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研究生:朱俊仲
研究生(外文):Chun-Chung Chu
論文名稱:人工植體與套疊式雙重冠於牙周補綴之臨床運用
論文名稱(外文):Clinical Application of Osseointegrated Implants and Telescopic Dentures in Periodontal Prosthesis
指導教授:鄧延通
指導教授(外文):Andy Yen-Tung Teng
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:牙醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:342
中文關鍵詞:病理性牙齒移位後方咬合崩塌牙周補綴
外文關鍵詞:pathologic tooth migrationposterior bite collapseperio-prothetic therapy
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牙周病齒列由於健康牙齒支持組織破壞,造成維持牙齒於正常位置的均衡力量瓦解,伴隨各種不同程度的咬合問題;如病理性牙齒移位、咬合加深、牙齒喪失及/或牙齒過度萌出、後方咬合崩塌、繼發性咬合傷害。
在牙周病齒列,治療上常面臨兩個挑戰:牙周組織發炎與感染的控制,及咬合安定性的建立。因此牙周補綴治療上除了牙周病處理,往往還需借助跨科際治療如口腔外科、根管治療,輔助性齒列矯正,最後還需贗復補綴,建立生理性穩定咬合,恢復功能及美觀。
另外病患方面的挑戰如全身健康因素、生活習慣、經濟上能負擔的治療,無一不牽動治療的成效。如何有計劃的依病患條件設計治療順序,是一個複雜的工程,及不變的原則。
本論文提出10個病例,屬中、重度牙周病侵犯齒列,經牙周病非手術與手術治療,及其它輔助性治療,最後借助人工植體固定支持補綴,或雙重冠補綴恢復病人功能、美觀。治療完成以定期檢查、保養,維護長期口腔健康。


In periodontal compromised dentition, the forces needed to maintain the teeth in a normal position are collapsed due to periodontal tissue breakdown; followed by a variety of different occlusal problems which includes: pathologic tooth migration, deepened bite, tooth loss, supraeruption, posterior bite collapse, and secondary occlusal trauma.

As critical and complex conditions exist in treating periodontal compromised dentition, two major challenges are faced, one is the control of infection and inflammation, the other is the establishment of a stable occlusion. Perio-prothetic therapy is an interdisciplinary treatment process which may involve many sectors of dental treatment such as oral surgery, endodontic treatment, adjunctive orthodontic treatment, and restoration. All these treatment regimens contribute to establish a physically stable occlusion, which will restore the function and esthetics of the patient.

Apart from the risk factors of the disease, other factors such as systemic condition, behavior, and financial demands will affect the outcome of the treatment.

A complicated yet time-consuming course is required to tailor a proper plan for every individual case; however, it is the only way to achieve the ultimate success.

In this article, 10 cases of advanced periodontal involved dentition are presented. These cases underwent a series of treatments; and restoration of function and esthetics was achieved through the use of implant supported prosthesis or telescopic dentures. After finishing the treatment, a maintenance therapy was offered, and the patients were recalled at regular intervals.


中文摘要 --------------------------------------------------------------------------1
英文摘要---------------------------------------------------------------------------2
前言---------------------------------------------------------------------------------3
致謝---------------------------------------------------------------------------------6
材料與方法------------------------------------------------------------------------7
病例摘要表-----------------------------------------------------------------------10
病例(一):骨再生術、結締組織移植及人工植體於廣泛性重度慢性牙周炎及
植體黏膜炎之局部重建--------------------------------------------------12
病例(二):人工植體及輔助性矯正於廣泛性中度慢性牙周炎合併
牙齒過度萌出之全口重建-----------------------------------------------49
病例(三):人工植體、輔助性矯正及牙冠增長術於廣泛性中度慢性牙周炎之
全口重建 ----------------------------------------------------------------82
病例(四):人工植體於廣泛性重度慢性牙周炎之全口重建---------------------- 122
病例(五):人工植體及自體游離牙齦移植於廣泛性中度慢性牙周炎及
局部重度牙周炎之局部重建-------------------------------------------158
病例(六): 套疊式雙重冠義齒於廣泛性重度慢性牙周炎之全口重建-----------186
病例(七): Konus雙重冠義齒於廣泛性重度慢性牙周炎之全口重建------------214
病例(八): Konus雙重冠義齒於廣泛性重度慢性牙周炎之全口重建------------243
病例(九): Konus雙重冠義齒於廣泛性重度慢性牙周炎之全口重建------------276
病例(十): 套疊式雙重冠義齒於廣泛性中度慢性牙周炎之全口重建-----------304
綜合討論------------------------------------------------------------------------335


前言
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材料與方法
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病例(一)
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病例(四)
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病例(五)
1.Henry PJ, Laney WR, Jemt T, et al. Osseointegrated implants for single-tooth replacement:a prospective 5-year multicenter study. Int J Oral Maxillofac Implants 1996;11(4):450–5.
