咬合重建病例的蜡型设计与口内实现1例

Wax design and intraoral implementation of occlusal reconstruction cases

目的:通过1例咬合重建病例介绍咬合重建过程中技师的制作过程。方法:选择1例来首都医科大学附属北京口腔医院就诊的下颌牙齿重度磨耗伴上前牙修复体崩瓷的患者,采用稳定型咬合板恢复垂直距离,诊断蜡型恢复牙齿的功能及形态,压模式垫直接转换暂时冠,计算机辅助设计及辅助制造(computer aided design/computer aided manufacturing,CAD/CAM)复制暂时冠形态制作永久修复体。结果:最终修复完成后,检查患者发音、髁突轨迹描记仪,均达到满意效果。并在治疗后1个月、3个月、6个月、12个月后复查,患者面形无异常,发音清楚,关节肌肉无异常,T-scan检查咬合力分布均匀,前伸、侧方运动平顺无干扰。结论:该病例通过咬合重建的序列治疗,恢复了美观和功能,获得了较好的效果。

Objective:To introduce the fabrication process of technician part in occlusal reconstruction through a case of occlusal reconstruction.Methods:A patient with severe mandibular tooth wear accompanied by porcelain of anterior prosthesis was selected.A stable occlusal plate was used to restore the vertical distance,the function and shape of the tooth was diagnostic wax-up,the temporary crown was directly transformed by pressing occlusal pad,and the temporary crown shape was reproduced by computer aided design/computer aided manufacturing(CAD/CAM)to make permanent prosthesis.Results:After the final repair,the patient's pronunciation and condylar track recorder were checked and satisfactory results were achieved.After treatment,follow up examination at 1,3,6 and 12 months later showed that the patient had no abnormal facial shape,clear articulation,no abnormal joint muscles,uniform distribution of bite force and smooth extension and lateral movement without interference by T-scan.Conclusions:The patient’s appearance and function were restored by the sequence therapy of occlusal reconstruction,and good results were obtained.