臺灣博碩士論文加值系統

牙周補綴裝置如同Dr. Amsterdam所強調的，對於受到嚴重牙周病破壞的齒列，需要有一良好之補綴裝置。由於牙周病治療技術日新月異的發展如：引導組織再生術、引導骨再生術、牙釉基質蛋白之應用及PRF等新術式之引進，我們現在應用這些新術式可以保留更多的牙齒，而且可以得到更好的效果。

在治療嚴重牙周病破壞的齒列時，我們應該應用與一般正常齒列相同的治療原則及補綴原則，但仍必須做小部份的修正，其原因係為受到牙周病破壞的齒列與正常齒列仍有些不同；並且我們也應該做多方面的考慮，以顧及病人的意願、時間、經濟狀態及其身體及牙齒上的的狀況。

本文包括了11個臨床上的案例，年紀從30歲到50歲，這些臨床診斷包括了廣泛性慢性牙周炎、局部性嚴重牙周炎及局部性牙齦腫大。為了使這些病例能夠達到健康與美觀的要求，我們在這些病例上應用了矯正治療、根管治療、牙周病手術、口腔外科手術和人工植牙手術等術式；在補綴物的應用則包括了固定假牙、黏著性牙橋、植體支持性的覆蓋式義齒、傳統式的活動假牙及雙重冠合併薄冠蓋覆蓋義齒。

治療完成後，這些病例在牙周病指數、牙周囊袋深度及牙齒動搖度上，得到了非常明顯的進步，而且在某些病例上，還可看到骨頭有再生的現象，讓患者對於這些補綴的效果感到滿意。

這些病例已全部治療完成，而且追蹤治療時間超過一年，有些病例甚至已經達到三年半的追蹤時間。雖然，這些病患的治療目標都已達成，但為了要得到一個更加良好且更加長遠的癒後情況，我們必須讓病人定期回診及定期做補綴物的維護。

Periodontal prosthesis, as the definition from Dr. Amsterdam, emphasizes the necessity of restorative prosthesis for the dentition with advanced periodontal disease. With the help by the new development of new techniques like guided tissue regeneration, guided bone regeneration, enamel matrix derivatives and PRP (platelet rich plasma) we can keep more teeth and achieve better results than before.

In the treatment of severe chronic periodontitis (SCP), we should apply the same operative dentistry and prosthetics principles like we do with general dentition with some modification because the differences between SCP involved dentition and normal dentition. We should have multidirectional consideration about the involvement of patients’ will ,time, economic situation, medical and dental situation..

This paper includes 11 clinical cases, aged from 30 to 50. The clinical diagnosis includes generalized or localized chronic periodontitis and localized gingival enlargement.

To accomplish the demands of health and function, for these cases we had done orthodontic treatment, endodontic treatment, periodontal surgery, oral surgery and even implants. The prosthesis including tooth-supported fixed denture, adhesive bridge, implant-supported fixed denture, conventional removable partial denture and telescopic crown retained overdenture.

Until the end of active treatment, we and the patients have achieved significant improvements in the periodontal indices (plaque index, gingival index), probing pocket depth, and tooth mobility and in some cases we can see bone regeneration. The patients are satisfied the results with their prosthesis. Among these cases, all have been finished and followed for more than one year, for some even up to 3.5 years; their treatment goals have been followed and found fulfilled. But to achieve a further good long-term prognosis we have to do frequent hygiene recalls and prosthetic maintenance.

牙周補綴學臨床病例報告
－目次－
誌謝
中文摘要 ------------------------------------------------------- 001
英文摘要 ------------------------------------------------------- 002
前言 ------------------------------------------------------------- 004
材料與方法 ---------------------------------------------------- 008
病例報告 ------------------------------------------------------- 010
病例摘要表 ---------------------------------------------------- 011
病例(一)：黃先生 -------------------------------------------- 012
病例(二)：李小姐 -------------------------------------------- 051
病例(三)：蕭先生 -------------------------------------------- 073
病例(四)：廖小姐 -------------------------------------------- 101
病例(五)：黃小姐 -------------------------------------------- 121
病例(六)：周先生 -------------------------------------------- 142
病例(七)：林小姐 -------------------------------------------- 167
病例(八)：王小姐 -------------------------------------------- 194
病例(九)：許小姐 -------------------------------------------- 215
病例(十)：盛先生 -------------------------------------------- 241
病例(十一)：莊先生 ----------------------------------------- 263
討論 ------------------------------------------------------------- 281
結論 ------------------------------------------------------------- 292
參考文獻.-------------------------------------------------------- 294

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