变异式烤瓷冠修复上侧切牙反牙合临床观察.doc

变异式烤瓷冠修复上侧切牙反牙合临床观察[摘要]目的：探讨运用变异式贵金属烤瓷冠修复上侧切牙反牙合的临床设计、牙体预备及修复效果。方法：对30颗(15例)上侧切牙反牙合采用变异式贵金属烤瓷冠进行修复，修复后经6个月～3年随访，观察修复后牙周情况和患者满意度。结果：变异式贵金属烤瓷冠修复后,基牙牙龈无明显炎症，无崩瓷、瓷裂发生，前牙美观程度明显改善，患者无不适，效果满意。结论：变异式贵金属烤瓷冠可以有效纠正上侧切牙反牙合，改善美观，可作为正畸治疗的替代手段。 [关键词]上侧切牙；反牙合；烤瓷冠 [中图分类号]R783 [文献标识码]A [文章编号]1008-6455（2012）01-0103-02 Clinical observation of the use of mutation type porcelain crown on the anti-bite of lateral incisor TANG Ya,CHEN Bi-xin （Department of Stomatology,The Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211100,Jiangsu,China) Abstract: Objective To investigate the clinical design, tooth preparation and restoration effects of the use of mutation type precious metal ceramic crowns on the anti-bite of lateral incisor. Methods We used mutation type precious metal ceramic crown to restore 30(15 cases) anti-bite of lateral incisor. Then after 6 months to 3 years follow-up,we observed the periodontal conditions of the teeth and patients’ satisfaction. Results After the restoration of mutation type precious metal ceramic crown, there was no inflammation of the abutment gums,no collapse and crack of porcelain.The appearance of teeth was significantly improved,the patients had no discomfort,and the results were satisfactory. Conclusion Mutation type precious metal ceramic crown on the lateral incisor can be effective in restoring anti-bite of lateral incisor,improving the appearance,and can be used as an alternative to orthodontic treatment. Key words:lateral incisor;anti-bite;porcelain crown 个别上颌侧切牙反牙合畸形在临床上比较常见，往往引起功能性牙合干扰与牙合创伤，还明显影响美观，因此引起患者重视[1-2]。而一些成人患者因条件所限不愿意接受正畸治疗。笔者于2008～2011年，对这些患者采用变异式贵金属烤瓷全冠修复，达到了满意的效果。现分析报道如下。 1 资料和方法 1.1临床资料：本组15例（男4例，女11例）患者，共30颗牙，年龄18～45岁。均为上颌侧切牙反牙合畸形，颈缘均低于邻牙1～2mm。选择标准：反覆牙合不超过1/2 冠长，反覆盖小，无严重拥挤，治疗牙无明显松动，无明显骨性畸形。 1.2方法：本组病例治疗前均进行全口洁治，检查治疗牙的牙周情况，常规拍摄牙片，取研究模进行模型测量和模拟修复，并与患者进行沟通。 治疗过程：①治疗牙先常规行根管治疗；②牙体预备：切割切端使其离开对颌牙切缘2mm，较大量地磨削牙舌侧，使舌侧呈唇向倾斜的斜面，并在舌侧颈部预备肩台，唇侧只少量磨改，不预备肩台。邻面按贵金属烤瓷全冠常规预备；③制作桩核：进行根管预备，并从切端开始向