咬合重建修复过程中需要注意的临床问题

The clinical considerations in the process of the occlusal reconstruction

咬合重建修复是对现有牙列咬合状态进行改造和重新建立,通常涉及全牙弓面的再造及颌位的改变,因此属于修复领域的疑难问题。修复前需要充分评估患者的现有口腔条件,制订周密的修复计划并与患者充分沟通;修复过程一般包括颌位调整、临时冠桥过渡、永久修复体完成及修复后维护4个阶段,每个阶段因患者的个体差异而致内容各不相同。修复中应注意咬合垂直距离的升高、临时修复体的选择、咬合设计的个性化以及修复各阶段新建颌位的稳定等问题。成功的咬合重建修复充分体现口腔修复的整体观、精品意识和团队合作理念。

The occlusal reconstruction or full mouth rehabilitation is a restoration method to reconstruct or rehabilitate the existing occlusion, normally including the reconstruction of the full dental arch occlusal surface or change of the occlusal vertical dimension (OVD), therefore it is a difficult process in the field of the prosthodontics. Before restoration we should fully evaluate the patients' current oral condition, formulating a careful restoration plan and well communicating with the patients. The process of the restoration includes four stages as follows: increasing OVD, fabricating the temporary crown and bridge, completing permanent restoration and, following up and maintaince after restoration. The details are different at each stage because of patients’ individual condition. During the process, some clinical considerations should be paid attention to,such as increasing OVD, selection of the temporary restoration, individuality of the occlusal design and the stability of the new jaw position in each stage of the rehabilitation. A successfull occlusal reconstruction can well demonstrate the concept of the integration, precision and cooperation in the prosthodontics,