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  • 學位論文

牙周補綴之全方位治療及全口重建 --- 病例報告

The integrated therapy and the full-mouth rehabilitation in the periodontal prosthesis--- Cases report

指導教授 : 周肇茂

摘要


1974年美國賓州大學阿姆斯特丹教授提出「牙周補綴」一辭,並加以定義:「牙周補綴即在嚴重牙周病治療當中,全然的復形與補綴,其所應用的醫療觀念、原則與技術,亦適用於自然齒列的補綴或牙齒的替換。」牙周補綴為「整合性治療」,在牙周重症患者中,常需要牙體復形、牙髓治療、牙周治療、口腔外科、矯正及補綴治療等各科的合作,才能達到良好的治療結果。牙醫師必須考量患者的實際需求、經濟能力及人格特質,與患者進行溝通以選擇最適合的治療計劃。本論文共提出十個全口重建的病例報告。採用不同的補綴物設計,牙周治療包括非手術性治療及手術性治療。手術性治療包括:牙周翻瓣術、根叉侵犯治療、牙冠增長術、引導骨再生手術;四個病例合併矯正治療。最終補綴物包含固定式及可撤式二種。固定式義齒包括傳統固定局部義齒、植體固位式固定義齒。可撤式義齒包括傳統可撤式局部義齒、könus雙重冠可撤式義齒,套筒薄冠蓋套疊可撤式義齒,覆蓋式活動義齒。經由整合性的牙周補綴治療,使患者重新獲得穩定的咬合功能和牙周健康,同時滿足患者美觀的需求。

並列摘要


In 1974, Dr. Amsterdam(the professor of Pennsylvania University) pointed out “periodontal prosthesis” and defined it as “Those restorative prosthetic endeavors that are absolutely essential in the treatment of advanced periodontal disease. whereas specifically it refers to the treatment of the dentition mutilated by the ravages of periodontal disease, in general ,its concepts, principles and techniques may be employed in any restorative or tooth replacement service involving the nature dentition.”The periodontal prosthesis is the “integrated treatment”. In the severe periodontal disease, to achieve the appropriate treatment result and the good prognosis, we need the cooperation of different specialized fields such as operative dentistry, endodontic therapy, periodontal treatment, oral surgery, orthodontics and prosthodontics .The dentist must evaluate the practical need, financial capabilities and personal characteristics of the patient to select the most appropriate treatment plan. In this thesis, the ten cases of the full mouth rehabilitation were presented. These cases applied with the different prosthetic design and the periodontal therapy that included non-surgical & surgical treatment. The surgical treatment included open-flap curettage, furcation involvement therapy, crown lengthening, guided bone regeneration. The orthodontic treatment was used in four cases. The definite prosthesis are fixed or removable partial denture, including conventional fixed prosthesis, implant-supported fixed prosthesis, conventional removable prosthesis, Konuskrone telescopic denture, crown sleeve-coping telescopic denture, overdenture. Again, the patients acquire the stability of the occlusion and the health of the periodontal apparatus by the integrated periodontal-prosthetic treatment and satisfy esthetic appearance.

參考文獻


1. Rosenberg M.M., Kay H.B., Keough B.E., Holt R.L.
Periodontal and Prosthetic Management for advanced
cases. Chicago : Quintessence, 1988: 407.
2. Polson A.M. , Zander H.A. Effect of periodontal trauma
upon intrabony pocket. Journal of Periodontology 1983;

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