伴牙周病错畸形的正畸治疗要点

伴牙周病错畸形的正畸治疗,需要正畸医师有过硬的业务水平;同时,需要正畸医师深刻理解牙周病患者的口腔组织特征,具备多学科协同治疗的理念。本文从伴牙周病错畸形患者正畸治疗的九大要点入手,希望能给正畸医师一些警示与指导。     

牙周病正畸治疗中的误区

随着成人正畸患者的不断增加,正畸医生在临床工作中将面对越来越多的成人牙周病患者。牙周病患者因为牙周支持组织的破坏常会导致前牙唇向移位、散开,出现间隙,并形成创伤,进一步加剧牙周组织的丧失,最终导致患牙的脱落。同时前牙的形态和位置直接影响患者的美观,患者具有强烈的主观要求,希望能够得到治疗。为牙周病导致牙齿病理性移位的患者进行正畸治疗是广大正畸医生的任务和职责,这就要求我们对牙周病以及牙周病的正畸治疗有充分的理解和认识。但是,正畸医生在对成人牙周病患者的治疗中存在着一些模糊的理解,甚至是错误的概念。这些错…     

牙周病正畸治疗与牙周维护

近年来成人正畸患者数量与日俱增,因成人正畸患者多伴有不同程度的牙周疾患,因此牙周病治疗和口腔正畸治疗之间的关系变得越来越密切。鉴于牙周病患者正畸治疗的特殊性,正畸医生应该对治疗中的相关问题及治疗后牙周维护两个方面给予高度重视。     

成人牙周病患者正畸治疗临床分析

目的：探讨成人牙周病患者正畸治疗的临床疗效。方法：18例牙周病患者先行牙周病基础治疗,待牙周组织炎症消除后再行正畸治疗,并对牙龈炎的严重度、牙齿松动度、牙周袋深度和牙槽骨吸收度进行评价。结果：通过正畸治疗,牙周状况显著好转,关系及颜面均有明显改善。结论：成人牙周病患者正畸治疗能够基本达到个别正常,恢复咀嚼功能达到颜面美观的目的。     

成人牙周病20例的正畸治疗

目的探讨正畸治疗对牙周病的治疗作用。方法通过对20例成人牙周病患者运用正畸及牙周联合治疗并对患牙牙周、牙槽骨情况进行对比观察,了解正畸治疗对成人牙周病患者的治疗作用,探讨治疗成功的关键因素。结果20例患者移位的牙齿得到了复位,前牙覆牙合覆盖关系正常、咬合关系及外貌均有明显改善。结论成人牙周病经过正畸治疗可以恢复牙列外形,达到美观及恢复咀嚼功能的目的。     

成人牙周病正畸治疗的疗效分析

目的通过对牙周病患者施行牙周和正畸联合治疗,探讨正畸治疗对牙根长度和牙槽骨高度的影响。方法选择30例牙周病患者,采取牙周治疗和直丝弓固定矫治器正畸的联合方法,拍摄正畸治疗前后的曲面断层片,借鉴Sche i提出测量牙槽骨吸收程度的方法,测量正畸治疗前后牙根长度和牙槽骨高度,用计算机进行统计分析。结果 30例牙周病患者,经过牙周和正畸联合治疗,治疗前后牙根长度和牙槽骨高度的变化差异无统计学意义（P〉0.05）。结论牙周病患者严格控制炎症、采取轻力,通过牙周和正畸联合治疗,不会对牙根长度和牙槽骨高度产生影响。     

成人牙周病的正畸治疗

目的探讨正畸治疗对成人牙周病的治疗作用。方法通过对28例患有牙周病的错畸形患者进行常规牙周治疗及正畸治疗,通过比较治疗前后患者的牙周、牙槽骨情况的变化来评价正畸治疗对患有牙周病的错畸形患者的治疗作用。结果28例患者的错畸形得到矫正达到个别正常,矫正结束时牙周情况较矫治前明显改善。结论正畸治疗为错畸形患者创造了健康的牙周环境和功能良好的牙列,对牙周病的治疗有显著作用。     

牙周正畸治疗的研究进展

不少成人牙周病患者因牙周病导致牙周组织的缺损,影响美观及功能,需进行正畸治疗。这使牙周正畸治疗日益被关注。本文就牙周病的病因、牙周正畸治疗的方法、时机、加力方式、力值选择和治疗后牙周组织的改建进行综述。     