2.Mraiwa N, Jacobs R, Cleynenbreugel JV, Sanderink G, Schutyser F, Suetens P, Steenberghe DV, Quirynen M. The nasopalatine canal revisited using 2D and 3D CT imaging. Dentomaxillofacial Raidiology 2004; 33:396-402.
3.Verardi S, Pastagia P. Obliteration of the Nasopalatine Canal in Conjunction with Horizontal Ridge Augmentation Compendium :February 2012; 33(2):116-20.
4.Artzi Z, Nemcovsky CE, Bitlitum I, Segal P. Displacement of the incisive foramen in conjunction with implant placement in the anterior maxilla without jeopardizing vitality of nasopalatine nerve and vessels: a novel surgical approach. Clin Oral Implants Res. 2000 Oct;11(5):505-10.
5.Higginbottom F, Belser U, Jones JD, Keith SE. Prosthetic management of implants in the esthetic zone. Int J Oral Maxillofac Implants 2004; 19(suppl):62-72.
6.Spray JR, Black CG,Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response stage 1 placement through stage 2 uncovering. Ann Periodontol 2000; 5(1):119-28.
7.Chang M, Wennstrom JL. Peri-implant soft tissue and bone crest alterations at fixed dental prostheses: a 3-year prospective study. Clin Oral Implants Res. 2010 May;21(5):527-34.
8.Small PN, Tarnow DP. Gingival recession around implants: a 1-year longitudinal prospective study. Int J Oral Maxillofac Implants 2000; 15(4):527-532.
9.Bartolomeo A ; Antonio S ; Giovanna P; Giovanna I, Thams, Ulf MD, Fidel SR; Adriano P Crestal Bone Remodeling in Loaded and Unloaded Implants and the
Microgap: A Histologic Study Implant Dentistry:2003; 12(3)September :235-241.
10.Al-Sabbagh M. Implants in the esthetic zone. Dent Clin N Am 2006;50:391-407.
11.Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical consideration. Int J Oral Maxillofac Implants 2004; 19(suppl):43-61.
12.Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol. 2000 Apr;71(4):546-9.
13.Zetu L, Wang HL. Management of inter-dental/ inter-implant papilla. J Clin Periodontol 2005; 32:931-839.
病例(六)
1. Michael A. Brunsvold.: Review pathologic tooth migration. J Periodontol 2005;
76:859-866.
2. Martinez-Canut P, Carrasquer A, Magan R, Lorca A. A study on factors associated with pathologic tooth migration. J Clin Periodontol 1997; 24:492-497.
3. Pierre E. Gaumet, Michael I. Brunsvold, C. Alex McMahan. Spontaneous repositioning of pathologically migrated teeth. J Periodontol 1999; 70:1177-1184.
4.王兆祥 Konuskrone telescopic system 復文出版社 高雄2007; p27 & p120-122.
5.Derry A, Bertram U. A clinical survey of removable partial denture after 2 years usage. Acta. Odont. Scand. 1970;30:581-598.
6.Kabcenell JL. Effective clasping of removable partial dentures. J Prosthet Dent. 1962;12:104-110.
7.Akihiko Shiba. The concial double-crown telescopic removable periodontic prosthesis. Ishiyaku EuroAmerica, Inc. St Louis. Tokyo 1993; p5.
8.Bohannan HM, Abrams L. Intentional vital pulp extirpation in periodontal prosthesis. J Prosthet Dent.1961;11(4): 781-789.
