摘要
長久以來在台灣牙周病一直是主要的牙科疾病。隨著年齡增加，牙周病也越來越嚴重，從牙齦萎縮、齒槽嵴萎縮、牙齒移位、頰側突出、喪失咬合高度到咬合崩塌、咀嚼困難、美觀不佳，甚至顳顎關節(TMJ)病變。在牙周病的治療過程，除了徹底清創(debridement)，去除致病原(pathogen)外更須對殘存的齒列加以積極性的重建就是牙周補綴。舉凡由口腔診斷、牙體復形、牙髓治療、牙周治療、口腔外科、種植體到矯正以及補綴治療等等，都應屬於牙周補綴的範圍，也就是所謂的「整合性治療」。 在過去十年，植體及引導組織再生(GTR)的進展就大大的改變了原先的治療概念。一些老舊的方式被一些較新較好的方式所取代。例如使用GTR使三面缺損的臼齒有較高的治療成功率。患者有權知道各種方式的優缺點，醫師必須有能力明言，選擇各種治療的推演過程。 本論文有十個臨床常見的病例，所遇到的問題有：全口無牙、骨上囊袋〈suprabony pocket〉、骨內囊袋〈intrabony pocket〉、根叉侵犯、粗隆倒凹，針對牙周問題所採取的治療方式包括非手術治療與手術治療。如：牙周翻瓣手術、引導組織再生術、種植體、上腭軟組織移植、牙冠增長術、顎竇增高術、骨移植等。而補綴物的設計則有1、植體型覆蓋式義齒，2、固定式牙冠牙橋，3、可撤式活動義齒，4、全口義齒，5、KÖNUS雙重套冠系統活動義齒，依照病例的不同而做各種不同的整合性療法。
並列摘要
Peridontal disease has long been the major dental disease in Taiwan. Symptoms such as gingival recession, alveolar bone resorption, teeth migration, labial flaring out, bite collapse and losing of vertical dimension, will further lead to occlusal trauma, lost of chewing function, and TMJ syndrome in severe periodontitis. Through mechanical debridement to eliminate periodontal pathogens is of no doubt to be the first priority of periodontal treatment. However, the restorative work on the residual dentition is more important. A successful periodontal prosthetic treatment plan may be involved in the integration of multidisciplinary regimen that includes periodontal, prosthetic, orthodontic, endodontic, implant, even oral surgical, substantiating the concept of “integrated treatment” Especially, Regeneration has become the effective regenerative procedure of periodontal tissue. GTR can be used for periodontal tissue regeneration in intrabony defects and furcation involvement areas caused by periodontal diseases. Compared to all other dental disciplines, implantology has enjoyed far more innovation and progressive development in recent years. Endosteal implants have broadened greatly the therapentic spectrum of surgical-prosthetic dentistry during the last 10 years. There are 10 case reports about periodontal prosthesis in this thesis. These cases applied with many different periodontal therapies and prosthetic designs. Such as: vestibuloplasty, lingualsulcoplasty, palatal soft tissue graft, implant, flap curettage, crown lengthening procedure. Sinus lift, distal wedge procedure, guide tissue regeneration, odontoplasty, bone graft, and conventional full denture, implant overdenture, implant-supported fixed prosthesis, removal partial denture, fixed prosthesis, telescopic denture. Although all prostheses function well, the further follow-up and more studies also are necessary for the long-term results.