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補綴前的牙周考量

Pre-Prosthetic Periodontal Considerations

摘要


補綴過程中,補綴物邊緣放置的位置、牙冠吻合程度、牙冠外型、橋體之設計、補綴材料等均會影響牙周組織的健康。在補綴前,徹底之牙周處理,包括完整之潔牙、牙根整平、甚至手術之治療,以建立一健康之牙周根基,是補綴前必備之條件。在補綴過程中,常會遇到齲齒或牙齒破折處位於牙齦下,使補綴邊緣與齒槽脊間無法維持足夠之生物寬度,附連牙齦不足或缺乏,或基於美觀上的考量,補綴邊緣位於牙齦下等狀況,本文主要是針對這些狀況對牙周組織之影響,補綴前牙冠增長術,附連牙齦是否要增加等問題加以探討。

並列摘要


The health of periodontium and the success of a prosthodontic treatment are intimately related. Jeopardized by untreated periodontal disease, the functions, esthetics and the prognosis of a restoration will be compromised. A poor restoration may have adverse effects on the periodontium by increasing accumulation of the dental plaques. Violation of the biologic width can lead to the deterioration of periodontal support and compromise the long term success of a restoration. Improper placement of the margin in the cervicular area or the presence of overhanged margin can influence the ecology of the subgingival area by changing the bacterial flora. Therefore, a thorough periodontal consideration before prosthodontic reconstruction is indispensable. This article discusses the significance of the concept of biologic width, the interaction between the periodontal tissue and the restorations. The current crown-lengthening procedures and the related important factors in selecting the operation are also covered.

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