病例(七)
1.Corah NL. Development of a dental anxiety scale.J Dent Res. 1969 Jul-Aug;48(4):596.
2.Froum SJ, Coran M, Thaller B, Kushner L, Scopp IW, Stahl SS. Periodontal healing following open debridement flap procedures. 1. Clinical assessment of soft and osseous repair. J Periodontol 1982 Jan; 53(1):8-14.
3.Heitz-Mayfield LJ, Trombelli L, Heitz F, Needleman I, Moles D. A systematic review of the effect of surgical debridement VS non- surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol 2002; 29 (suppl 3):92-102.
4.陳宏周 陳立亮 王傳啟 王兆祥 Konuskrone 之基本理論及製作 J. Formosan Dent Assoc 1989;12:413-426.
5.王兆祥 Konuskrone telescopic system 復文出版社 高雄2007; p53.
6.洪純正 蔡政文 王震乾 李惠娥 洪昭民 Konus 雙重冠系統的臨床運用( I )理論篇 J. Formosan Dent Assoc 1988; 11:359-365.
7.Akihiko Shiba. The concial double-crown telescopic removable periodontic prosthesis. Ishiyaku EuroAmerica, Inc. St Louis. Tokyo 1993; p8.
8.Kelly E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. J Prosthet Dent 1972; 27:140 -150.
9.Shen K, Gongloff RK. Prevalence of the combination syndrome among denture patients. J Prosthet Dent 1989; 62:642-644.
10.Lechner SK, Mammen A. Combination syndrome in relation to osseointegrated implant-supported overdenture: a survey. Int J Prosthodont 1996; 9(1):58-64.
11.Gupta S, Lechner SK, Duckmanton NA. Maxillary change under complete dentures opposing mandibular implant-supported fixed prostheses. Prosthodont 1999;12(6):492-497.
12.Lopez-Roldan A, Abad DS, Bertomeu IG, Castillo EG, Otaolaurruchi ES. Bone resorption processes in patients wearing overdentures. A 6-years retrospective study. J Clin Exp Dent 2009;1(1): e24-30.
13.Palmqvist S, Carlsson G E, Owall B. The combination syndrome: A literature review. J Prosthet Dent 2003; 90: 270-275.
14.Tolstunov L. Combination Syndrome Symptomatology and Treatment Compendium 2011; 32(3):62-66.
15.Tolstunov L. Combination Syndrome: Classification and case report. Journal of Oral Implantology 2007;18(3):139-151.
16.Gibbs CH, Mahan PE, Lundeen HC. Occlusal forces during chewing: Influences of biting strength and food consistency. J Prosthet Dent. 1981; 46:561-567.
17.蔡昆哲 等 心因性壓力對牙周病的影響 台灣牙周醫誌 2012; 17:199-215.
病例(八)
1.洪純正 蔡政文 王震乾 李惠娥 洪昭民 Konus 雙重冠系統的臨床運用( I )理論篇 J. Formosan Dent Assoc 1988; 11:359-365.
2.陳宏周 陳立亮 王傳啟 王兆祥 Konuskrone 之基本理論及製作 J. Formosan Dent Assoc 1989;12:413-426.
3. 王兆祥 Konuskrone telescopic system 2007 高雄復文圖書出版社
4. Kwon H-B. and Lee S-H. The comparison of initial retentive force in different double crown systems. J Korean Acad Prosthodont: 2006; 44 (6): 677-682.
5. Sato F. Koyama S. Chiba T. Kadowaki K. Kawata T. and Sasaki K. Changes in periodontal conditions of remaining teeth five years after RPD placement. Ann Jpn Prosthodont Soc. 2009; 1:130-138.
6. Yamamodo T. Kinoshita Y. Tsuneishi M. Takizawa H. Umemura O. and Watanabe T. Estimation of the remaining periodontal ligament from attachment-level measurements.
J Clin Periodontol 2006;33 :221-225.
7. Wang C-H., Lee H-E., Lan T-H., and Igarashi Y. : Method of retention control for
compromised periodontal bone support abutment of conical crown retained denture. Kaohsiung J med Sci 2010; 26(8): 435-443.
