臺灣博碩士論文加值系統

現今牙科在醫療上的進步與技術蓬勃發展，人工植牙已被廣泛的運用在單顆缺牙、多顆缺牙、甚至到全口無牙患者身上。當植牙手術、齒槽嵴增進術、牙科材料不停的演進，以及困難植牙區在技術層面上被克服之後，植牙成功的機率可謂大大的提升，而活動假牙也不再是多顆缺牙患者唯一的選擇。患者在固定式補綴物製作後裝戴的滿意度很高，但牙醫師在面對缺牙患者經常面臨到的問題就是牙周病，而補綴物的製作必須建立在良好的牙周健康下，除了牙周病必須做有效的治療控制之外，贋復補綴的利用亦可幫助恢復和穩定牙齒及其周邊組織的生理性形態和功能。
本論文共提出九個局部或是全口重建的病例，其中包括局部性、廣泛形慢性牙周炎，在治療過程中，其中有四位患者接受矯正治療，改善牙齒軸向與排列並挪出適當空間後以利將來補綴物製作，有八位患者運用人工植體搭配電腦斷層及牙周補綴的觀念，讓在術前的評估、手術方式的選擇、補綴物的設計、跨科治療的整合中達到更精確的治療目標。

The technology of dentistry has taken a huge leap and improved tremendously especially in the skill aspect nowadays which makes implantology no longer limited to patient with single tooth replacement and benefits patient with multiple teeth missing and complete dentures patient. With the development through out the years of implant surgery, alveolar bone augmentation, and dental materials, the successful rate of implant surgery on challenging area has improved. Removable partial denture is not the only choice for patients with multiple teeth missing replacement. Patient becomes more satisfied with combination of fixed partial denture and implants. Periodontal disease is usually the first obstacle for dentists encountering with implant patients. One of the fundamental elements in order to have excellent result in implantology is a healthy periodontal dentition. Partial denture can be used for restoring and stabilizing both physiological and functional of teeth and surrounding
tissues with one condition required; the periodontal disease needs to be effectively controlled and treated.
There are nine cases of partial and full mouth rehabilitation which includes partial and full mouth periodontitis being presented. During the treatment period , four out of the nine patients underwent orthodontics treatment to improve teeth inclination and alignment in order to provide space to accommodate prosthetics.Eight patients were informed with periodontal treatment procedure with the aid of computerized tomography and implantology for better assessment in presurgical evaluation, surgery types, design in restoration, and interdisciplinary integration to obtain the most accurate result.

目錄
中文摘要……………………………………………………………… 1
英文摘要……………………………………………………………… 2
前言…………………………………………………………………… 3
材料與方法…………………………………………………………… 4
病患資料一覽表……………………………………………………… 5
病患治療方式一覽表………………………………………………… 6
病例報告
案例一 人工植體支持之固定式義齒運用於慢性牙周炎患者後方咬合之病例…7
案例二 運用Locator 的設計合併自然牙與人工植體進行全口重建之病例… 55
案例三 人工植體支持之固定式義齒於慢性牙周炎患者之重建病例…………103
案例四 運用強逼萌出術將無望牙於前牙美觀區立即植牙之案例……………143
案例五 利用人工植體支持之固定式義齒重建下顎咬合之病例………………176
案例六 前牙錯咬利用矯正與牙冠增長術來改善美觀之病例…………………213
案例七 利用人工植體於後牙重建咬合之病例…………………………………245
案例八 運用矯正與人工植牙進行全口重建之病例報告………………………279
案例九 運用固定式義齒與人工植體於後牙重建之病例………………………318
總討論…………………………………………………………………354
結論……………………………………………………………………361
參考文獻………………………………………………………………362

