王金莹　郝俊祥　高志强　刘玉霞

[摘要]目的：探討口腔不良修复体的成因及二次修复。方法：选取2019年3月-2020年3月笔者医院修复科收治的110例口腔不良修复体患者为研究对象。对不良修复体患者进行检查，分析不良修复体类型、成因及并发症发生情况，对不良修复体进行微创拆除和二次修复。结果：110例不良修复体中，结扎捆绑类25例、金属烤瓷失败类23例、钢丝卡环类21例、卡环活动类17例、锤造冠类15例、桩冠类9例，不良修复体成因包括违反修复体原则57例、设计不当26例、选材不当21例、制作工艺不佳19例、基牙制备不准确8例、其他10例。不良修复体并发症包括基牙疼痛73例、牙龈炎症71例、基牙松动47例、牙齿龋坏34例、口腔异味29例、恶变4例。结论：不良修复体可引起多种并发症的发生，对患者的口腔健康造成不同程度的损害，影响牙齿的日常功能及外貌美观。临床上应及时拆除不良修复体，并进行二次修复，从而维持牙周组织的健康。

[关键词]口腔不良修复体;成因;二次修复;微创拆除

[中图分类号]R783    [文献标志码]A    [文章编号]1008-6455（2021）09-0137-03

Analysis of the Causes of Oral Bad Prosthesis and Secondary Repair

WANG Jin-ying1，HAO Jun-xiang2，GAO Zhi-qiang1，LIU Yu-xia1

（1. Department of Restoration; 2. Department of Endodontics，Peking Union Medical College Hospital，Tangshan City，Tangshan 063000，Hebei，China）

Abstract： Objective  To explore the causes of the oral bad prosthesis and secondary repair. Methods  Total of 110 patients with oral bad prosthesis admitted to our hospital's prosthetics department from March 2019 to March 2020 were selected. Examine the patients with oral bad prosthesis， the types of oral bad prosthesis， the causes of the oral bad prosthesis and the occurrence of complications were analyzed， and carry out the minimally invasive removal and secondary repair of the patients with oral bad prosthesis. Results  Among the 110 cases of oral bad prosthesis， 25 cases were ligated and bundled， 23 cases were metal ceramic failures， 21 cases were steel wire clasp， 17 cases were clasp activities， 15 cases were hammer crowns， and 9 cases were pile crowns. The causes of oral bad prosthesis included 57 cases of violation of the restoration principle， 26 cases of improper design， 21 cases of improper material selection， 19 cases of poor manufacturing technology， 8 cases of inaccurate preparation of abutment teeth， and 10 cases others. The complications of oral bad prosthesis included 73 cases of abutment pain， 71 cases of gingival inflammation， 47 cases of abutment loosening， 34 cases of dental caries， 29 cases of oral peculiar smell， and 4 cases of malignant transformation. Conclusion Oral bad prosthesis can cause a variety of complications， causing varying degrees of damage to the patient's oral health， and affecting the daily function and appearance of the teeth. Clinically， in order to maintain the health of periodontal tissue， the oral bad prosthesis should be removed in time and the secondary repair should be performed.

Key words：oral bad prosthesis; causes; secondary repair; minimally invasive removal

牙齿作为口腔的重要部分，具有咀嚼、咬合及发音等重要功能，且是衡量外貌美观的关键标志之一[1]。在日常生活中，人们往往会出现牙体牙列缺损、牙扭转等问题，对外貌美观及日常功能造成影响，并降低患者自信心[2]。随着人们对牙齿的美学需求日益增长，牙齿修复越来越受到人们的重视。牙齿修复治疗是利用人工制作的装备对缺损牙齿进行一系列的修复操作，使患者的牙齿达到正常水平。……