定义齿咬合重建组患者较垫式可摘局部义齿咬合重建组患者主观感觉更好,咀嚼效率增加更多(P<0.05)。有颞下颌关节病症状的患者咬合重建后症状均有改善,两种咬合重建方法间未见明显差异。结论:垫式可摘局部义齿与固定义齿咬合重建治疗均能一定程度恢复牙列重度磨耗伴缺损老年患者的口颌功能,改善颞下颌关节病症状。采用固定义齿进行咬合重建治疗更具有美观、舒适、提高咀嚼效率的作用。     

咬合重建相关病例回顾及修复流程研究

目的根据咬合异常的不同临床表现，应用不同的修复方法进行咬合重建，评价临床效果，讨论与咬合重建相关疾病的临床诊断及修复设计流程。方法64例咬合异常患者按照修复前检查-诊断-修复设计-咬合重建修复-修复后评价的临床步骤，进行固定修复、固定-可摘局部义齿修复及可摘局部义齿修复咬合重建，于修复前后分别检查颞颌关节健康状况、义齿使用情况与咀嚼效能。结果咬合重建修复1年后，30例颞颌关节紊乱病患者中的25例治愈，对关节区疼痛与关节弹响的疗效差异有统计学意义：全部患者对咬合重建修复的临床效果满意，与可摘局部义齿修复相比较，固定修复、固定-可摘局部义齿修复在义齿舒适度（X^2=5．25，P〈0．05）和对发音影响（X^2=10．86，P〈0．05）等方面的满意度较高，差异有统计学意义；不同种类修复之间及选用不同种类修复咬合重建修复前（F=9．248，P〈0．05）和修复后（F=4．858，P〈0．05），患者咀嚼效能的差异有统计学意义。总结和制定与咬合重建相关疾病的临床诊断流程及修复设计流程。结论运用系统化的临床诊断流程及修复设计流程，能保障获得准确的诊断与针对性的修复设计，保证咬合重建诊疗修复取得成功。     

牙列缺损伴重度磨耗的咬合重建及修复

目的探讨牙列缺损伴重度磨耗咬合重建及修复方法。方法本文重点介绍了牙列缺损并伴有严重磨耗,面下1/3高度变短的病例,采用固定义齿与简单或垫式通可摘局部义齿进行联合性修复,以获得永久性咬合重建治疗。结果对牙列缺损伴重度磨耗的病例,可通过暂时性修复进行过渡,固定义齿与简单或垫式可摘局部义齿进行联合性修复以达到满意的疗效。结论合理的咬合重建修复治疗可有效恢复患者正中颌位关系及正常的咀嚼功能、治疗及预防颞下颌关节疾病、改善美观。     

锁骨颅骨发育不全综合征患者的咬合重建修复

目的 对锁骨颅骨发育不全综合征(CCD)患者进行咬合重建修复,观察疗效并总结修复要点.方法 对1例CCD成年患者抬高垂直距离,上颌行垫式可摘局部义齿修复,下颌行可摘局部义齿修复,过渡性咬合重建修复6个月,随访观察疗效.结果 修复6个月后,患者主观感受和临床检查均显示美观及咀嚼功能得到明显改善,建议以此时的垂直距离为最佳...     

遗传性乳光牙患者附着体修复的效果观察

[摘要] 目的 探讨遗传性乳光牙本质患者固定修复与附着体可摘局部义齿修复的可行性、临床疗效及随访观察。方法 对2例遗传性乳光牙患者进行咬合重建,采用固定修复及附着体可摘局部义齿修复缺失牙部分,并长期随访评价修复后效果,观察疗效及出现的问题和处理方法。结果 义齿修复效果良好,2年后1例患者义齿部分损坏,仍可达到良好的咀嚼效果。结论 遗传性乳光牙本质患者进行附着体义齿修复是可行的,但须长期随访观察及处理。     

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目的    探讨烤瓷冠和可摘局部义齿联合修复在牙列缺损伴重度磨耗咬合重建中的应用。方法    选择2006—2009年中共辽宁省委机关门诊部口腔科就诊的牙列缺损伴重度磨耗患者24例,对其进行咬合重建后采用烤瓷冠和可摘局部义齿联合修复,随访6～36个月,观察疗效。结果    修复后临床效果的主观评价为美观24例、咀嚼有力24例、感觉舒适22例。修复后基牙均无根尖病变、叩痛及松动等现象。1例患者出现义齿塑料部分损坏,其余均未见异常。修复前牙周膜增宽的基牙,修复后牙周膜宽度基本恢复正常,牙槽嵴高度无明显改变。结论    牙列缺损伴重度磨耗患者进行咬合重建后,应用烤瓷冠和可摘局部义齿联合修复方法可得到满意的修复效果。     