1. Waerhaug J. Healing of the dento-epith elial junction following subgingival
plaque control. I. As observed in human biopsy material. J Periodontol
1978;49(1):1-8.
2. Waerhaug J. Healing of the dento-epithelial junction following subgingival
plaque control. II: As observed on extracted teeth. J Periodontol
1978;49(3):119-34.
3. Matia JI, Bissada NF, Maybury JE, Ricchetti P. Efficiency of scaling of the molar
furcation area with and without surgical access. Int J Periodontics Restorative
Dent 1986;6(6):24-35.
4. Stern N, Brayer L. Collapse of the occlusion--aetiology, symptomatology and
treatment. J Oral Rehabil 1975;2(1):1-19.
5. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous
marrow and bone. J Oral Surg 1980;38(8):613-6.
6. Tatum H, Jr. Maxillary and sinus implant reconstructions. Dent Clin North Am
1986;30(2):207-29.
7. Summers RB. A new concept in maxillary implant surgery: the osteotome
technique. Compendium 1994;15(2):152, 54-6, 58 passim; quiz 62.
8. Summers RB. The osteotome technique: Part 3--Less invasive methods of
elevating the sinus floor. Compendium 1994;15(6):698, 700, 02-4 passim; quiz
9. Wallace SS, Mazor Z, Froum SJ, Cho SC, Tarnow DP. Schneiderian membrane
perforation rate during sinus elevation using piezosurgery: clinical results of
100 consecutive cases. Int J Periodontics Restorative Dent 2007;27(5):413-9.
10. Misch CE. Maxillary sinus augmentation for endosteal implants: organized
alternative treatment plans. Int J Oral Implantol 1987;4(2):49-58.
11. Simion M, Fontana F, Rasperini G, Maiorana C. Long-term evaluation of
osseointegrated implants placed in sites augmented with sinus floor elevation
associated with vertical ridge augmentation: a retrospective study of 38
consecutive implants with 1- to 7-year follow-up. Int J Periodontics
Restorative Dent 2004;24(3):208-21.
12. Wang HL, Katranji A. ABC sinus augmentation classification. Int J Periodontics
Restorative Dent 2008;28(4):383-9.
13. Dahlin C, Gottlow J, Linde A, Nyman S. Healing of maxillary and mandibular
bone defects using a membrane technique. An experimental study in
monkeys. Scand J Plast Reconstr Surg Hand Surg 1990;24(1):13-9.
14. Buser D, Bragger U, Lang NP, Nyman S. Regeneration and enlargement of jaw
bone using guided tissue regeneration. Clin Oral Implants Res
362
1990;1(1):22-32.
15. Jovanovic SA, Spiekermann H, Richter EJ. Bone regeneration around titanium
dental implants in dehisced defect sites: a clinical study. Int J Oral Maxillofac
Implants 1992;7(2):233-45.
16. Jovanovic SA, Kenney EB, Carranza FA, Jr., Donath K. The regenerative
potential of plaque-induced peri-implant bone defects treated by a
submerged membrane technique: an experimental study. Int J Oral Maxillofac
Implants 1993;8(1):13-8.
17. Nyman S, Lang NP, Buser D, Bragger U. Bone regeneration adjacent to titanium
dental implants using guided tissue regeneration: a report of two cases. Int J
Oral Maxillofac Implants 1990;5(1):9-14.
18. Linde A, Alberius P, Dahlin C, Bjurstam K, Sundin Y. Osteopromotion: a
soft-tissue exclusion principle using a membrane for bone healing and bone
neogenesis. J Periodontol 1993;64(11 Suppl):1116-28.
19. Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A.
Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J
Plast Reconstr Surg 1969;3(2):81-100.
20. Nyman S, Lang NP, Buser D, Bragger U. Bone regeneration adjacent to titanium
dental implants using guided tissue regeneration: a report of two cases. Int J
Oral Maxillofac Implants 1990;5(1):9-14.
21. Becker W, Becker BE. Guided tissue regeneration for implants placed into
extraction sockets and for implant dehiscences: surgical techniques and case
report. Int J Periodontics Restorative Dent 1990;10(5):376-91.18. Dykes FD,
Dunbar B, Lazarra A, Ahmann PA. Posthemorrhagic hydrocephalus in high-risk
preterm infants: natural history, management, and long-term outcome. J
Pediatr 1989;114(4 Pt 1):611-8.
22. Salama H, Salama M. The role of orthodontic extrusive remodeling in the
enhancement of soft and hard tissue profiles prior to implant placement: a
systematic approach to the management of extraction site defects. Int J
Periodontics Restorative Dent 1993;13(4):312-33.
23. Park YS, Yi KY, Moon SC, Jung YC. Immediate loading of an implant following
implant site development using forced eruption: a case report. Int J Oral
Maxillofac Implants 2005;20(4):621-6.