牙周補綴全口重建

Periodontal Proshtheis Full Mouth Reconstrution

黃登楷(Teng-Kai Huang)

指導教授 ： 洪純正

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(2008年)

https://doi.org/10.6832/KMU.2008.00161

摘要

隨著牙周病的進程，造成的牙周破壞有：牙周組織發炎、牙周附連喪失、根叉病變、牙齒動搖、牙冠/牙根比不佳、甚至牙齒缺失。

臨床治療中，去除牙周病致病因素之後，對於遭受牙周病破壞的齒列更需要給予適當的補綴修復，以回復咬合功能，並提供容易清潔的口腔環境。這即是美國賓州大學Dr. Amsterdam所定義的牙周補綴治療觀念。

本案例報告中，包含有殘存齒數目少並且牙冠/牙根比不佳、根叉病變、游離端缺牙、前牙美觀區缺牙、臨床牙冠不足等狀況，以牙科植體手術、骨嵴增進術、軟組織豐隆術、牙根分離術、牙冠增長術等牙周治療方式，合併矯正治療或者強逼萌出術，最後利用補綴方式重建，如：固定式或可撤式雙重套冠系統義齒、固定式或可撤式牙科植體補綴、可撤式鉤靠式義齒、固定式局部義齒；以達到病患對於功能及美觀的要求，病患對治療的成效均滿意，但長期的追蹤仍是必要的。

關鍵字

牙周補綴 ； 雙重套冠義齒

並列摘要

With the progression of periodontal disease, the periodontal destructions may occur: periodontal inflammation, loss of attachment, furcation involvement, tooth mobility, improper crown/root ratio, even tooth lost.

In clinical treatment, besides the removal of periodontal etiological factors, the dentition mutilated by periodontal disease rather needs proper prosthesis to restore occlusal function. This is exactly the concept that Dr. Amsterdam (University of Pennsylvania) defined as periodontal prosthesis.

In this cases report contains situations such as few residual teeth with improper crown/root ratio, furcation involvement, distal free-end edentulous, teeth lost at esthetic zone, and insufficient clinical crown. The corresponding periodontal treatments are dental implant placement, ridge augmentation, soft tissue graft, tooth separation, crown-lengthening procedure, with orthodontic treatment and force eruption involving. At last, the restorative prostheses are as following: fixed or removable telescopic denture, fixed or removable dental implant prostheses, removable clasp-retained denture, fixed partial denture. All patients are satisfied with the result of treatments; however, the long-term follow-up checks are essential.

並列關鍵字

periodontal prosthesis ； telescopic denture

參考文獻

1. Starr, N.L., Treatment planning and treatment sequencing with and without endosseous implants: a comprehensive therapeutic approach to the partically edentulous patient. Seattle Study Club Journal, 1995. 1(1): p. 21-34.

2. Amsterdam, M., Periodontal prosthesis. Twenty-five years in retrospect. Alpha Omegan, 1974. 67(3): p. 8-52.

3. Flemmig, T.F., Periodontitis. Annals of Periodontology, 1999. 4(1): p. 32-8.

4. Nyman, S. and J. Lindhe, Examination of patients with periodontal disease. In: Lindhe J., 4ed Text Book of Clinical Periodontology. 2003, Copenhagen: Munksgaard. 403-413.

5. Hamp, S.E., S. Nyman, and J. Lindhe, Periodontal treatment of multirooted teeth. Results after 5 years. Journal of Clinical Periodontology, 1975. 2(3): p. 126-35.