利用合垫式义齿修复治疗低位咬合疗效分析.docVIP

利用合垫式义齿修复治疗低位咬合疗效分析 　　【摘要】目的 通过对牙缺失及伴有重中度磨耗引起的低位咬合的患者进行设计和修复治疗，以达到口颌系统正常秩序，重建咬合平衡的方法。方法 对上述45例符合条件的患者，采用全牙列解剖式合垫进行修复治疗，并进行2、4、6周随访观察。结果 45例中戴用修复体2-3周关节区及咀嚼区疼痛及关节弹响得到缓解42例（93.3%）；5-6周后患者颞下颌关节症状、咀嚼效能颜面不美观、发音及牙齿磨耗及敏感等均得到显著改善44例（97.7%）临床效果满意，均达到修复目的。结论 此种修复不仅恢复了原由组织的外形和功能、同时改善了牙周条件，消除了颞下颌关节症状，是一种有效可靠的保守治疗方法。 　　【关键词】合垫 牙列缺损 磨耗 　　中图分类号：R783文献标识码：A文章编号：1005-0515（2011）4-002-02 　　Splint denture repair by treatment of low efficacy of occlusal 　　HongYanqing YuanHaibo 　　（Dental Hospital of Jinan, Shandongjinan 250000） 　　【Abstract】Objective To re-associated with tooth loss and low to moderate occlusal wear caused by design and rehabilitation of patients treated, in order to achieve the normal order of Stomatognathic system, reconstruction of occlusal balance method. Methods 45 cases of the eligible patients, the use of the whole dentition anatomical repair type splint treatment, and for 2,4,6 weeks of follow-up observation. Results 45 patients to wear the prosthesis in 2 - 3 zone and peripheral joint pain in chewing and the joints have been alleviated in 42 patients (93.3%); 5 - 6 weeks in patients with symptoms of temporomandibular joint, masticatory efficiency unsightly facial , pronunciation and tooth wear and sensitivity Dengjun improved significantly in 44 cases (97.7%), satisfactory clinical results, are up to repair purposes. Conclusion This fix not only restored the appearance and function originally organized, while improving the periodontal condition, eliminating the symptoms of TMJ is an effective and reliable method of conservative treatment. 　　【Keywords】Gaskets defect wear 　　 　　1 临床资料 　　1.1 本组患者男37例，女8例年龄49-70岁，除5例患者牙列完整外，均伴有上下颌牙列不同程度的缺损。但无多数后牙缺失。所有患者均伴有面下1/3缩短，鼻唇沟变深，苍老面容、咀嚼无力，同时??有不同程度的颞下颌关节刚开口和闭口末关节弹响，关节区及咀嚼区压疼，关节运动异常等颞下颌关节紊乱症状。 　　1.2 修复方法及标准 首先选择健康余留牙作基牙，行基牙制备，注意磨除锐利的边缘嵴及过高的牙尖，调磨基牙倒凹，对重度磨耗近平齐牙龈的牙齿，需做x线检查，对需做治疗的牙齿进行全面治疗，对有敏感的牙齿进行脱敏治疗，然后常规制取功能性印模，灌注硬石膏。在口内做正中合关系蜡合记录（注意测定好垂直高度），保持正常的合间隙，嘱病人做张比口运动，让病人自己找到一个弹响消失或减轻的位置，此时患者感觉舒适，面下1/3与面中1/3比例正常，表情自然，取得正确的上下