应力中断义齿基托对游离端基牙牙周状况影响临床观察.docVIP

应力中断义齿基托对游离端基牙牙周状况影响临床观察 　　[摘要]目的：研究应力应力中断义齿基托对游离端基牙牙周状况的影响。方法：对64例肯氏Ⅱ类患者随机分成两组行可摘局部义齿修复，其中一组进行常规钴铬支架修复，另一组进行维他灵应力中断义齿基托修复，3、6、12个月复查并记录基牙及对侧同名牙菌斑指数，牙龈指数，牙龈出血指数，探针深度，牙齿松动度等指标。结果：活动义齿修复后，患者基牙的4项指标均明显升高，牙齿松动度刚开始无明显变化，随着义齿使用时间的延长，常规钴铬支架组基牙松动度明显高于应力中断组。结论：戴用活动义齿后基牙牙周指数增加，应力中断式基托对基牙松动度影响小，有利于基牙牙周健康。 　　[关键词]可摘局部义齿；维他灵；应力中断；牙周 　　[中图分类号]R783 [文献标志码]A [文章编号]1008-6455（2015）15-063-03 　　Abstract： Objective To study the influence of stress interrupts denture base on the situation of free end abutment periodontal statuses. Methods Conducted removable partial dentures on 48 kennedyⅡpatients who were randomly divided into two groups.One group underwent regular Cobalt chromium stent repair，and the other group underwent Vitallium stress interrupts denture base. Four indices of abutments and the contralateral same name teeth，including plaque index （PLI），gingival index （GI），bleeding index （BI），probing depth （PD） were reviewed and recorded after 3 months，6 months and 18 months. Results The periodontal indices of the abutments of the patients wearing removable partial dentures were significantly higher than those of the contralateral same name teeth.Tooth mobility was no significant change beginning with the extension of denture use of time， conventional cobalt chromium stent group was significantly higher than the base tooth mobility stress interruption group. Conclusion Abutments periodontal index is increased after wearing a removable denture.Stress interrupts denture base small degree of influence in favor of abutment periodontal. 　　Key words：removable partial denture；Vitallium；stress interrupt；periodontal status 　　肯氏Ⅰ和Ⅱ类是牙列缺损的常见类型，据目前国内最新调查表明，肯氏Ⅱ类牙列缺损占所有牙列缺损类型的比例高达37%，数量较大，但同时也是活动义齿修复中难度较大的类型之一。铸造可摘局部义齿仍是目前游离端缺损的主要修复方式之一，由于缺失牙远中没有任何基牙，义齿支持主要为天然牙和黏膜共同承担的混合支持形式。由于天然牙和黏膜间组织的可让性不同，受力不均衡引起基牙和支持组织的损伤，严重者会引起基牙的松动，进而影响义齿咀嚼、固位功能等功能，从而影响义齿近远期修复效果，一直以来都是修复科医师关注和研究的临床热点之一[1-2]。 　　游离端缺失修复设计，传统的修复方法多为钴铬合金刚性整体铸造，整体铸造支架是刚性的整体结构，不容许发生形变，其不可让性容易导致应力集中。虽然是基牙和黏膜共同承担咀嚼力，但由于二者结构和可让性的不同，使得受力不均衡而引起