- 期刊
垂直型磨牙的全口重建－病例報告
Oral Rehabilitation for Vertical Bruxism-A Case Report
摘要
磨牙症為全口重建病例中常見的問題，可分為水平型磨牙與垂直型磨牙。水平型磨牙患者會造成牙齒所有咬頭磨損，垂直型磨牙患者則會造成功能性咬頭的咬耗，及美觀區薄弱齒質的斷裂。本病例為一中年男性，因嚴重咬耗導致美觀不佳與咬合功能喪失，治療目標為恢復基本美觀與重建咬合功能，並能使此補綴物達到使用上的穩定。療程中先後使用兩副咬合板，並配合咬合平面分析儀製作觀察性固定補綴物，在病患完成其他牙周、根管等治療的同時，也適應了新的咬合高度與牙齒型態，最後製作金屬咬合面之陶瓷燒附金屬補綴物，期達到理想的犬齒導引功能性咬合與適當的前牙美觀及良好的長期預後。在下顎前牙區有較差的牙周支持與齒質磨損，故使用複合樹脂復形並使前牙參與咬合。在理想的犬齒導引咬合與金屬咬合面的設計下，本病例已追蹤一年多，並無補綴物斷裂的情形發生，病患滿意治療的結果。
並列摘要
Bruxism was very popular problem in oral rehabilitation cases. Horizontal bruxer expressed noted wearing on outer aspects of any teeth. Vertical bruxer manifested much attrition on functional cusps of posterior teeth and prominently frail incisal edges of anteriors. The reported case was a middle-age male patient. His chief complaint was aesthetics and chewing function loss due to severely vertical-worn. The treatment goal was to rehabilitate his anterior aesthetics and occlusal function and to attain to long-term success. In the course of treatment, we gave two biteplates successively and combined the use of occlusal plane analyzer with them to fabricate provisionally fixed partial dentures. The patient adapted to the new vertical height and occlusal morphology after several-months periodontal and endodontic treatment. The permanent prosthesis was designed as PFM crown and bridge with metal occlusal surface and mutually canine-protected occlusion. We also restored the periodontally-compromised and worn lower anterior teeth with composite resin to restore ideal occlusion and estheteics. No prosthesis material fracture was found during the first year follow up course and the patient was satisfied by the treatment results.