牙本质发育不全Ⅱ型患者的重建治疗

Occlusal reconstruction for patients with dentinogenesis imperfecta typeⅡ

目的对牙本质发育不全Ⅱ型(DG I-Ⅱ)患者进行重建修复,观察疗效并总结修复要点。方法收集1个DG I-Ⅱ的家系资料,对先证者(患者1,女性,21岁)及其亲属(患者2,男性,40岁)的临床特征、修复过程和随访情况进行回顾性分析。结果 2例DG I-Ⅱ患者均以牙列重度磨耗为主要特征,其中患者2伴上下牙列缺损。患者1经重建、冠延长后行烤瓷固定修复;患者2经重建后以可摘局部义齿修复。修复后1年进行随访,患者主观感觉和临床检查均显示美观及咀嚼和发音功能均得到明显改善。结论 DG I-Ⅱ的修复应以阻断磨损及重建咬为原则,在重建基础上的固定或可摘局部义齿修复效果良好。

Objective To perform occlusal reconstruction for patients with dentinogenesis imperfecta type Ⅱ(DGI-Ⅱ),observe the clinic effect and summarize the clinical experience. Methods The data of one family of DGI-Ⅱ were collected,and the clinical characteristics,treatment process and follow-up status of the proband(patient 1,female,21 years old) and her relative(patient 2,male,40 years) were retrospectively analysed. Results The main feature of these two cases of DGI-Ⅱ was severe wear of the dentition,including upper and lower dentition defect in patient 2.After occlusal reconstruction and crown lengthening,patient 1 was restored by ceramic fixed partial denture to reconstruct the occlusion.Patient 2 was restored by removal partial denture after occlusal reconstruction.Patients were followed up 1 year after prosthetic treatment,and the subjective feelings of patients and clinical examinations indicated that the esthetics,mastication function and pronunciation of patients were significantly improved. Conclusion The principle of prosthetic treatment of patients with DGI-Ⅱ should be occlusal reconstruction of worn dentition.Occlusal reconstruction in combination with fixed or removable partial denture may yield favorable clinic effect.