固定-活动-种植义齿联合应用于咬合重建1例

对1例患者采用固定-活动-种植义齿联合进行咬合重建。患者口内13颗残根、10颗龋齿、5颗缺失牙,正中[牙合]化无验接触,咬合垂直距离降低,息止[牙合]间隙6mm,无颞下颌关节疾患,用要摘局部义齿撕升高咬合4mm．建市新的颌位关系。16、24、26植入种植体5个月后,上愈合基台,上颌用烤瓷冠桥修复,下颌用铸造支架可摘局部义齿修复。修复后1年复查,效果良好。     

(牙合)垫式可摘局部义齿修复老年重度磨耗(牙合)182例疗效分析

目的：探讨[牙合]垫式可摘局部义齿修复重度磨耗[牙合]的疗效。方法：182例重度磨耗低位咬合的老年患者进行口腔预备后,取模作树脂调位性咬合板,3个月后更换为金属[牙合]垫或复合垫可摘局部义齿,并进行半年期、1年期复诊问卷调查,2年期、3年期复诊和4年期电话随访或巡诊问卷调查。检查项目为义齿的固位和稳定性、咀嚼功能、颞下颌关节改善情况。结果：[牙合]垫式可摘局部义齿修复后能够提高咀嚼功能,义齿固位稳定性好,颞下颌关节功能紊乱综合症疗效明显,结论：[牙合]垫式可摘义齿是重度磨耗[牙合]修复的一种理想方法。     

牙列缺损伴重度(牙合)面磨损(牙合)重建修复的临床研究

目的 通过对不同类型牙列缺损并伴重度(牙合)面磨损的患者进行修复治疗,探讨(牙合)重建的有关问题.方法 选取牙列缺损并伴重度(牙合)面磨损患者69例,制取修复前研究模型,根据不同的缺损类型进行(牙合)垫式可摘局部义齿、固定义齿或固定-可摘义齿联合修复,随访3个月～4年,观察修复治疗效果.结果 患者的咀嚼功能明显改善,有颞下颌关节症状者,症状得到了缓解,无颞下颌关节症状者在咬合升高后未出现新的颞下颌关节症状.结论 对于牙列缺损伴重度(牙合)面磨损患者,(牙合)垫式可摘义齿及固定义齿修复均是(牙合)重建修复的有效方法.     

重度磨耗牙垂直距离评估与固定修复

目的:探讨重度磨耗牙垂直距离的变化与固定修复方法的选择.方法:对65例129颗重度磨耗牙,根据垂直距离有无变化,分为三类修复:①重度磨耗牙,垂直距离未减小,(牙合 )龈距离尚能进行常规固定修复;②重度磨耗牙,垂直距离未减小,(牙合)龈距离不足进行常规固定修复;③重度磨耗牙伴有垂直距离减小,(牙合)龈距离不足进行固定修复...     

Dahl appliances used for the restorative management of localized anterior tooth erosion

Dahl partial bite-raising appliances have been used over the past 30 years for the management of occlusal tooth tissue loss, particularly in patients who have lost normal occlusal vertical dimension. The more recent use of Dahl-type appliances for individual teeth has changed the restorative management of patients with localized anterior tooth erosion. The Dahl treatment principle can be applied to those patients with and without the loss of occlusal vertical dimension. Palatal bite-raising platforms can be used to re-establish anterior tooth guidance for disocclusion of the posterior teeth without occlusal interferences. The treatment principle is illustrated with clinical cases.     

老年牙体重度磨耗伴牙列缺损关系处理的临床研究

目的探讨老年牙体重度磨耗伴牙列缺损关系处理问题。方法对86例老年牙体重度磨耗伴牙列缺损关系分为三类处理：①垂直距离不改变;②一次升高垂直距离修复;③一次升高垂直距离过渡修复,采用了多种修复方式。随访时间为3个月～5年,其中72例两年以上。结果患者的咀嚼功能均得到了明显改善;美观方面获得了不同程度的满意度;修复后多数未出现颞下颌关节问题（TMD）,偶发者经调后消失,修复前有TMD者,经修复治疗得到了缓解或并未加重;牙体牙髓牙周及修复体等一般情况多数良好。结论按本研究分类处理老年牙体重度磨耗伴牙列缺损关系的方法,临床易于掌握,既可保证患者疗效又适当缩短了疗程,取得了良好的临床效果。     

固定修复重建改善重度成人前牙深覆的研究

目的：总结重建改善成人重度深覆修复方法的综合应用和临床体会。方法：对9例重度前牙深覆伴不同程度牙体牙列缺损的患者,综合应用固定义齿修复,通过适度增高垂直距离的重建方式改善患者的咬合关系。结果：重建以后全部患者牙列形态良好,咬合稳定,咀嚼功能及前牙美观均得到明显改善,经过半年至1年观察,无患者出现颞下颌关节不适主诉。结论：在患者已存在牙体牙列缺损需要修复时,采取适当增加垂直高度的修复性重建方法,可在修复牙体牙列缺损的同时,有效改善成年重度前牙深覆患者的咬合关系、咀嚼功能和美观,是一种较理想的选择。     

