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      金屬面與應(yīng)力中斷設(shè)計(jì)在齦距不足游離端牙齒缺失修復(fù)中的應(yīng)用

      2022-09-07 06:45:54羅景庭王煜民孫冠陽秦甜吳國鋒巴睿愷
      口腔疾病防治 2022年12期
      關(guān)鍵詞:印模基牙導(dǎo)板

      1 資料和方法

      1.1 病例資料

      患者,女性,51 歲,陜西西安人,因雙側(cè)下頜后牙缺失3 年,來我院要求修復(fù)治療?;颊邿o吸煙、酗酒史。全身健康狀況良好,否認(rèn)有高血壓、心臟病等系統(tǒng)性疾病,否認(rèn)有乙肝、艾滋病等傳染性疾病,無藥物過敏史?;颊咦允觥? 年前兩側(cè)下后牙因嚴(yán)重齲壞于外院拔除,曾于外院行活動義齒修復(fù)2 次,均半年內(nèi)折斷。最近一次活動義齒損壞至今1 年時間內(nèi),未對缺失牙進(jìn)行修復(fù)。以往修復(fù)過程中曾因缺牙區(qū)對頜牙伸長,對右側(cè)上后牙進(jìn)行調(diào)磨,右側(cè)上后牙進(jìn)食過冷過熱食物有不適感”。臨床檢查:37 牙缺失,鄰缺隙牙無傾斜、無扭轉(zhuǎn),對

      2.金融轉(zhuǎn)換效率指標(biāo)。一個地區(qū)儲蓄轉(zhuǎn)換為貸款的比率越高,反映該地區(qū)金融機(jī)構(gòu)在提供金融服務(wù)、日常經(jīng)營以及金融體系中資金配置的效率越高。本研究用縣域金融機(jī)構(gòu)貸款總額占存款總額的比值(SLR)表示廣西縣域金融轉(zhuǎn)換效率指標(biāo)。

      1.2 治療計(jì)劃

      治療計(jì)劃:可摘局部義齒修復(fù)缺失牙。

      甲基蓮心堿與荷葉堿作用HepG2細(xì)胞對其上清液中LDH、TGF-β1、VEGF 的比較…………………………………… 李 娜,宋金春(2·89)

      1.3 治療過程

      1.3.1 初模型分析與支架設(shè)計(jì) 取初模型,利用導(dǎo)線觀測儀進(jìn)行分析,進(jìn)行義齒初步設(shè)計(jì),完成義齒設(shè)計(jì)圖(圖3)。

      1.3.2 基牙預(yù)備與精細(xì)印模 依據(jù)義齒就位道方向制備備牙導(dǎo)板,并利用備牙導(dǎo)板進(jìn)行基牙預(yù)備,消除基牙過大倒凹,制備導(dǎo)平面及支托窩。并用個別托盤與流動性更好的聚醚橡膠,兩步法制取精細(xì)印模(圖4)。

      1.3.4 功能性印模 1 周后復(fù)診,支架調(diào)改,口內(nèi)試戴合適后,用光敏樹脂在支架上制作缺牙區(qū)局部個別托盤,并進(jìn)行邊緣整塑,利用聚醚橡膠制取功能性印模后,進(jìn)行模型切割、圍模灌注及模型修整。重新上架后,送交技工室(圖6)。

      1.3.5 義齒完成與試戴 義齒初戴時,首先對義齒組織面、基托邊緣進(jìn)行調(diào)磨。義齒完全就位后,用咬合紙輔助進(jìn)行咬合調(diào)改。T-scan 檢測調(diào)改后患者口內(nèi)咬合狀態(tài)(圖7)。

      2 結(jié) 果

      3 討 論

      】 Luo JT, Wang YM collected, analyzed the data and revised the article. Sun GY, Qin T analyzed the data and re-vised the article. Wu GF designed the study and revised the article. Ba RK designed the study and wrote the article. All authors read and ap-proved the final manuscript as submitted.

      [1] Kurosaki Y, Kimura-Ono A, Mino T, et al. Six-year follow-up as-sessment of prosthesis survival and oral health-related quality of life in individuals with partial edentulism treated with three types of prosthodontic rehabilitation[J]. J Prosthodont Res, 2021, 65(3):332-339.doi:10.2186/jpr.JPR_D_20_00095

      [2] Ali Z, Baker SR, Shahrbaf S, et al. Oral health-related quality of life after prosthodontic treatment for patients with partial edentu-lism: a systematic review and meta-analysis[J]. J Prosthet Dent,2019,121(1):59-68.doi:10.1016/j.prosdent.2018.03.003

      [3] Arita S, Gonda T, Togawa H, et al. Influence of mandibular distal extension implant-supported removable partial dentures on the force exerted on maxillary anterior teeth[J]. J Prosthodont Res,2021,65(4):541-545.doi:10.2186/jpr.JPR_D_20_00077.