成人牙周病正畸治疗疗效分析

目的:探讨正畸治疗对成人慢性牙周病的治疗作用。方法:选择伴有前牙唇倾、牙间隙增宽、覆牙合覆盖增大的18例患有牙周病的错牙合畸形患者进行常规牙周治疗及正畸治疗,通过比较治疗前后患者的牙周、牙槽骨情况的变化来评价正畸治疗对患有牙周病的错牙合畸形患者的治疗作用。结果:18例患者平均疗程21个月,正畸治疗后牙齿稳定度增加、移位牙复位、牙周袋变浅或消失、牙龈无明显炎症,患者的错牙合畸形均达到个别正常牙合,结束时牙周情况较矫治前明显的改善。结论:正畸治疗改善了错牙合畸形患者的牙周环境和牙列功能,对牙周病的治疗有显著的作用,为成人牙周病的正畸治疗提供一定的参考依据。牙周病是多因素所致的慢性进展性疾病。牙周病患者因牙周支持组织的破坏吸收,常引起牙齿的松动、移位、伸长等,从而引起继发性的牙牙合畸形及咬合创伤。成人牙周病通常会伴有前牙唇侧漂移、牙间隙增宽,覆牙合覆盖增大等错牙合畸形,不仅影响咀嚼功能,还严重影响美观。正畸治疗成为牙周病治疗的重要手段之一,应用固定矫治器对牙周病致错牙合畸形的患者进行矫治,恢复相对理想的牙弓形态和咀嚼功能以及稳定的口腔环境,一直是学者们所关注的问题。临床笔者对18例因牙周病所致前牙散隙的错牙合畸形患者进行牙周及正畸联合治疗,取得满意疗效。     

牙周病患者和普通正畸患者拔牙模式的分析

目的：分析牙周病患者正畸治疗和普通正畸患者拔牙模式的区别。方法：抽取山东大学15腔医学院正畸科2000--2006固定矫治患者566例,其中牙周病患者占137例。对正畸减数拔牙模式进行分析,并采用SAS10．0统计学软件进行卡方检验。结果：566例固定矫治患者中,牙周病患者采用策略性拔牙模式为63．50％,明显高于非牙周病正畸患者,差异有统计学意义（P〈0．05）。结论：策略性拔牙模式更适合于牙周病正畸患者。     

Bisphosphonates and the dental patient: part 1

This 2-part article is intended to educate readers on the current recommendations with regard to specific treatment for dental patients who will be starting or are currently taking the different types of bisphosphonate medications. The first article deals with the basic science and medicine surrounding the use of bisphosphonate medications. The second article will be clinically orientated, dealing with possible treatment options for dental patients who are on or will be starting bisphosphonate medications. These treatment options will be based on the most current literature available and the authors' experiences. However, readers should note that the newness of the subject matter and the research that is sure to follow will make some of these recommendations obsolete within a few years. Readers are invited to view this article not as the "final word" on this subject but rather as a foundation.     

The importance of the operating sequence: a multidisciplinary treatment approach.

Dental professionals will, from time to time, be presented with a patient who requires substantial treatment to correct trauma, caries damage, or severely compromised teeth. Such cases often require a multidisciplinary approach, which may include emergency endodontic, or periodontal pretreatment to obtain a morphological, functional, and aesthetic rehabilitation, while maintaining the residual dental and periodontal structures. This article will discuss a process to correctly develop the most appropriate treatment plan and how best to sequence treatment in cases requiring a multidisciplinary approach. LEARNING OBJECTIVES: This article will demonstrate how the formulation of a correct multidisciplinary treatment plan can provide the basis for predictable clinical success. Upon reading this article, the reader should: 1) Understand the importance of and learn how to determine the sequence for a multidisciplinary treatment plan. 2) Become familiar with the value of a correct dental-periodontal relationship.     

Effects of periodontal disease and its treatment on the condition of the pulp

Since there is a close relationship between the periodontium and the pulp, formed by the apical foramen, dentinal tubules, lateral and accessory canals, it is evident that both compartments influence one other. In this article, the influence of periodontal disease and its treatment on the dental pulp is described. The review shows that periodontal disease and its treatment, very seldom compromise the vital functions of the pulp, but can cause local pulpal response. A more common reaction is dentinal hypersensitivity. Although there's no clear treatment for dentinal hypersensitivity, this article presents a few guidelines for treatment.     

Treating complex cases using an interdisciplinary approach for predictable aesthetic and functional outcome.

The successful introduction of endosseous implants has significantly changed dental treatment planning and therapy. To date, implants can be utilized not only to convert removable prostheses into fixed restorations, but also to improve the overall functional and aesthetic outcome. The sequence of treatment involving the different disciplines in the comprehensive treatment of the patient is an important factor needed to achieve excellence in complex restorative cases. This article presents a comprehensive interdisciplinary approach to a complex full-mouth fixed reconstruction in the aesthetically and functionally compromised partially edentulous patient. LEARNING OBJECTIVES: This article describes a sequential approach to the interdisciplinary treatment of a partially edentulous patient. Upon reading this article, the reader should be able to: Understand the relevance of proper diagnosis and treatment planning on full-mouth rehabilitations. Identify the goals for the various sequences involved in treating complex restorative cases.     

