下顎植體覆蓋式義齒之早期漸進及立即荷力

牙周補綴依Amsterdam（1974）及Rosenberg（1988）定義：在嚴重的牙周病患所作的復形及補綴治療。由中、重度的牙周病所衍生的問題包括牙齒病理性的移位，中心關係位置偏移，後牙咬合塌陷，甚至引起顳顎關節疾患，這些複雜的連鎖效應須藉由牙科團隊的整合治療方能讓牙周病患獲得更好的治療。本論文提出九個中、重度牙周補綴病例報告；根據患者的主訴、身體狀況、經濟能力，採用符合病患需求的治療方式。前三例以植體覆蓋式假牙作下顎無牙患者的早期漸進及立即荷力，從生物機械、手術及補綴的觀點，可藉由臨床的的操作讓患者迅速恢復咀嚼能力。所有的病例亦藉由非手術性及手術性的牙周治療，包括牙根整牙術、雷射治療、牙周翻瓣術、牙周再生術等，並藉由人工植體的輔助，製作固定式及可撤式義齒，同時滿足患者對咀嚼功能，發音及美觀的要求。

關鍵字

牙周補綴；植體覆蓋式假牙；立即荷力

並列摘要

The definition of periodontal prosthesis from Amsterdam And Rosenberg emphasizes “those restorative prosthetic endeavors that are absolutely essential in the treatment of advanced periodontal disease”. These periodontaly compromised dention may lead to various oral problems，such as pathological migration, centric relation discrepancy, posterior bite collapse and TMJ disorder. The complicated chain reactions should be treated by interdisciplinary and integrated approach from dental team. In this thesis,nine cases involving moderate to advanced periodontal prostheses are presented . In according to patient’s chief complaint, physical conditions and financial capability， multidisciplinary treatment modalities were used to satisty their practical need. The early-progressive and immediate loading of mandibular implant overdenture is reported in three cases. From biomechanical,surgical and prosthetic view points,we can assess clinical parameters of immediating loading to restore the ability of mastication rapidly. Moreover, all of these cases were completed through non-surgical and surgical periodontal treatment, such as root planning, Laser treatment, open-flap surgery and GTR. The definite prostheses including fixed and removable prostheses supplemented by implant were delivered which are effective in terms of satisfying the patient’s needs for mastication, phonetics and esthetics.