1例桥基牙根尖手术后的固定桥修复  

Fixed Bridge Restoration after Apical Surgery for A Bridge Abutment Tooth:A Case Report

作　　者：彭俐 安娜[1] 王祖华[2] 葛雯姝[1] 许桐楷[1] Li Peng;Na An;Zuhua Wang;Wenshu Ge;Tongkai Xu(Department of General Dentistry II,Peking University School and Hospital of Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology,Beijing,P.R.China;Department of Endodontics,Peking University School and Hospital of Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology,Beijing,P.R.China)

机构地区：[1]北京大学口腔医学院·口腔医院综合二科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室 [2]北京大学口腔医学院·口腔医院牙体牙髓科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室

出　　处：《中国口腔医学继续教育杂志》2023年第4期264-272,共9页Chinese Journal of Stomatologial Continuing Education

基　　金：北京市卫生健康委员会2021年住院医师规范化培训质量提高项目·住培2021071。

摘　　要：目的:通过个性化的综合诊疗,实现右上中切牙慢性根尖周炎疾病控制、美观调整与功能恢复。诊治经过:主诉患牙为旧固定桥的基牙,拆除旧固定桥后,对进行了显微根管治疗。8个月后,仍存在根尖病变,通过显微根尖手术纠正根充超填、囊肿样变化及可能存在的根外感染。期间进行了定期的牙周基础治疗,其他楔状缺损患牙的复合树脂直接粘接修复。通过功能适合性美学诊断蜡型进行美学调整和功能适应。针对修复环节,患者综合考虑疗程、费用、美观、功能及预后,选择了固定桥修复。结果:控制了的根尖周炎症,良好地恢复了牙体缺损及牙列缺损的功能与美观。结论:通过一站式的个性化综合诊疗,可降低患者转换不同专业的沟通成本和转诊次数。Objective:This article presents a case about a right upper central incisor with chronic apical periodontitis,which achieved infection control,aesthetic adjustment and functional recovery,through personalized comprehensive diagnosis and treatment.Diagnosis and treatment:The chief complaint tooth was the abutment of the old fixed bridge.After the old fixed bridge was removed,the right upper central incisor was treated with microscopic endodontic treatment.After 8 months,there was still lesion after root canal therapy.The over filling,cyst-like change and possible extra-root infection were corrected through apical microsurgery.During the period,regular periodontal initial treatment was performed,and other wedge-shaped defects were filled with composite resin.Functional suitability and aesthetic diagnosis wax pattern was used for aesthetic adjustment and functional adaptation.The patient chose the fixed bridge considering the course of treatment,cost,aesthetics,function and prognosis.Results:The periapical inflammation of the right upper central incisor was controlled,and the function and aesthetics of tooth defect and dentition defect were well restored.Conclusions:Through one-step personalized comprehensive diagnosis and treatment,the communication cost and referral times between different specialties of the patient were reduced.

关 键 词：慢性根尖周炎 综合诊疗 显微根尖手术 基牙 固定桥 

分 类 号：R78[医药卫生—口腔医学]