牙周補綴於牙周炎病例之廣泛考量與臨床應用

General Consideration and Clinical Application of Periodontal Prosthesis in Periodontitis Cases

吳晉福(Chin-Fu Wu)

指導教授 ： 王震乾副教授

高雄醫學大學/口腔醫學院/牙醫學研究所碩士在職專班/碩士(2007年)

https://doi.org/10.6832/KMU.2007.00079

摘要

阿姆斯特丹（1974）定義牙周補綴為「在嚴重牙周病治療當中不可或缺的復形與補綴的努力，特別是針對遭受牙周病多重破壞齒列的治療」。嚴重牙周病經常伴隨深的牙周囊袋、牙齒搖動及缺牙，進而演繹出牙齒病理性移位、咬合創傷、後牙咬合塌陷、咬合止位不穩，甚至出現顳顎關節症候。為了能有效的解決這些問題，同時也要提供患者功能（咀嚼、發音）與美觀的長期需求，牙醫師除了執行牙周疾病與補綴的治療與控制外，往往需要配合根管治療、矯正、口腔外科與牙科植體學才能達成任務。因此牙周補綴學是一門跨科性與整合性的牙科治療。牙醫師必須考量患者的現實需求、人格特質、經濟能力及治療方法的差異性，與患者進行溝通，選擇最合適的治療計畫。本病例論文共提出十一個牙周補綴病例，男性四位，女性七位，年齡分佈於38至80歲，平均年齡55歲。所有病例的治療次序為(1)資料收集與分析 (2)建立正確的診斷 (3)消除所有的發炎現象 (4)消除或控制咬合的病因 (5)改正疾病進程所造成的變形 (6)各種形式的咬合重建 (7)追踪。
治療時間由5個月至22個月，平均療程為16個月。經由跨科性與整合性的牙周補綴治療，幫助患者達到對健康、功能、美觀與舒適的要求。

關鍵字

牙周補綴 ； 咬合治療 ； 牙根分離切除術 ； 人工植牙手術 ； 輔助性矯正

並列摘要

Periodontal prosthesis is defined by Amsterdam（1974） as “those restorative and prosthetic endeavors that are absolutely essential in the treatment of advanced periodontal disease. Whereas specifically it refers to the treatment of the dentition multilated by the ravages of periodontal disease.” These periodontally compromised dentitions have deep periodontal pocket, tooth mobility, missing teeth, and lead to pathological migration, trauma from occlusion, posterior bite collapse, centric stop deviation, and TMJ syndrome. In order to effectively solve the above problems and to fulfill the long-term satisfication of function and esthetic demands of periodontal patients, not only periodontal and prothetic therapy are required, but also need endodontic, orthodontic, oral surgical and dental implant therapies. Therefore, periodontal prosthodontics is an interdisciplinary and integrated dental perspective treatment. Dentist must evaluate the patient’s practical need, personal characteristics, financial capabilities and performance variabilities to select the most appropriate treatment. In this thesis, 11 moderate to advanced periodontal prosthetic treated cases including 4 males and 7 females whose age ranging from 38 to 80 years old（mean 55 years old）were presented. The sequence of therapy in all cases were as follow: (1) Data collection and analysis. (2) Establishment of a correct diagnosis. (3) Elimination of all inflammation. (4) Elimination or control of the occlusal etiology. (5) Correction of the deformities contributing to or created by the disease process. (6) Occlusal reconstruction with a variety of designs. (7) Follow up. The average treatment time was 16 months. By using the interdisciplinary and integrated approach of treatments, patients’requirements of heath, function, esthetics and comfort were meet.

並列關鍵字

periodontal prosthesis ； occlusal therapy ； roots separation and resection ； adjunctive orthodontic ； dental implant

參考文獻

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