牙周補綴全口重建之病例報告-以重度牙周病患者之全口重建病例報告為代表

現今牙科在醫療上的進步與技術蓬勃發展，人工植牙已被廣泛的運用在單顆缺牙、多顆缺牙、甚至到全口無牙患者身上。當植牙手術、齒槽嵴增進術、牙科材料不停的演進，以及困難植牙區在技術層面上被克服之後，植牙成功的機率可謂大大的提升，而活動假牙也不再是多顆缺牙患者唯一的選擇。患者在固定式補綴物製作後裝戴的滿意度很高，但牙醫師在面對缺牙患者經常面臨到的問題就是牙周病，而補綴物的製作必須建立在良好的牙周健康下，除了牙周病必須做有效的治療控制之外，贋復補綴的利用亦可幫助恢復和穩定牙齒及其周邊組織的生理性形態和功能。本論文共提出九個局部或是全口重建的病例，其中包括局部性、廣泛形慢性牙周炎，在治療過程中，其中有四位患者接受矯正治療，改善牙齒軸向與排列並挪出適當空間後以利將來補綴物製作，有八位患者運用人工植體搭配電腦斷層及牙周補綴的觀念，讓在術前的評估、手術方式的選擇、補綴物的設計、跨科治療的整合中達到更精確的治療目標。

關鍵字

人工植牙；全口重建；牙周補綴

並列摘要

The technology of dentistry has taken a huge leap and improved tremendously especially in the skill aspect nowadays which makes implantology no longer limited to patient with single tooth replacement and benefits patient with multiple teeth missing and complete dentures patient. With the development through out the years of implant surgery, alveolar bone augmentation, and dental materials, the successful rate of implant surgery on challenging area has improved. Removable partial denture is not the only choice for patients with multiple teeth missing replacement. Patient becomes more satisfied with combination of fixed partial denture and implants. Periodontal disease is usually the first obstacle for dentists encountering with implant patients. One of the fundamental elements in order to have excellent result in implantology is a healthy periodontal dentition. Partial denture can be used for restoring and stabilizing both physiological and functional of teeth and surrounding tissues with one condition required; the periodontal disease needs to be effectively controlled and treated. There are nine cases of partial and full mouth rehabilitation which includes partial and full mouth periodontitis being presented. During the treatment period , four out of the nine patients underwent orthodontics treatment to improve teeth inclination and alignment in order to provide space to accommodate prosthetics.Eight patients were informed with periodontal treatment procedure with the aid of computerized tomography and implantology for better assessment in presurgical evaluation, surgery types, design in restoration, and interdisciplinary integration to obtain the most accurate result.