上顎旋鎖可撤式局部義齒應用於單側支柱牙－病例報告

Maxillary Swinglock Removable Partial Denture Using Unilateral Abutments-Cases Report

王慧媛(Huey-Yuan Wang) ； 陳韻之(Yunn-Jy Chen) ； 盧幼情(Yo-Chin Lu) ； 趙書群(Shu-Chun Chao) ； 蕭裕源(Yuh-Yuan Shiau) ； 王若松(Juo-Song Wang)

《中華牙醫學雜誌（中文版）》 25卷1期 (2006/03) Pp. 49-59

https://doi.org/10.7106/CJD.200603.0049

摘要

當上顎單側後牙合併跨弓前牙缺失，僅剩單側支柱牙存在時，常會因上顎前方為無牙嵴區，下顎前方為自然牙，而呈現上顎後縮與下顎相對前突的關係，造成傳統可撤式局部義齒(conventional removable partial denture)的不穩定及鬆脫，這是因為下顎自然牙施力方向，朝向上顎無牙嵴外側，對義齒產生旋轉力量所致。為了克服這種不利的咬合關係，上顎植牙贋復是可行的方法之一，而旋鎖可撒式局部義齒(swinglock removable partial denture)是一種經濟的方法，它靠唇側桿及支柱，利用剩餘牙齒及組織的倒凹，得到義齒的因位及穩定。本報告除了回顧旋鎖可撒式局部義齒的適應症、非適應症、設計原理、及製作過程外，還提出四個上顎單側支柱牙的病例，二男二女，年齡從51-95歲，平均76.2歲，他們原本都配戴傳統可撤式局部義齒，其支持、因位及適合度等方面，經評估及調整後都在可接受範圍，但是患者仍主訴咀嚼時無牙嵴區疼痛、支柱牙不適、義齒易鬆脫、及咀嚼效率不佳等，經建議改為旋鎖可徹式局部義齒後，之前的問題都獲得解決。藉由患者配戴旋鎖可撤式局部義齒前後的反應，探討以旋鎖可撤式局部義齒改善傳統可撤式局部義齒缺點的機制。

關鍵字

旋鎖可撤式局部義齒 ； 單側支柱牙

並列摘要

When unilateral posterior teeth and cross arch anterior teeth are missing, there is usually a retruded maxillary anterior edentulous ridge and relatively protruding mandibular anterior natural dentition, which can compromise the retention and stability of a conventional maxillary removable partial denture (RPD). This is caused by the force of the natural mandibular dentition being directed toward the labial side of the maxillary anterior edentulous ridge, causing the conventional RPD to rotate around the ridge. To overcome this unfavorable occlusal condition, maxillary implant prostheses are a better choice. However, a swinglock removable partial denture is a more-economical choice. The swinglock RPD with a labial bar and struts utilizes the undercut of all remaining teeth and tissue and achieves maximum retention and stability of the denture. In this paper, we reviewed the indications, contraindications, design principles, and fabrication procedures of the swinglock RPD and report on 4 clinical cases of 2 male and 2 female patients, aged 51-95 (average, 76.2) years. They had worn conventional maxillary RPDs for a long time, and the support, retention, and fitness of the dentures were acceptable after evaluation and adjustment. However, they still complained of pain over the edentulous ridge, discomfort of the abutments, rocking of the denture, and lack of chewing efficiency. After fabricating a new swinglock RPD, all previous complaints were resolved. From the response of patients before and after wearing the swinglock RPD, we discuss mechanical differences between swinglock and conventional RPDs.

並列關鍵字

swinglock removable partial denture ； unilateral abutments