8. Igarashi Y. and Cata T., Ten-year follow-up study of conical crown - retained dentures. Int J Prothodont. 1997; 10(2): 149-155.
9. Widbom T. Widbom C. Soderfeldt B. and Kronstrom M. : Tooth-supported telescopic crown--retained dentures: An up to 9-year retrospective clinical follow-up study. Int J prothodont. 2004; 17(1): 29 -34.
10. Shimakura M., Nagata T., Takeuchi M., and Nemoto T. Retentive force of pure Titanium Konus telescope crowns fabricated using CAD/CAD system. Dental Materials Journal 2008; 27(2):211-215.
11. Sakai Y., Takahashi H., Iwasaki N., and Igarashi Y. Effects of surface roughness and tapered angle of cone crown telescopic system on retentive force. Dental Materials Journal 2011;30(5):635-641.
12. Bergman B.,Ericson A. and Molin M. Long-term clinical results after
treatment with conical crown - retained dentures. Int J Prothodont. 1996; 9:533-539.
13. Wenz HJ, Hertrampt K, and Lehmann KM. Clinical longevity of removable partial dentures retained by telescopic crowns: outcome of the double crown with clearance fit. Int J prothodont. 2001;14(3):207- 213.
14. Minagi S, Natsuaki N, Nishigawa G, and Sato T. New telescopic crown
design for removable partial dentures. J Prosthet Dent 1999; 81:684-688.
15. Gungor MA, Artunc C, Sonugelen M. Parameters affecting retentive force
of conus crowns. J Oral Rehabil. 2004; 31:271-277.
16. Osada Y, Oda S, Iida M, Taguchi S, Muraoka Y, Kowashi Y, Kinoshita S. Study on the root surface area corresponding with periodontal tissue reduction. Japanese Society of Periodontology 1982;24:293-298.
17. Nobuo Oda, A study on human dental surface area. 九州齒會誌1976; 30(4): 582-599.
18. Randow K, Glantz P-O, Zoger B. Technical failures and some related clinical complications inextensive fixed prosthodontics. An epidemiological study of long term clinical quality. Acta Odontol Scand 1986; 44:241-255.
病例(九)
1.謝典華 檳榔塊成分對人類口腔黏膜纖維化及癌化之影響 2003
高雄醫學大學牙醫學研究所博士論文
2.Lin WY, Chiu TY, Lee LT, Huang CY, Huang KC. Betel nut chewing is associated with increased risk of cardiovascular disease and all-cause mortality in Taiwanese men. Am J Clin Nutr 2008; 87:1204-11.
3.王敏瑩,洪雨棠,蔡菁穗 嚼食檳榔與牙周致病菌之關係及檳榔成分對牙周致病菌之影響 2002 行政院國家科學委員會補助專題研究計劃成果報告
4.de Miranda CM, van Wyk CW, van der Biji P, Basson NJ The effect of areca nut on salivary and selected oral microorganisms. Int Dent J. 1996 Aug;46(4):350-6.
5.Tseng YH, Chang KW, Liu CJ, Lin CY, Yang SC, Lin SC. Areca nut extract represses migration and differentiation while activating matrix metalloproteinase-9 of normal gingival epithelial cells. J Periodontal Res. 2008 Oct; 43(5):490-9.
6.Lu HH, Chen LK, Cheng CY, Hung SL, Lin SC, Chang KW. Areca nut extract-treated gingival fibroblasts modulate the invasiveness of polymorphonuclear leukocytes via the production of MMP-2. J Oral Pathol Med. 2009 Jan;38(1):79-86
7.Chang LY, Wan HC, Lai YL, Kuo YF, Liu TY, Chen YT, Hung SL Areca nut extracts increased expression of inflammatory cytokines, tumor necrosis factor-α, interleukin-1β, interleukin-6 and interleukin-8, in peripheral blood mononuclear cells. J Periodontal Res. 2009 Apr;44(2):175-83.
8.Chang YC, HuCC, Lii CK, Tai KW, Yang SH, Chou MY. Cytotoxicity and arecoline mechanism in human gingival fibroblasts in vitro. Clin Oral Investig 2001; 5(1):51-56.