A potential link between oral status and hearing impairment: preliminary observations

Some previous studies suggest an association between tooth loss and hearing loss. The aim of this study is to assess the relation between oral status and hearing acuity. Forty-eight patients (mean age: 64.7 years) were allocated to four groups: one was wearing complete dentures in both jaws, another had shortened dental arches, a third had full dental arches in both jaws and the last lacked any occlusal stops (i.e. no occlusal vertical dimension, because of the absence of teeth or occlusal pairs). Audiological testing was performed in a noise-free chamber. Air and bone conduction were checked at different frequencies and the air-bone gap was determined. After correction for age and gender, a difference in air and bone conduction because of the oral status was found for low and for high frequencies while no significant differences were (P < 0.05) found for the air-bone gap. The number of teeth, number of occluding tooth pairs and presence or lack of occlusal vertical dimension, was significantly related to the gradient of hearing loss (P < 0.05). The discrepancy in hearing loss between complete denture wearers and patients without any occlusal vertical dimension, strengthens the hypothesis that it is the lack of the latter that is associated with hearing loss. At what level hearing loss occurs, needs further investigation.     

Maxillary Rehabilitation Using a Removable Partial Denture with Attachments in a Cleft Lip and Palate Patient: A Clinical Report

Clefts of the lip and/or palate (CLP) are oral‐facial defects that affect health and overall quality of life. CLP patients often need multidisciplinary treatment to restore oral function and esthetics. This paper describes the oral rehabilitation of a CLP adult patient who had maxillary bone and tooth loss, resulting in decreased occlusal vertical dimension. Functional and cosmetic rehabilitation was achieved using a maxillary removable partial denture (RPD) attached to telescopic crowns. Attachment‐retained RPDs may be a cost‐effective alternative for oral rehabilitation in challenging cases with substantial loss of oral tissues, especially when treatment with fixed dental prostheses and/or dental implants is not possible.     

Efficient prosthodontic treatment in a young patient with long-standing bulimia nervosa: A clinical report

Time-saving, efficient dental treatment is essential for patients in poor dental condition. This clinical report describes a systematic technique for restoration of the visibly-destroyed dentition of a long-term bulimia nervosa patient, including occlusal vertical dimension increase, with composite resin core foundations and prosthetic rehabilitation with ceramic crowns, in only a few treatment sessions. The efficiency of this procedure is gained from composite resin core restorations that establish the new occlusal vertical dimension (OVD) and replace and form the foundation for the subsequent crown preparation.     

A literature review of dental erosion in children

Dental erosion is increasingly recognized as a common condition in paediatric dentistry with complications of tooth sensitivity, altered aesthetics and loss of occlusal vertical dimension. The prevalence of erosion in children has been reported to range from 10% to over 80%. The primary dentition is thought to be more susceptible to erosion compared to the permanent dentition due to the thinner and less mineralized enamel. The aim of this paper was to critically review dental erosion in children with regards to its prevalence, aetiology, diagnosis and prevention. The associations between erosion and other common conditions in children such as caries and enamel hypoplasia are also discussed.     

牙侵蚀与胃食管反流病间的关系

牙侵蚀是指牙体硬组织在无细菌参与的化学作用下的不可逆性丧失,胃食管反流病是常见的胃肠道紊乱性疾病,是牙侵蚀主要的病因之一。本文主要就牙侵蚀的病因、胃食管反流病导致的牙侵蚀机制,牙侵蚀的临床表现,牙侵蚀的预防和治疗等研究进展作一综述。阐明了牙侵蚀是胃食管反流病食管外最重要的表现之一,其诊治需要多科的共同协作,早期诊断胃食管反流病并通过改变生活方式和药物来抑制酸反流,对预防牙侵蚀的发生和干预牙矿质的进一步丢失和损伤极为重要。     

Reestablishing occlusal vertical dimension using a diagnostic treatment prosthesis in the edentulous patient: A clinical report

To maintain a harmonious craniofacial system, the dental practitioner must establish an appropriate occlusal vertical dimension (OVD). Several methods can be used to determine an appropriate OVD. The patient presenting with decreased OVD represents a particular challenge for the dental practitioner in fabricating conventional dentures. This clinical report describes the use of a diagnostic treatment prosthesis to evaluate the patient's ability to manage such an increase in vertical dimension and to reestablish an appropriate occlusal vertical dimension. The use of a diagnostic treatment prosthesis at a vertical dimension 5 mm greater than what the patient presented with was determined to not cause discomfort over a 2-month period. A conventional complete denture was fabricated based on the patient's ability to handle the increase during the trial period. This report reviews the literature on this topic and describes a clinical technique for reestablishing the OVD in edentulous patients.