牙周補綴應用於全口重建：病例報告

Periodontal Prosthesis Application for The Full Mouth Rehabilitation: Cases Report

張思潔(Szu-Chien Chang)

指導教授 ： 王震乾

共同指導教授 ： 何坤炎(Kun-Yen Ho)

高雄醫學大學/口腔醫學院/牙醫學系碩士在職專班/碩士(2020年)

摘要

牙周病侵犯過後的齒列重建在牙科治療中相當具有挑戰性。每位患者的狀況都十分獨特，且其複雜的問題往往需要多專科的治療。本論文中將提出9個臨床案例，其中有4位男性、5位女性，年齡介於55歲到73歲，其中8位有系統性疾病。這些案例的齒列狀況分布在PDI Class III至IV，伴隨嚴重程度不等的牙周病。在案例一至案例三中可見到，因應不同患者狀況以及不同的補綴計畫時，抉擇問題牙齒去留須納入不同考量。在案例四至案例六可見到，牙周病患磨耗齒列的不同成因，其局部產生的問題有不同處理方式。在案例六及案例七，藉由牙周手術改善了軟組織及硬組織的缺損，進而改善口腔衛生維持情形。案例八至案例九，則可見牙周病侵犯的咬合對數不足齒列，在重建上的困境。案例二及案例八亦包含矯正治療在其中。在治療計畫擬定及治療期間，各科的治療理念可能互有牴觸，而牙周補綴的思考流程則能為患者提供具整合性且有系統的治療模式，以達到符合、功能、美觀及舒適的重建目標，治療成果亦易於維持。

關鍵字

牙周補綴 ； 全口重建

並列摘要

Full mouth rehabilitation is a challenging situation. Every case is unique in itself. And the complex problems need multidisciplinary approach. This paper presents 9 clinical cases, including 4 males and 5 females from ages 55 to 73; 8 of the cases have systemic disease. These cases are ranging from PDI class III to IV with different severity of periodontitis. From case no.1 to case no.3, preserving questionable teeth or not depends on different situations and final treatment plan. From case no.4 to case no.6, patients with periodontitis and attrition dentition are caused by different reasons and are treated different way. In case no.6 and case no.7, because the deficiency of periodontal tissue has improved after periodontal surgery, the patients can maintain oral hygiene more easily. In case no.8 and case no.9, we faced difficult conditions that patients with insufficient occluding pair and severe periodontitis. In case no.2 and case no.8, orthodontic treatment was involved. At the treatment plan decision and active treatment phase, there is contradiction between different divisions. Periodontal prosthesis thinking process provides a systemized and integrated way to approach objective of health, restoring function, aesthetics, comfort, and to maintain easily.

並列關鍵字

periodontal prosthesis ； full mouth rehabilitation

參考文獻

1. Gamer, S., R. Tuch, and L.T. Garcia, MM House mental classification revisited: Intersection of particular patient types and particular dentist's needs. The Journal of prosthetic dentistry, 2003. 89(3): p. 297-302.

2. Proffit, W.R., H.W. Fields Jr, and D.M. Sarver, Contemporary Orthodontics, 5th ed. 2012: Elsevier India. p. 2-4

3. Okeson, J., History and Examination for Temporomandibular Disorders Management of Temporomandibular Disorders and Occlusion. 4th ed. . 1998: St. Louis: Mosby. p. 234-309.

4. Rosenstiel, S.F. and M.F. Land, Contemporary Fixed Prosthodontics-E-Book. 2015: Elsevier Health Sciences. p. 31-33.

5. Tonetti, M.S., H. Greenwell, and K.S. Kornman, Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of clinical periodontology, 2018. 45: p. 149-161.