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。

A clinical study on the treatment of the occlusal relationship of elderly patients with defection of dentition and severe attrition

Objective To investigate the treatment of occlusal relationship of elderly patients with defection of dentition and severe attrition.Methods Eighty-six elderly patients with defection of dentition and severe attrition were divided into three classifications：①the occlusal vertical dimension （OVD） did not been changed; ②the occlusal vertical dimension in once treatment for reconstruction was increased; ③the occlusal vertical dimension as the midway treatment was increased,a variety of prothodontal treatments was applied. Follow-up period was from 3 months to 5 years,72 cases were followed up for over 2 years.Results The masticatory function of the patients was improved significantly,the esthetic aspect was satisfying. Temporo-mandibular joint disorder （TMD） was not found in most of the cases after treatment,a few cases with TMD were found but the symptoms disappeared after adjustment of the occlusion. Patients with TMD before the prothodontal treatment,the symptoms decreased or did not deteriorate after treatment. Most of the dental,endodontal,periodontal and prothodontal situations were fine.Conclusion With the guidance of this research,it is easy to operate for treating occlusal relationship of the elderly patients with defection of dentition and severe attrition in different ways. The result of the treatment is ensured and the treatment time is shortened. Satisfying clinical results were achieved.