9.Mullally BM. The influence of tobacco smoking on the onset of periodntitis in young persons. Tobacco induced diseases. 2004; 2(2):53-65.
10.Johnson GK. Tobacco use and periodontal patient. J Periodontol 1999; 70:1419-27.
11.Pejcic A, Obradovic R, Kesic L, Kojovic D. Somking and periodontal disease a review. Medicine and biology. 2007; 14(2):53-59.
12.Sham AS, Cheng LK, Jin LJ, Corbet EF. The effect of tobacco use on oral health. Hong Kong Med J. 2003; 9(4):271-277.
13.Chang YC, Hu CC, Tseng TH, Tai KW, Lii CK, Chou MY. Synergistic effects of nicotine on arecoline-induced cytotoxicity in human buccal mucosal fibroblasts. J Oral Pathol Med. 2001 Sep;30(8):458-64.
14.Chang YC, Lii CK, Tai KW, Chou MY. Adverse effects of arecoline and nicotine on human periodontal ligament fibroblasts in vitro. J Clin Periodontol. 2001 Mar;28(3):277-82.
15.J0hnson GK, Slach NA. Impact of tobacco use on periodontal status. J Dent Educ 2001; 65:313-321.
16.Lopez-Roldan A, Abad DS, Bertomeu IG, Castillo EG, Otaolaurruchi ES. Bone resorption processes in patients wearing overdentures. A 6-years retrospective study. J Clin Exp Dent 2009;1(1): e24-30.
17.王兆祥 Konuskrone Telescopic System 2007; 復文圖書出版社:103-106.
病例(十)
1.Pama-Benfenati S, Fugazzotto PA, Ferreira PM, Ruben MP, Kramer GM. The effect of restorative margins on the postsurgical development and nature of the periodontium. Part II. Anatomical considerations. Int J Periodontics Restorative Dent. 1986;6(1):64-75.
2.Becker CM, Kaldahl WB. Current theories of crown contour, margin placement, and pontic design. J Prosthet Dent. 1981 Mar;45(3):268-77
3.Kohal RJ, Gerds T, Strub JR.Effect of different crown contours on periodontal health in dogs. Clinical results. J Dent. 2003 Aug;31(6):407-13.
4.Kohal RJ, Pelz K, Strub JR. Effect of different crown contours on periodontal health in dogs. Microbiological results. J Dent. 2004 Feb;32(2):153-9.
5.Jonathan M. Broadbent, Karen B. Williams,W. Murray Thomson,and Sheila M. Williams. Dental restorations: a risk factor for periodontal attachment loss?J Clin Periodontol. 2006 November; 33(11): 803–810.
6.Goldman H, Cohen D, The infrabony pocket: classification and treatment, Journal of Periodontology, 1958;29: 272.
7.Bassi F, Mantecchini S, Carossa S, Preti G. Oral conditions andaptitude to receive implants in patients with removable partialdentures: A cross-sectional study. Part I. Oral conditions. J OralRehabil 1996;23:50–54.
8.Nyman S, Lindhe J. A longitudinal study of combined periodontal and prosthetic treatment of patients with advanced periodontal disease. J Periodontol 1979; 50: 163-169.
9.Nyman S, Ericsson I. The capacity of reduced periodontal tissues to support fixed bridgework. J Clin Periodontol. 1982 Sep;9(5):409-14.
10.Tadashi M. Study of facing in Knous-Telescoe Denture: Application of metal bonding porcelain. The Journal of the Japan Prosthodontic Society. 1988; 32(3): 561-76. (Abstract).
11.Akihiko Shiba. The conical double-crown telescopic removable periodontic prosthesis. Ishiyaku Euro America Inc. 1993; Chap 3; P40-55.
12.王兆祥 Konuskrone telescopic system 復文圖書出版社 2007; P:295.
綜合討論
1.Amsterdam M: Periodontal Prosthesis, Twenty-five years in retrospect. Alpha Omegan, Dec. 1974.
2.Amsterdam M, Weisgold AS. Periodontal Prosthesis: a 50-year perspective. Alpha Omegan 2000;93:23-30.
3.Nyman S, Erisson I. The capacity of reduced periodontal tissues to support fixed bridgework. J Clin Periodontol 1982;9(5) : 409-414.
