[部分无牙患者牙周支持减少的牙列固定修复]。

Parodontologie (Berlin, Germany) Pub Date : 1990-05-01
J A De Boever
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引用次数: 0

摘要

对牙齿数量有限、牙周支持减少的患者进行修复不再有争议,只要仔细选择患者,进行牙周修复前治疗,并进行彻底的维护计划。在本文中,提请注意一般假肢规划,包括使用大跨度桥梁。由于增加了牙齿的流动性,因此提倡使用互锁或后焊连接的桥来稳定交叉弓。框架应足够刚性,以避免桥梁的挠度。重要和非重要基牙的预备是非常重要的。为了避免使用可移动的假体,可以使用悬臂桥,但它使结构更容易断裂。许多牙周修复患者表现出“后牙合塌陷”。康复需要在“新的”咬合垂直维度上进行修复。这可以在一步临床程序中完成,没有功能危害。不需要长时间的功能适应期。功能的治疗结果并不总是可预测的。因此,半切或截肢往往是治疗的选择。在这些半切的根上,可以建立桥梁并成功地维持。最后,需要强调的是,并不是所有的牙齿都必须更换:前磨牙,短弓咬合通常足以保持足够的功能。
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[Fixed restorations of a dentition with reduced periodontal support in partially edentulous patients].

Placing restorations in patients who have a limited number of teeth and reduced periodontal support is no longer controversial, given careful selection of patients, preprosthetic periodontal treatment, and a thorough maintenance program. In this paper, attention is drawn to general prosthetic planning, including the use of long-span bridges. Because of increased tooth mobility, cross-arch stabilization of the bridges with interlocks or with postsolder connections is advocated. The framework should be rigid enough to avoid deflection of the bridges. Preparation of the vital and nonvital abutment teeth needs much attention. To avoid using a removable prosthesis, a cantilever bridge can be used, but it makes the construction more prone to fracture. A number of periodontal-prosthetic patients demonstrate a "posterior collapsed bite." Rehabilitation requires the restoration at a "new" vertical dimension of occlusion. This can be done, without functional hazards, in a one-step clinical procedure. A long functional adaptation period is unnecessary. The treatment outcome of furcations is not always predictable. Therefore, hemisection or amputation are often the treatments of choice. On these hemisected roots, bridges can be made and successfully maintained. Finally, it should be stressed that not all teeth have to be replaced: a premolar, shortened-arch occlusion is often sufficient for adequate function.

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