牙周補綴全口重建之病例報告

Periodontal Prosthodontic Application for The Full Mouth Rehabilitation Cases

曾郁惠(Yu-Hui Tseng)

指導教授 ： 洪純正

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

在過去台灣的社會中，生活所求僅在溫飽，有病看醫生都不一定可以如願，更遑論看牙醫。一般人觀念中會認為，牙齒有那麼多顆，缺幾顆還是可以吃東西，自然不那麼看重。過往的古人，年未四十，就已是髮蒼蒼、視茫茫、齒牙動搖。而今的世界，大家對牙齒保健的認識已日漸成熟，但由於心理恐懼，或經濟因素，而使得牙齒問題總在實在無法進食的情況下，才能提起勇氣去就醫，也因為拖延時日，所以牙醫師面對的不是只有單純的牙周或是缺牙問題，還有排列失序、外觀不佳、牙齒移位、咬合崩壞…等等複雜的跨科性困難，牙周補綴的整合性治療對全口重建而言就相對的重要！
本論文一共收列了十個臨床案例，皆以2018年最新發布的牙周分類為基準95,96、牙周問題的處理乃以基本治療為基礎，有些案例再加上先進的上顎竇增高術與牙周補骨再生手術；補綴設計則有傳統的覆蓋式活動，還有利用植牙加強戰略位置的雙重套冠可撤式假牙，更有完全以植牙為主的固定式補綴物，配合最新的3D CAD/CAM製作牙冠…。治療過程中 有植牙8周後產生的膿瘍，也有植牙後一周就在手術區受到外物侵入而導致手術失敗，還有完成後才發生牙根裂痕的解決案例，皆因現代牙醫學在材料與技術上的進步，最終都能滿足患者的需求，圓滿解決問題。

關鍵字

咬合崩壞

並列摘要

In the past Taiwanese society, the only thing that most people desired in daily life was food and clothing. It was not always possible to see a doctor if you were sick, let alone a dentist. People normally thought that there are so many teeth in the oral cavity; they can still eat without a few, so naturally they don't value it that much. The ancients of the past, who were not even forty years old, were already with gray hair, reading glasses, shaking teeth. Nowadays, everyone’s understanding of dental health care has matured day by day, but due to the fear or economic conditions, patients may go to see a dentist only in the last moment when they cannot bite, hence the dentist of this kind of patient may face not only simple edentulous or periodontal problem, but also malposition、occlusion disorder、poor appearance、tooth displacement... and other complex cross disciplinary difficulties. Hence the integrated treatment of periodontal prosthesis is relatively important for the full mouth reconstruction!
A total of ten clinical cases in this thesis are all according to the latest periodontal classification that was released in 2018, and the treatments for periodontal problems of these cases are based on the basic treatment. Some cases are combined with advanced maxillary sinus lift technique and periodontal bone regeneration surgery; the different designs of prosthetic restoration including traditional covering dentures、double crown removable denture with the addition of implants that strengthen the strategic position、fixed prosthesis based entirely on implants and the design with the latest 3D CAD/CAM technique to make crowns....etc. During the treatment, there were cases with appearance of abscesses 8 weeks later after the implant treatment, foreign objects invaded the surgical area within a week after the implant surgery and the operation failed, and there were cases with the root fracture occurring after the completion of the treatment. However, due to the advancement of materials and technology in modern dentistry, all of the problems had been solved at the end with the satisfaction and demand of the patients.

並列關鍵字

bite collapse

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