不同类型附着体用于牙列缺损修复临床效果观察的病例报告(硕士)

不同类型附着体用于牙列缺损修复临床效果观察的病例报告(硕士)(论文32000字)
Clinical case reports of different types of attachment for clinical observation of dentition defect
摘  要
目的：通过使用不同类型附着体义齿对牙列缺损患者实施修复的临床效果观察，为临床上口腔修复医生选择合适的附着体义齿提供参考依据。
方法：选取从2016年10月至2017年11月期间来我院修复科就诊，因牙列缺损要求修复且完全接受使用附着体义齿修复的患者共为21例，其中男11例，女10例，平均年龄为62岁。
纳入标准：①缺牙区牙合龈间距离≥4.0mm，非固定桥适应证患者；②对美观要求较高者；③牙周组织健康，基牙的条件为无松动或松动度≤Ⅰ°，牙槽骨吸收≤牙根长的 1/3 且未经治疗的牙或经根管治疗后的根尖周组织正常的残根残冠；④患者无主观精神障碍，思维清晰，无身体运动障碍性疾病等。
21例修复病例中，使用5种不同类型附着体义齿：①球帽附着体义齿9例，其中侧方球帽附着体义齿3例、常规球帽附着体4例、种植球帽附着体2例；②磁性附着体义齿4例；③杆型附着体义齿（种植）2例；④栓体栓道附着体义齿3例，⑤太极扣附着体义齿3例（双侧）。随访观察2～15个月，以患者主观感觉和临床检查结果作为评价标准。戴牙后无主观不适，义齿固位好，咀嚼有力，美观，舒适，摘戴自如，且经检查后基牙无疼痛或松动，牙龈组织健康，基托与黏膜之间密贴无缝隙，黏膜无明显红肿或溃疡，则评定为满意。患者自觉不适，义齿摘戴困难，咀嚼效率差，义齿松动脱落，异物感明显及出现基牙松动，义齿固位差或稳定性不佳，基托与黏膜之间有缝隙或有明显的不适感如疼痛等，经调整后仍不能达到要求者则评定为不满意。
结果：经过2～15个月的随访观察过程中，在应用5种不同类型附着体义齿修复牙列缺损的21例病例中：20例无明显不适，义齿固位稳定，咀嚼有力，美观，舒适，摘戴自如，牙龈健康，基托与黏膜间接触紧密，无黏膜红肿及溃疡。1例患者修复4个月后出现疼痛不适，总体满意度为95.2%。5种不同类型附着体义齿中，4种类型患者满意度极高均达到满分，仅在磁性附着体义齿修复中出现1例因附着体一侧基牙周围牙龈以及基托下黏膜红肿溃疡导致不适，后经重新调整咬合，重衬基托组织面，义齿缓戴一周后缓解。
结论： 5类附着体义齿在病例选择恰当时均可起到改善义齿的固位、支持及稳定，提高咀嚼效率，保护基牙、延长基牙寿命的作用，可明显提高患者对外观、语音及咀嚼功能及舒适方面的满意度。
关键词： 附着体义齿 牙列缺损  固位

Abstract
Objective：
   In order to observe the clinical effect of denture defect and dentition defect by using different types of attachment denture, which can be helpful to select clinically appropriate denture attachment.
Methods：
Twenty-one patients with prosthetic denture repaired due to dentition defect, including 11 males and 10 females, with an average age of 62 were selected from October 2016 to November 2017 in our hospital. Inclusion criteria；① gingival gap of edentulous area ≥ 4.0mm; non-fixed bridge indications of patients;② higher aesthetic requirements;③ periodontal health, no loosening or loose abutment≤Ⅰ°, alveolar bone resorption ≤ 1/3 of the normal tooth root or residual root canals after root canal treatment;④ conscious, mental and physical movement disorders;
Among the 21 cases, 5 different types of attachment dentures were used: ① 9 cases were ball-cap attachment dentures: 3 cases were lateral ball-cap attachment denture, 4 cases were normal ball-cap attachment and 2 cases were implant-ball-cap attachment dentures. ②4 cases were magnetic attachment dentures; ③2 cases were implant-bar-clip attament dentures. ④ 3 cases were key-key way attachment dentures. ⑤ 3cases were ERA attament dentures.

Follow-up observation of 2 to 15 months, the patient's subjective feeling and clinical examination results as the evaluation criteria. After wearing the teeth no subjective discomfort, denture solid, chewing strong, beautiful, comfortable, easy to pick and check the abutment without pain or looseness, gum health, close contact with the mucosa, mucosa without obvious swelling and ulcers, as satisfied. Patients with discomfort, pick the dentures difficult to wear, chewing inefficient, loosening and loosening of the denture, foreign body sensation and the occurrence of abutment loose, poor retention or poor stability of the denture, the base and the mucosa is not close or obvious pain, can not be adjusted Reached as unsatisfactory.
Results：
After 2 to 15 months of follow-up observation, 21 cases of using 5 different types of attachment denture repair cases: 20 cases without obvious discomfort, stable denture retention, chewing strong, beautiful, comfortable, pick comfortable, gingival health, base Support and mucosal contact between close, no mucosal swelling and ulcers. One patient had pain discomfort after 4 months of repair, with an overall satisfaction of 95.2%. Of the 5 different types of attachment dentures, four types of patients reached full marks with satisfactory satisfaction. Only one case of dislocation of the gums around the abutment on the side of the attachment and the inflamed mucosa of the base caused by ulceration occurred in the magnetic attachment prosthesis , After re-adjustment occlusion, re-base surface of the organization, denture ease after a week to ease.
Conclusion：
when choice of cases is appropriate, Five kinds of attachment dentures can improve denture retention, support and stability, improve chewing efficiency, protect abutments and extend the life span of abutments, which can significantly improve the appearance, speech and masticatory function And comfort satisfaction.
key word：attachment denture  dentition defect  rentention
 
目    录
一、摘要……………………………………………………………………………………………….…
（一）中文摘要……………………………………………………………………………………
（二）英文摘要……………………………………………………………………………..……
二、正文…………………………………………………………………………………….……………
（一）前言………………………………………………………….…………….…………………
（二）病例………………………………………………………………………………………….
1. 病例一.....................................................................................
2. 病例二....................................................................................
3. 病例三..................................................................................
4. 病例四...................................................................................
5. 病例五....................................................................................2
6. 病例六....................................................................................
7. 病例七....................................................................................3
8. 病例八....................................................................................3
9. 病例九....................................................................................4
10.病例十....................................................................................4
（三）讨论……………………………………..…………………………………………………
（四）总结……………………………………………….………………………………………5
（五）参考文献………………………………….……………………………………………
三、综 述……………………………………………….……………………………………………5
（一）综 述……………………………………….……………………………………………5
（二）参考文献……………………………………………………………….………….…6
四、致 谢……………………………………………………………………………..……………