4.Yi SW, Carlsson GE, Ericsson I, Wennstrom JL. Long-term follow-up of cross-arch fixed partial dentures in patients with advanced periodontal destruction: evaluation of occlusion and subjective function. J Oral Rehabil. 1996;23(3):186-96.
5.Yi SW, Carlsson GE, Ericsson I. Prospective 3-year study of cross-arch fixed partial dentures in patients with advanced periodontal disease. J Prosthet Dent. 2001;86(5): 489-94.
6.Kourkouta S, Hemmings KW, Laurell L. Restoration of periodontally compromised dentitions using cross-arch bridges. Principles of perio-prosthetic patient management.
7.Laurell L, Lundgren D, Falk H, Hugoson A. Long term prognosis of extensive polyunit cantilevered fixed partial dentures. J Prosthetic Dent. 1991; 18:390-395.
8.Starr NL. Treatment planning and treatment sequencing with and without endosseous implants: A comprehensive therapeutic approach to the partially edentulous patient. Seattle Study Club Journal l995;1:1,21-34.
9.Beikler T, Flemmig TF. Implant versus tooth retention from the periodontal perspective. Perio 2006; 3(3):167-176.
10.Konig J, Plagmann HC, Ruhling A, Kocher T. Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis. J Clin Periodontol. 2002 Dec;29(12):1092-100.
11.Ruhling A. Treatment strategies in the case of advanced attachment loss. Part 2: Extraction of critical teeth and dental restoration on movable abutments. Perio 2004; 1(3):213-225.
12.Wennstrom JL, Ekestubbe A, Grondahl K, Karlsson S, Lindhe J. Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects. A 5-year prospective study. J Clin Periodontol 2004;31(9):713-724.
13.Al-Zahrani MS. Implant therapy in aggressive periodontitis patients: a systemic review and clinical implication. Quintessence Int 2008; 39(3):211-215.
14.Liu CH. The impact of osseointegrated implants as an adjunct and alterative to conventional periodontal prosthesis. Compendium 2005; 25(9):653-663.
15.Nyman S, Lindhe J. A longitudinal study of combined periodontal and prosthetic treatment of patients with advanced periodontal disease. J periodontal 1979; 50: 163-169.
16.Danser MM, van Winkelhoff AJ, van der Velden U. Periodontal bacteria colonizing oral mucous membranes in edentulous patients wearing dental implants. J Periodontol. 1997;68(3):209–216.
17.Karoussis KI, Salvi GE, Heritz-Mayfield LJA, Hammerle CHF, Lang NP. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI dental implant system. Clin. Oral Impl. Res. 2003;14:329-339.
18.Schou S. Implant treatment in periodontitis-susceptible patients : a systemic review. J Oral Rehabil. 2008; 35 suppl(1):9-22.
19.Schou S, Holmstrup P, Worthington HV, Esposito M. Outcome of implant therapy in patients with previous tooth loss due to periodontitis. Clin Oral Implants Res 2006; 17 suppl2:104-123.
20.Mengel R, Behle M, Flores-de-Jacoby L. Osseointegrated implants in subjects treated for generalized aggressive periodontitis: 10-year result of a prospective, long-term cohort study. J Periodontol 2007; 78(12)229-237.
21.Papaspyridakos P, Chen CJ, Chuang SK, Weber HP, Gallucci GO. A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants. 2012 Jan-Feb;27(1):102-10.
22.Zurdo J, Romao C, Wennstrom JL. Survival and complication rates of implant-supported fixed partial dentures with cantilevers: a systematic review. Clin Oral Implants Res. 2009 Sep;20 Suppl 4:59-66.
23.Behr M, Hofmann E, Rosentritt M, Lang R, Handel G. Technical failure rates of double crown-retained removable partial dentures. Clin Oral Invest 2000; 4:87-90.
24.Salama H, Garber DA, Salama MA, Adar P, Rosenberg ES. Fifty years of interdisciplinary site development: lessons and guidelines from periodontal prosthesis. J Esthet Dent 1998;10(3):149-156.
25.Considerations about periodontal prosthesis. Salusvita Bauru. 2002;21(3): 137-143.





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