倾斜短基牙冠内附着体的可行性研究

Feasibility of Intracoronal Attachment for Tilted Abutment with Low Occlusogingival Distance

目的:通过典型病例探讨倾斜短基牙冠内附着体临床应用的可行性,为解决牙列缺损中类似修复难题探索一条新路。方法:以一临床病例的整个治疗过程为基础,全面分析各种设计方案的优缺点及可操作性,确定最佳设计方案并实施。创新性地反向使用了SD球帽附着体,充分利用了倾斜短基牙的髓腔空间,从而解决了修复间隙不足造成的设计难题;在修复体制作中创造性地使用了聚合瓷固位法、冠内肩台等技术手段使之更加符合临床要求。通过短期疗效反馈得出其可行性的初步判断。结果:随访发现,患者主观评价修复体整体疗效好。临床检查结果经Kruskal-W alls秩和检验分析,修复体在的形态、边缘适合性、周围龋、磨损与折裂、附着体基牙牙周健康状况、义齿咬合状况等性能方面在戴用6个月后和12个月后较即刻均无显著性改变,无统计学意义。结论:倾斜短基牙做为可摘局部义齿的固位体,可利用其髓腔空间放置冠内附着体,典型病例修复短期效果良好。

Objective： To explore the feasibility of clinical application of the intracoronal attachment for tilted abutment with low occlusogingival distance. Methods ： The difficulty of design proposal caused by the shortage of space for the restoration was solved with the innovative use of the reverse SD ball attachment and the full use of the space of the canal of the tilt - tooth. The use of polymer - ceramic, shoulder inside the crown and other technical means in the production of dental prosthetic restoration made it more in line with the clinical requirements. The feasibility was determined through the initial judge of short - term effect. Kruskal - Walls rank sum test was used to evaluate the appearance, edge fitness, recurrent caries, abrasion and fracture, health of periodontal and denture occlusion wear performance of the dental prosthetic restoration immediately, 6 months and 12 months after the restoration. Results： The inlays had no significant changes 12 and 24 months after the restoration. Conclusion： Tilted abutment with low occlusogingival distanceteeth could be used as a retainer of the removable partial denture retention with the placement of inside attachment in cavity space. The short - term effect was good in the typical case.