用铸造支架式设计制作局部义齿修复治疗老年牙缺损  

Treatment of geriatric odontoptosis with removable partial denture:framework design and fabrication

作　　者：侯康林[1] 宁江海[1] 

机构地区：[1]解放军总医院口腔科,北京100853

出　　处：《解放军医学杂志》2007年第6期607-608,631,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的总结针对老年复杂牙列缺损,采用铸造支架可摘局部义齿的设计制作经验和体会,为临床局部义齿的修复治疗作借鉴。方法对1998年以来门诊病案中老年复杂牙列缺损542例的义齿修复治疗病例,按照缺牙类型、部位施行铸造支架式设计进行分析总结。结果542例的义齿修复治疗病例,按照缺牙类型、部位,采用铸造义齿支架个别设计修复义齿,分别设计了后牙低间隙缺牙铸造金属围墙强化义齿,牙齿重度磨耗设计金属垫、金属塑料混合垫义齿,牙周病伴随缺牙设计铸造牙列式夹板义齿,食物嵌塞设计防嵌器。其中36例进行两年随访,31例义齿使用正常,4例卡环折断,经重新设计修复体铸造支架获得满意效果,患者戴用义齿情况良好,能很快适应,复诊率低,义齿的强度也有不同程度的提高。采用义齿个别设计铸造支架式可摘局部义齿修复各类缺牙,可较好地解决牙列重度磨耗、食物嵌塞、牙周疾患等问题。结论针对老年牙列缺损伴有垂直距离过低、重度磨耗、食物嵌塞以及牙周病患者,采用铸造围墙式义齿、垫式义齿、防嵌器和铸造牙列式夹板义齿可以取得良好的临床效果。Objective To summarize and analyze the clinical experiences of treatment of complicated geriatric odontoptosis for the purpose of establishing a better technique to cope with such situation. Method The data of 542 outpatients with geriatric odontoptosis, from 1998 till the present treated in the Department of Outpatient, General Hospital of PLA, were summarized and analyzed according to the type and location of odontoptosis, with complications such as severe attrition, periodontitis, food impaction and detective occlusion. The special prosthetic designs on certain cases were also summarized, Some cases were followed-up. Results Removable partial dentares （RPD） with cast framework were prescribed to the geriatric odontoptosis patients. According to the site and type of odontoptosis, four special designed frameworks include casting fence-wall enforced artificial tooth prosthesis for lower clearance cases, metal strengthened plastic occlusive pad or metal occlusive pad for severe attrition cases, casting splint prosthesis for periodontal and food impaction with impaction preventive denture. 36 cases were followed up for two years with satisfactory result in 31 cases, but in four cases the clasp was broken. In the cases with failure the dentures were redesigned and fabricated with cast framework, and better results were accomplished. Generally, the patients were accustomed to the new RPD quickly and revisit times were less frequent. The strength of prosthesis was enhanced. It was proved that custom designed framework could solve the clinical dilemma of severe dentition attrition, food impaction and periodontitis, and the odontoptosis was repaired. Conclusion The designed fence-wall prosthesis, metal strengthened plastic occlusal pad and metal occlusal pad, casting splint prosthesis and casting food impaction stop are effective prosthetic procedure for certain cases.

关 键 词：老年人牙科医疗 牙科铸造技术 义齿设计 

分 类 号：R783.6[医药卫生—口腔医学]