熊世龙

【摘要】 目的：探讨伴有牙列缺失的老年牙齿重度磨耗者采用烤瓷和活动义齿联合修复的效果。方法：选取68例2013年4月-2014年4月笔者所在医院接收的伴牙列缺失的老年牙齿重度磨耗患者，修复方式均为烤瓷联合活动义齿，观察临床效果。结果：修复后，患者美观满意度、咀嚼有力、舒适度均显著优于修复前，且食物嵌塞及牙齿敏感均显著改善，差异有统计学意义（P<0.05）；与修复前相比，修复后3个月患者咀嚼效率显著提高，Helkimo评分显著下降，差异均有统计学意义（P<0.05）；本组68例患者，其中有效15例，无效3例，显效50例，临床有效率为95.6%。结论：伴有牙列缺失的老年牙齿重度磨耗者采用烤瓷和活动义齿联合修复效果显著，具有推广价值。

【关键词】 牙列缺失； 牙齿重度磨耗； 活动义齿； 烤瓷

doi：10.14033/j.cnki.cfmr.2017.17.065 文献标识码 B 文章编号 1674-6805（2017）17-0125-03

Effect of Porcelain Combined with Removable Denture on the Restoration of Severe Tooth Wear and Tooth Loss in the Elderly/XIONG Shi-long.//Chinese and Foreign Medical Research，2017，15（17）：125-127

【Abstract】 Objective：To study the effect of combined repair of porcelain and active denture in elderly patients with severe tooth wear associated with dentition loss.Method：Sixty eight patients with severe tooth wear were collected from April 2013 to April 2014.The repairing methods were porcelain joint removable dentures，and the clinical effect was observed.Result：After the repair，the satisfaction rate，chewiness and comfort were significantly better than those before repair，and the food impaction and tooth sensitivity were significantly improved（P<0.05）；compared with before repair，3 months after repair，masticatory efficiency was significantly increased，Helkimo score decreased significantly（P<0.05）.In 68 cases，the effective was 15 cases，the failure was 3 cases，the example was 50 cases，the rate of clinical effect was 95.6%.Conclusion：The combined effect of porcelain and active denture is significant and valuable in the elderly patients with severe tooth wear.

【Key words】 Missing dentition； Severe tooth wear； Removable denture； Porcelain

First-authors address：Yuancheng District Peoples Hospital of Heyuan City，Heyuan 517000，China

研究顯示，老年人的牙列磨耗率达100%，而重度磨耗占1/3以上。此外牙齿重度磨耗者常伴有牙列缺损，此类患者常表现为咀嚼效率低下、咀嚼肌肉疼痛不适、食物嵌塞等，且伴有面下1/3过短，影响美观[1]。本文通过资料回顾性分析、探讨伴有牙列缺失的老年牙齿重度磨耗者采用烤瓷和活动义齿联合修复的效果，现作以下报道。

1 资料与方法

1.1 一般资料

选取68例2013年4月-2014年4月笔者所在医院接收的伴牙列缺失的老年牙齿重度磨耗患者为研究对象。入选者中，女30例，男38例，年龄62～78岁，平均（68.50±3.63）岁。纳入标准：患牙合面和切缘釉质丧失；连续缺牙数≤2颗，牙列缺失为单侧非游离端缺失；龋病易感性相对较低；无进行性牙周疾病。

1.2 方法

修复前对患者颞颌关节和口腔健康状况进行检查，对牙体缺损者进行充填，必要时行牙髓治疗，对口腔卫生状况较差者进行牙周洁治。对牙冠过短的固定修复者行龈切术。同时加强口腔卫生宣教。修复过程：确定最适颌位，制作过渡塑料可摘局部义齿，指导患者佩戴3～6个月，观察升高的高度是否合适，如患者不能接受，及时调改，直至患者感觉咀嚼有力、舒适时，以此作为最适颌位。……