旋转就位美学可摘局部义齿的设计特点及临床应用  

Dual insertion paths design characteristics and short-term clinical observation of rotational path removable partial dentures

作　　者：李健[1] 姜婷[1] 李赛[2] 陈薇[2] 

机构地区：[1]北京大学口腔医学院.口腔医院修复科,北京100081 [2]北京大学口腔医学院.口腔医院义齿加工中心,北京100081

出　　处：《北京大学学报（医学版）》2013年第1期64-68,共5页Journal of Peking University:Health Sciences

摘　　要：目的:探索省略前方卡环的旋转就位美学可摘局部义齿(removable partial denture,RPD)的模型观测、设计类型和规律,观察短期临床应用效果。方法:选取需要RPD修复的患者40名,分为旋转就位RPD修复组(Ken-nedyⅢ类和Ⅳ类牙列缺损患者各10名)和线性就位RPD修复组(20名,牙列缺损类型、范围与旋转就位RPD修复组匹配)。在研究模型上进行观测和就位道设计,归纳旋转就位RPD的设计特点,进行模型模拟预备后,制作模板用于指导临床基牙预备。义齿戴用2周和1年复查,按A(效果优良)、B(效果尚能接受)、C(效果不良)3个等级评价修复效果,比较旋转就位RPD和线性就位RPD的修复效果。结果:归纳旋转就位RPD的设计要点,双重就位道的夹角(α)一般为10°～15°,α越大固位力越好,但要增加对后方基牙的牙体预备量,前方基牙的近中或者远中邻面设置进入倒凹区的导平面板。临床应用中,40件义齿顺利戴入。旋转就位RPD的初戴时间[(32±8)min]与线性就位RPD的初戴时间[(33±8)min]比较,差异没有统计学意义(P>0.05);戴用2周和1年复查,旋转就位RPD和线性就位RPD的固位、稳定、咀嚼和取戴的评价差异无统计学意义;20件旋转就位RPD的美观评价都为A,线性就位RPD分别只有7件和6件的美观评价为A(P<0.05)。结论:旋转就位RPD减少了金属卡环显露,可有效提高美观效果,在功能恢复上和线性就位RPD没有明显差别,临床应用时需要模型模拟预备和使用模板指导口内牙体预备,并需要精密制作义齿支架。Objective：To investigate design methods of dual insertion paths and observe a short-term clinic overview of rotational path removable partial dentures （RPDs）. Methods： In the study, 40 patients with partial edentulous arches were included and divided into two groups. The patients in group one were restored with rotational path RPDs （ 10 Kennedy class m and 10 Kennedy class 1V respectively）. The patients in group two （20 patients）, whose edentulous area was matched with the patients＇ in group one, were restored with the linear path RPDs. After surveying and simulative preparation on diagnostic casts, the basic laws of designing rotational path RPDs were summarized. The oral preparation was accurately performed under the guidance of indices made on diagnostic casts after simulative preparation. The 40 dentures were recalled two weeks and one year after the insertion. The evaluations of the clinic outcome, including retention, stability, mastication function, esthetics and wearing convenience, were marked out as good, acceptable, and poor. The comparison of the evaluation results was performed between the two groups. Results： In the rotational path design for Kennedy class m or IV RPDs, the angles （ct） of dual insertion paths should be designed within a scope, approximate 10° -15°. When the angle （or） became larger, the denture retention turned to be better, but accordingly the posterior abutments needed more preparation. In the clinical application, the first insertions of the 40 dentures were all favorably accom- plished. When the rotational path RPDs were compared to linear path RPDs, the time consuming on first insertion had no statistical difference [ （32± 8 ） min and （ 33±8 ） min respectively, P 〉 0.05 ]. Recalledtwo weeks and one year after the insertion, in the esthetics evaluation, 20 rotational path RPDs were all evaluated as ＂A＂, but only 7 （two weeks after） and 6 （one year after） linear path RPDs were evaluated as ＂A＂ （P 〈 O. 05 ）. There was

关 键 词：义齿设计 义齿 局部 可摘 美学 牙科 

分 类 号：R783.6[医药卫生—口腔医学]