-第四章-牙列缺损的固定义齿修复课件.ppt

1、牙列缺损是指牙列中的部分牙齿缺失牙列缺损是指牙列中的部分牙齿缺失(Dental arch deficiency:Dental(Dental arch deficiency:Dental arch with some teeth missing)arch with some teeth missing)tooth defaultDental arch missing 龋病、根尖周病、牙周病、外伤、龋病、根尖周病、牙周病、外伤、颌骨疾病、发育障碍等。颌骨疾病、发育障碍等。(Caries(Caries、Apical disease Apical disease、PeriodonticalPeriod

2、ontical disease disease、Trauma Trauma、Maxillary and Maxillary and Mandibular disease Mandibular disease、AnodontiaAnodontia etc.)etc.)CariesApical diseaseApical diseasePeriodonticalPeriodontical disease disease、TraumaTraumaAnodontiaAnodontiaTooth position and alignment are maintained,in part,by inter

3、action between teeth(arrows).When a tooth is removed,adjacent teeth often migrate into the vacated space.If a fixed partial denture is fabricated without first re-establishing the occlusal plane,an occlusal interference may be created(arrow).Occlusion is properly restored by correction of the occlus

4、al plane in conjunction with placement of a fixed partial denture.1 1固定义齿固定义齿（fixed partial denturefixed partial denture）利用缺牙间隙两端或一端的天然牙为支持，利用缺牙间隙两端或一端的天然牙为支持，通过其上的固位体将义齿粘固于基牙上，患通过其上的固位体将义齿粘固于基牙上，患者不能自行摘戴。者不能自行摘戴。(retainer connect with(retainer connect with ponticpontic and fixed to abutment)and fix

5、ed to abutment)因其结构类似工程桥梁结构，故又称固定因其结构类似工程桥梁结构，故又称固定桥桥（fixed bridgefixed bridge）。fixed partial denturefixed partial denture 2 2可摘局部义齿可摘局部义齿removable partial denture removable partial denture 3 3固定活动联合修复体固定活动联合修复体 （fixed-removable partial denturefixed-removable partial denture）4 4种植义齿种植义齿 (ImplantalIm

6、plantal partial denturepartial denture)1 1义齿所受的合力通过基牙全部传义齿所受的合力通过基牙全部传导至牙周支持组织，其传导方式类导至牙周支持组织，其传导方式类似天然牙。似天然牙。（occlusal force-abutment-occlusal force-abutment-periodontal tissueperiodontal tissue）2 2义齿咀嚼效率高。义齿咀嚼效率高。(efficiency mastication)(efficiency mastication)3 3义齿舒适、无异物感。义齿舒适、无异物感。(comfortable.n

7、oneyewinker(comfortable.noneyewinker)（1）固位作用好（good retention）（2）支持作用好（good sustenance）（3）稳定作用好（good stability）（4）义齿舒适、无异物感。(comfortable.noneyewinker)（5）l（1）牙体切割少（）牙体切割少（less cut dental tissue）l（2）制作简单，容易修改（）制作简单，容易修改（easy to fabricate and amend）l（3）容易清洁（）容易清洁（easy to clean）由固位体、桥体、连接体三部分由固位体、桥体、连接体三

8、部分组成，它支持和固定在基牙上形成一组成，它支持和固定在基牙上形成一个整体行使功能。个整体行使功能。(retainer、pontic、connector、abutmentabutment)The components of a fixed partial denture.（一）固位体（一）固位体（retainerretainer）是在基牙上制作全冠是在基牙上制作全冠(full crown)(full crown)、部分冠、部分冠(partial crown)(partial crown)、桩冠、桩冠(post crown)(post crown)、嵌体、嵌体(inlay or onlay(in

9、lay or onlay)等。与桥体等。与桥体(pontic(pontic)相连。相连。（二）桥体（二）桥体（ponticpontic）即人工牙，是固定义齿修复缺失即人工牙，是固定义齿修复缺失牙的形态和功能的部分。牙的形态和功能的部分。连接桥体连接桥体(pontic(pontic)与固位体与固位体(retainer)(retainer)的部分称为连接体。的部分称为连接体。用焊接用焊接(soldering)(soldering)或整体铸造或整体铸造法法(casting)(casting)形成的连接体。固位形成的连接体。固位体和桥体之间不能活动。体和桥体之间不能活动。固位体固位体(retainer

10、)(retainer)和桥体和桥体(pontic(pontic)之间通过一种栓道之间通过一种栓道(attachment)(attachment)或关或关节节(joint)(joint)相连，形成一可活动相连，形成一可活动（non-rigid)的连接体的连接体(connector)(connector)。l双端固定桥双端固定桥（rigidly fixed bridgerigidly fixed bridge）（完全固定桥完全固定桥 complete fixed bridgecomplete fixed bridge；fixed-fixed bridgefixed-fixed bridge）l半固

11、定桥半固定桥（semi-fixed bridgesemi-fixed bridge）（应力中断式桥应力中断式桥 broken-stress fixed bridgebroken-stress fixed bridge）l单端固定桥单端固定桥（free-end fixed bridgefree-end fixed bridge）（悬臂固定桥悬臂固定桥 cantilever bridgecantilever bridge）l复合固定桥复合固定桥（compound fixed bridgecompound fixed bridge）l种植固定桥种植固定桥（implant fixed bridgeim

12、plant fixed bridge）l固定可摘联合固定桥固定可摘联合固定桥 （fixed-removable combined bridgefixed-removable combined bridge）l粘结固定桥粘结固定桥（adhesive fixed bridgeadhesive fixed bridge）第三节第三节 固定义齿的适应证固定义齿的适应证(Indications)l1.缺牙的数目缺牙的数目(Number of teeth missing)l2.缺牙的部位缺牙的部位(Area of teeth missing)l3.基牙的条件基牙的条件(Condition of abutm

13、ent teeth)The optimum crown-root ratio for a fixed partial denture abutment is 2:3(A).A ratio of 1:1(B)is the minimum that is acceptable.Although the root surface area of these teeth is similar,the root configuration of the maxillary premolar(A),with its greater faciolingual dimension,makes it a sup

14、erior abutment to the maxillary central incisor(B),whose root is essentially circular in cross section.The molar with divergent roots(A)will be a better abutment tooth than one whose roots are fused(B).Comparative root surface areas of maxillary teeth.The figure in parentheses above each tooth is th

15、e ratio between the root surface area of the respective tooth and the root surface area of the smallest tooth in the arch,the lateral incisor(based on data by Jepsen).Comparative root surface areas of mandibular teeth.The figure in parentheses above each tooth is the ratio between the root surface a

16、rea of the respective tooth and the root surface area of the smallest tooth in the arch,the central incisor(based on data by Jepsen).第三节第三节 固定义齿的适应证固定义齿的适应证(Indications)l4.咬合关系咬合关系(Occlussion)l5.缺牙区牙槽嵴的条件缺牙区牙槽嵴的条件(Condition of edentulous alveolar ridge)l6.年龄年龄(Age)l7.口腔卫生情况口腔卫生情况(Oral hygiene)l8.余留牙的情况余留牙的情况(Condition of the maintained teeth)第三节第三节 固定义齿的适应证固定义齿的适应证(Indications)l9.患者的要求和口腔条件的一致性患者的要求和口腔条件的一致性（consistency of patients demand and oral condition）l10.适应症的掌握（适应症的掌握（indication mastery）