牙周補綴全口重建之病例報告 --- 以利用自然牙與人工植體共同支持之Könus雙重套冠系統病例報告為代表

Full-Mouth Reconstruction with Perio-Prosthodontic Concepts --- Teeth and implants supporting Könus telescopic system

張玉麒(Yu-Chi Chang)

指導教授 ： 洪純正

高雄醫學大學/口腔醫學院/口腔衛生學系碩士在職專班/碩士(2019年)

https://doi.org/10.6832/KMU.2010.00002

摘要

治療嚴重牙周病患者時，除了去除致病因及改善牙周狀況外，全
口的重建治療計畫及提供患者容易清潔維護的環境更是牙周病治療
的重要課題。此時病患因多處牙齒喪失造成贋復困難的狀況，並常伴
隨有牙冠牙根比例不佳、間隔性缺牙而形成殘缺齒列、或咬合崩壞的
情形出現，運用牙周補綴的全口重建治療概念，如本論文所討論雙重
套冠可撤式義齒的設計，可提供除傳統鉤靠式可撤式義齒外另一種合
理的治療方，其式優點除提供跨弓式的固定效應並使咬合力量平均分
配外，同時其強支持的特性，能減輕牙床的過度受力，降低齒槽骨吸
收速度，同時亦提高義齒的穩定度、固持力以及支持性。雙重套冠可
撤式義齒的概念搭配人工植體，可改善支台齒分配不佳的問題，利用
人工植體支持的支台齒，不但可提供長缺牙區的咬合支撐，並與其他
支台齒共同形成一分散且均衡的力量分配。當然，對於無法以雙重套
冠可撤式義齒或人工植體治療之病患，藉由牙周補綴支持性療法，傳
統的鉤靠式可撤式局部義齒亦能恢復病患的美觀及功能。本論文所討
論之病例，其牙周狀況雖有不同，但經由縝密的治療計畫及評估，不
論是以固定義齒或可撤式義齒之形式完成治療，皆能提供病患滿意的
成果。

關鍵字

雙重套冠 ； 人工植體 ； 咬合崩壞 ； 牙周補綴支持性療法

並列摘要

Besides the eliminating of periodontal infection and improving the periodontal condition, the main issues of periodontal treatment including a well-designed treatment planning and a easily maintained oral condition. However, there are always some restorative problems in treating patients with periodontitis, such as a poor crown-to-root ratio, mutilated dentition, or poster bite collapse. We could use the perio-prosthodontic treatment concepts, like the design of telescopic crown system which will be discussed later, to provide another treatment modality other than the traditional removable partial denture with a number of clasps on it. It takes the advantages of cross-arch splinting effect and can evenily directs the occlusal force to all abutments. The concept of rigid support could help to relief the overload of the denture bearing area and help to decrese the resorption of alveolar ridge. It also increases the stability, support, and retention of the denture. The telescopic crown system combined with implantation could evenily and widely direct the occlusal force to all the denture abutments. For other patients which cannot be treated with the telescopic crown system and implants, the conventional removable partial dentures can also provides the esthetic and chewing function via the concept of perio-prosthodontic supportive treatment. All these cases in this article, no matter what treatmet modality used, can all be satisfied with the final results by the thorough evaluation and the careful treatment planning .

並列關鍵字

telescopic crown system ； implant ； bite collapse ； perio-prosthodontic supportive treatment

參考文獻

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