The edentulous patient and body image--achieving greater patient satisfaction.

Aesthetic outcomes in the rehabilitation of edentulous patients play an important role in regard to treatment satisfaction and its acceptance. While the dental literature is replete with techniques and treatment philosophies that allow the fabrication of aesthetic restorations, adhering to such mechanical practices alone does not necessarily guarantee patient satisfaction. Taking into consideration the patient's perspective can significantly enhance treatment success. This article outlines the relevant factors that influence the aesthetic result of complete denture treatment. LEARNING OBJECTIVES: This article describes factors that contribute to patients' satisfaction with denture aesthetics and provides guidelines for clinicians to follow in daily practice. Upon reading this article, the reader should be able to: Understand the role that a patient's body image plays in an aesthetic outcome. Recognize contemporary aesthetic trends that influence denture aesthetics.     

Managing congenitally missing lateral incisors. Part III: single-tooth implants

Three treatment options exist for the replacement of congenitally missing lateral incisors. They include canine substitution, a tooth-supported restoration, and a single-tooth implant. Selecting the appropriate treatment option depends on the malocclusion, anterior relationship, specific space requirements, and condition of the adjacent teeth. The ideal treatment is the most conservative option that satisfies individual esthetic and functional requirements.
Today, the single-tooth implant has become one of the most common treatment alternatives for the replacement of missing teeth. This article closely examines the many interdisciplinary issues that arise when treatment planning the placement of single-tooth implants in patients with congenitally missing lateral incisors. The specific criteria that must be evaluated illustrate the importance of an interdisciplinary treatment approach to achieve optimal esthetics and long-term predictability. This is the final article of a three-part series discussing the three treatment alternatives for replacing congenitally missing lateral incisors.     

An indirect immediate-load prosthetic protocol using a novel-winged analog.

Immediate loading of implants has increasingly become the preferred treatment modality for both patients and clinicians. While the concept has been accepted as the preferred method of treatment, there are various options in terms of completing the actual procedure. This article will discuss the utilization of a novel-winged analog in combination with polyvinylsiloxane-casting material. This correlation allows for the rapid chairside development of a high-precision cast. On this cast, a conversion denture is transformed into an interim fixed prosthesis. Both the conventional analog as well as the computer-guided protocols will be described herein. Learning Objectives: This article discusses a simplified, indirect method for placing an interim fixed prosthesis utilizing a novel-winged analog and polyvinylsiloxane casting material. Upon reading this article, the reader should: Understand the benefits attributed to the immediate loading of dental implants. Become familiar with the differences between conventional open-flap surgery and treatment protocol utilizing CAD/CAM technology.     

Composite restorations in the anterior region: clinical and aesthetic performances.

Composite resin has proven to be a predictable and reliable restorative material for the treatment of traumatized dentin or dental caries in the anterior region. Ongoing material advancements continue to contribute to favorable results in the treatment of the contemporary patient. In using a resin material, it is important for the dental professional to establish an appropriate clinical approach that will protect healthy tissues, while meeting the patient's expectations. This article presents a series of cases that encompass the clinical and aesthetic possibilities provided by modern composites. LEARNING OBJECTIVES: This article depicts the potential clinical and aesthetic results that can be achieved using contemporary composite resins. Upon reading this article, the reader should: 1) Understand operative techniques for obtaining aesthetic results in the anterior maxilla. 2) Become familiar with the importance of formulating a treatment strategy that combines minimum chairtime with a high-quality, aesthetic result.     

Getting your back back to work: pain relief--where to start?

Dental health care workers are vulnerable to back and neck pain resulting from poor occupational posture. While numerous choices exist for treatment, this article will provide them with a practical approach to seeking out appropriate care for this common malady. The McKenzie treatment approach is discussed and recommendations for its application are presented to provide the reader with a starting point for treatment. For the dental health care worker experiencing pain and dysfunction of the back and/or neck, as more than half will during their careers, this article will seek to provide an overview of potential causes while creating a roadmap for seeking the most appropriate conservative "antidote" for their care.     

Management of the exposure of e-PTFE membranes in guided bone regeneration.

Guided bone regeneration (GBR) has been used extensively since its introduction in the late 1980s. In such treatment, e-PTFE membranes are often preferred because of their inert biological features and the predictability of the barrier effect. One complication of GBR is the premature exposure of the membrane. A consequence of the resulting soft tissue dehiscence is compromised bone regeneration. There are situations in which an exposed membrane can be maintained and obtain satisfactory results. This article discusses suggested guidelines for the treatment of exposed e-PTFE membranes. Learning Objectives: This article discusses treatment options for e-PTFE membranes that are exposed with or without infection. Upon reading this article, the reader should: Be able to identify both Class I and Class II exposures. Understand how to properly treat both a Class I and Class II exposed e-PTFE membrane.