      [4] Inukai M,Baba K,John MT,et al.Does removable partial denture quality affect individuals'oral health?[J].J Dent Res, 2008,87(8):736-739.doi:10.1177/154405910808700816.

      [5] Park JH, Lee JY, Shin SW, et al. Effect of conversion to implant-assisted removable partial denture in patients with mandibular Kennedy classification: a systematic review and meta-analysis[J].Clin Oral Implants Res, 2020, 31(4): 360-373. doi: 10.1111/clr.13574.

      [6] Yunizar MF, Watanabe M, Ichikawa T. Current development sta-tus of additive manufacturing technologies for fabricating remov-able partial denture frameworks: a literature review[J]. Int J Com-put Dent,2022,25(1):57-70.

      [7] MyintOo KZ,Fueki K,Yoshida-Kohno E,et al.Minimal clinically important differences of oral health-related quality of life after re-movable partial denture treatments[J]. J Dent, 2020, 92: 103246.doi:10.1016/j.jdent.2019.103246.

      [8] Vozza I,Manzon L,Passarelli PC,et al.The effects of wearing a re-movable-partial-denture on the bite forces:a cross-sectional study[J]. Int J Environ Res Public Health, 2021, 18(21): 11401. doi:10.3390/ijerph182111401.

      [9] Watanabe C, Wada J, Mizutani K, et al. Chronological grey scale changes in supporting alveolar bone by removable partial denture placement on patients with periodontal disease: a 6-month follow-up study using digital subtraction analysis[J]. J Dent, 2017, 63: 8-13.doi:10.1016/j.jdent.2017.05.004.

      [10] Kuralt M,Bukleta MS,Kuhar M,et al.Bone and soft tissue chang-es associated with a removable partial denture. A novel method with a fusion of CBCT and optical 3D images[J].Comput Biol Med,2019,108:78-84.doi:10.1016/j.compbiomed.2019.03.024.

      [11] Rungsiyakull C, Rungsiyakull P, Suttiat K, et al. Stress distribu-tion pattern in mini dental implant-assisted RPD with different clasp designs: 3D finite element analysis[J]. Int J Dent, 2022:2416888.doi:10.1155/2022/2416888.

      [12] Harb IE, Abdel-Khalek EA, Hegazy SA. CAD/CAM constructed poly (etheretherketone) (PEEK) framework of Kennedy Class I re-movable partial denture: a clinical report[J]. J Prosthodont, 2019,28(2):e595-e598.doi:10.1111/jopr.12968.

      [13] Knapp JG, Shotwell JL, Kotowicz WE. Technique for recording dental cast-surveyor relations[J].J Prosthet Dent,1979,41(3):352-354.doi:10.1016/0022-3913(79)90023-4.

      [14] Mousa MA, Abdullah JY, Jamayet NB, et al. Biomechanics in re-movable partial dentures:a literature review of FEA-based studies[J].Biomed Res Int,2021:5699962.doi:10.1155/2021/5699962.

      [15] Chen X, Mao B, Zhu Z, et al. A three-dimensional finite element analysis of mechanical function for 4 removable partial denture de-signs with 3 framework materials: CoCr, Ti-6Al-4V alloy and PEEK[J]. Sci Rep, 2019, 9(1): 13975. doi: 10.1038/s41598-019-50363-1.

      [16] Wang W, Li T, Luo X, et al. Cytotoxic effects of dental prosthesis grinding dust on RAW264.7 cells[J].Sci Rep, 2020,10(1):14364.doi:10.1038/s41598-020-71485-x.

      [17] 崔嘉璽,譚力芯,熊宇,等.應(yīng)力中斷式附著體義齒修復(fù)下頜雙側(cè)游離端缺失的生物力學(xué)分析[J].中國美容醫(yī)學(xué),2017,26(3):25-28.doi:10.15909/j.cnki.cn61-1347/r.001627.Cui JX, Tan LX, Xiong Y, et al. Biomechanical analysis of the mandibular bilateraI-distal extension absence restored with a stress-breaking attachment retained removabalepartiaI denture[J]. Chin J Aesthet Med,2017,26(3):25-28.doi:10.15909/j.cnki.cn61-1347/r.001627.

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