植體治療時自然牙去留之決定

牙科治療前，牙醫師會事先評估單一牙齒及整個。腔的情況，而訂定一個完整的治療計劃。對於已無治療希望的牙齒，必須將之拔除；而癒後為佳或尚可的牙齒，牙醫師均可解決牙周病的病因及控制其進行，而較能訂定治療計劃。但對癒後仍有疑問的牙齒，尤其當此顆牙牽涉膺復治療時，情況就較複雜了。傳統的試戴暫用修復體用來評估牙齒是否合適做為支台齒，但此步驟不僅耗時，又無法立即得到明確的決定。1980年之後，口腔植體的引進使得牙科治療有了明顯的改變，它可以加號活動膺復物的穩定性，而其成功的條件是必須有足夠的骨頭來承戴植體。保留牙齒或許會造成更多的骨頭破壞，未來就無足夠的齒槽骨植牙，此時拔牙可能是較好的選擇。此外，牙齒超過8mm的附連高度喪失，牙根斷裂，牙齒已有大的復形物，牙根分又處破壞，考慮贗復物時，考慮美觀時，這些因素都必須一併評估以決定該牙是否拔除或保留。

關鍵字

癒後；附連組織喪失；牙科植體；牙根分叉處破壞

並列摘要

For all the dental treatment, dentists always rely on the prognosis of the individual tooth and the whole dentition to make a comprehensive restorative treatment plan. Teeth with poor prognosis always been extracted. For those with excellent, good, fair, and poor prognosis, it is easy for the dentist to control the etiologic factors and to make a straightforward treatment plan. When dealing with the questionable tooth, especially there is a restorative treatment is involved, the situation is always complicated. Traditionally, a trial provisional restoration can be used to evaluate the tooth as an appropriate abutment. During the mid-1980s, oral implant been introduced to the dental profession. It changed the philosophy of restorative treatment. The implant improved the retention of complete dentures and stability of distal extension removable partial dentures. But another issue is been brought up, that is the implant need to have adequate bony housing to accommodate. If retain the tooth will causing further bony destruction, there might not have enough bony housing in the future, then extract it might be a better choice. In the following, we recommended some situations, e.g. tooth with more than 8 attachment loss, root fracture, tooth which is heavily restored, furcation involved tooth, in periodontal prosthetic cases, and cases with esthetic hazard, as factors to evaluate when making a decision to retain the tooth or extact it.

並列關鍵字

Prognosis ； attachment loss ； dental implant ； furcation involvement

國際替代計量

植體治療時自然牙去留之決定

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