- 學位論文
牙周補綴病例報告與討論
Periodontal-Prosthetic Case Reports and Discussion
摘要
臨床上遇到許多牙周病患者，因牙周病、齲齒…等因素失去牙齒，而造成後牙咬合崩塌(posterior bite collapse)，也有因補綴物(restoration)不夠，造成牙周與咬合病變、美觀不佳、缺乏穩定的咬合、咀嚼(mastication)困難，甚至顳顎關節(TMJ)病變。 相信「尋求一個實用的準則及治療順序，獲得一個可預期且穩定的治療成果」是每位治療者所祈求的。牙周患者的治療，基本上可分為五個階段：初期的牙周治療階段(initial therapy phase)、暫時性補綴物與治療階段(provisional restoration and stabilization)、最後的牙周治療階段(definitive therapy management phase)、補綴治療階段(Prosthetic phase)、回診與維持階段(recall and maintenance phase) (Rosenberg, Kay, Keough, & Holt，1988)。 本論文有九個臨床常見的病例(男性六位、女性三位)，平均年齡約52歲(48歲至78歲)，所遇到的牙周問題有骨上囊袋(suprabony pocket)、骨內囊袋(intrabony pocket)、牙根分叉侵犯(furcation Involvement)等。根據每位患者的牙周特性，參考上述五個治療階段，設計適合每位患者的治療計畫。所採取的治療方式，則包括了非手術治療與手術治療，例如囊袋去除術、牙周翻瓣清創術、牙齒分割、牙根切除術等。而最終補綴物的設計有切除牙根製作固定牙冠牙橋(案例一)、薄蓋冠合併覆蓋式義齒(案例二、三)、可撤式活動假牙(案例三、四、五、六)、人工植牙(案例七、八、九)、全口假牙(案例七)等。
並列摘要
On clinical we have met many patients lost their teeth due to peridontitis, caries…etc, even worse posterior bite collapse, also because of inadequate restoration, induce periodontal and occlusal pathosis, esthetic impairment, absence of stable occlusion, difficulty in mastication, temporomandibular joint (TMJ) dysfunction. We want to find a practical guideline and sequence for the periodontal therapy. The treatment results should be predictable and long-lasting. A typical sequence of therapy in the management of the periodontal-prosthetic case is as follows:Initial therapy phase; Provisional restoration and stabilization; Definitive periodontal management phase; Prosthetic phase; Recall and maintenance phase (Rosenberg, Kay, Keough, & Hol, 1988). The thesis includes 9 clinical cases that often met in clinics (male 6, female 3), average age of the cases is 52 years old (48 years old to 78 years old), the periodontal problem were suprabony pocket , intrabony pocket, furcation involvement. According to every case’s periodontal characteristics follow the five sequence described above, to design treatment plane suit for every case indivally. The periodontal treatment includes nonsurgical treatment and surgical treatment (pocket reduction surgery, open debridement, tooth separation, root amputation). The final prosthesis design including root amputation with fixed crown bridge (case 1), capping with overdenture (case 2, 3), removeable partial denture (case 3, 4, 5, 6), implant (case 7, 8, 9), and complete denture (case 7).