深度齲齒之處理與窩洞復形考量：臨床病例報告

近年來，牙體復形的方法以直接複合樹脂復形與間接陶瓷嵌體復形為主流。面對後牙區深度齲齒的治療，須考量的有：最小侵犯性（minimal invasive）、足夠強度、良好美觀等等。另外針對剩餘牙本質厚度與牙髓的狀況，也要評估是否有需使用材料進行間接或直接覆髓的必要性。此病患主訴為口腔內有許多舊的填補物，感覺邊緣有縫隙，擔心有二度齲齒，故希望做全口評估及治療。經檢查發現，右上第一大臼齒除咬合面齲齒外，併有牙周及牙髓問題，頰側牙齦嚴重萎縮、預後不佳，但病患希望盡量保留牙齒，故進行根管治療、複合樹脂充填及牙根整平；左上第一大臼齒咬合面齲齒範圍較小，周圍剩餘齒質足夠，故選擇以複合樹脂充填復形；右下與左下第一大臼齒移除舊的銀粉填補物與齲齒後，剩餘齒質條件較差，故以間接陶瓷冠蓋體復形。

關鍵字

直接複合樹脂復形；間接復形；覆髓

並列摘要

Direct resin restoration and indirect ceramic restoration have become the preferable options for restoring the tooth decay in recent years. When faced with deep caries lesion over posterior tooth area, there are several points that we should take into consideration, including minimal invasiveness, material strength, good esthetics, and etc. Moreover, direct or indirect pulp capping may be a suggested treatment in certain situations when the remaining dentin thickness isn't enough or the pulp is contaminated. The patient in this case report was under interdisciplinary treatments in the dental department of TMUH. After thorough examination, the patient's upper right first molar was diagnosed with occlusal surface caries, combination of periodontal and endodontic diseases, which resulted in severe gingival recession. Although the prognosis was very poor, the patient still insisted on conserving the tooth. Therefore, a sequence of treatments were carried out, which included root canal treatment, root planing, and direct composite resin filling. Further, the patient's upper left first molar was diagnosed with occlusal surface caries, which was restored with direct composite resin due to its smaller caries size. Last, both sides of the patient's lower first molars were seen with ill-fitted restoration and secondary caries. Indirect ceramic onlay was used to protect the remaining tooth structure.

並列關鍵字

direct composite resin restoration ； indirect restoration ； pulp capping

國際替代計量

深度齲齒之處理與窩洞復形考量：臨床病例報告

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