薛强 唐丽琴 柳麟翔
[摘要]目的:观察标准化操作流程应用于美学修复的临床效果。方法:对门诊行美学修复的37例患者,106颗修复体采用标准化的修复操作流程制做,记录患者修复体验满意度,医生对每一例修复体戴牙时间,参照改良美国公共卫生署标准评价戴牙当天、术后6个月及12个月的临床效果。结果:患者就诊体验满意度(9.7±0.3)分,医师戴牙平均时间(4.7±0.5)min;戴牙当天3例(2.9%)修复体颜色略微不匹配,主要集中于后牙区,患者接受。修复12个月后,1颗(1.1%)修复体出现崩瓷,拆除重新制做,1颗(1.1%)修复体边缘适合性欠佳,4颗(4.4%)修复体牙龈轻度充血红肿,给予局部治疗。总体修复体效果良好稳定。结论:固定义齿修复中,应用标准化的操作流程能获得较高的患者满意度及良好的临床效果。
[关键词] 标准化;操作流程;前牙;美学修复;临床效果
[中图分类号]R783.4 [文献标志码]A [文章编号]1008-6455(2018)09-0091-03
The Clinical Effects of the Application of Standardized Operating Procedure in Anterior Teeth Aesthetic Restoration
XUE Qiang1,TANG Li-qin1,LIU Lin-xiang2
(1.Department of Prosthodontics;2.Department of Oral Planting,Wuxi Stomatology Hospital,Wuxi 214000,Jiangsu, China)
Abstract: Objective To evaluate the clinical effects of the application of standardized operating procedure in aesthetic restoration. Methods A standardized prothetic operating procedure was applied to 37 patients and 106 fixed restorations in clinic. The satisfaction of the patients and the time that doctors used to cement the restorations were recorded. The clinical effects were evaluated by the improved U.S. Public Health Sevice standards on the day and 6-months,12-months after the operation. Results After the repairing,patients satisfaction achieved (9.7±0.3) points, and the average time for doctors to wear the restorations was (4.7±0.5) minutes. On the day of the operation,3 cases (2.9%) appeared a slight mismatch in color,mainly concentrated on the posterior region,and the patients accepted.12-Months after the operation,1 case (1.1%) turned a cracked porcelain and the restoration was teared down to make a new one,1 case (1.1%) showed a poor rim of the restoration,4 cases (4.4%) appeared mild congestion and swelling in gingiva and a topical treatment was used.The general effects of the restorations are positive and stable. Conclusion The application of standardized operating procedure in fixed restoration can obtain higher satisfaction of patients and positive clinical effects.
Key words: standardized; operating procedure; anterior teeth; aesthetic restoration; clinical effects
随着物质生活水平及科学理念的提升,人们对口腔修复的要求已不仅仅局限于传统的功能与美学修复。而是对整个治疗程序提出了更加科学、更加精准的要求。美学修复作为日常门诊中最为常见的诊疗项目,从术前诊断蜡型的制做,术中导板指导下的牙体预备,到面弓转移及全可调咬牙合架的应用,使得义齿修复具备了一定的标准化临床操作流程。连续多牙的美学-固定义齿修复,由于其较高的牙体预备及精准的咬合要求,长期以来一直是临床修复的难点。本实验将上述标准化流程应用于临床操作,在“科学、精准”的基础上,大大降低了义齿修复难度,提高了临床工作效率。
1 材料和方法
1.1 一般资料:选择2015年1月-2017年12月于无锡口腔医院修复科就诊的37例患者,共106颗患牙。其中男9例,女28例,年龄19~54岁。所修复的患牙包括釉质发育不良、四环素牙、龋齿、牙体缺损,过小牙,牙间隙,咬合接触不良等。选择病例均无明显颞下关节疾患,基牙无松动,牙周狀况稳定,口腔卫生状况良好。