下颌远中游离缺失局部义齿制作的改良方法：临床病例报告

口腔医师通常采用模型修正印模法制作游离端局部义齿。模型修正印模法的优点在于其能够使软硬组织均匀受压．减少基牙所受压力。临床医师对于该方法及基牙、软组织的处理还存在争议。本文介绍了一种游离端局部义齿制作的改良方法．该方法只需要进行一步法印模．然后在模型上制作义齿,最后在技工室完成义齿的功能性重衬。进行功能性重衬能够提高基托与余留牙槽嵴的适合性，获得稳定良好、边缘伸展充分的义齿。本法不仅操作简单、技术敏感性低，而且提高了患者舒适度，减少了义齿的调改次数。     

数字印模在牙支持式可摘局部义齿修复中的应用

目的:运用口内扫描技术获取患者口腔软硬组织形态,并生成数字化模型,结合CAD/CAM技术完成牙支持式可摘局部义齿修复体制作,并对其临床应用效果进行观察和评价.方法:实验组使用3shape口腔数字印模仪扫描患者口腔软硬组织形态、咬合关系生成数字化模型,并创建3OXZ格式文件.将其导入计算机辅助设计软件中,虚拟设计可摘局部义齿支架,运用3D打印技术制作支架树脂熔模、树脂工作模型.完成可摘局部义齿30件.对照组运用传统技术取模、制作完成可摘局部义齿30件,评估两组修复体与口腔软硬组织的适合性.结果:检查修复体的适合性,根据义齿的密合度、稳定性、固位力以及咬合关系的恢复情况等方面进行评分,经卡方检验实验组与对照组无显著性差异,P=0.112.轻压义齿顺利就位方面实验组比对照组表现出更多优势.结论:口内直接数字印模结合CAD/CAM设计制作的牙支持可摘局部义齿完全能满足临床要求.     

模型置换印模技术修复下颌游离端牙列缺损的临床研究

目的：探讨模型置换印模技术对双侧下颌游离端缺牙患者的修复效果。方法：在解剖式印模上常规制作铸造支架,在铸造支架上制作自凝暂时基板,经口内肌功能修整并制取咬合记录后于口内取功能性印模。经模型置换后常规完成义齿。结果：90.2%的患者用模型置换印模技术制作的义齿疗效良好。结论：模型置换印模作为游离端可摘部分义齿的重要功能印模方法,可以有效改善义齿修复质量。     

游离端义齿的压力分布

取口腔支持组织和固位解剖结构印模所采用的方法。对可摘局部义齿,特别是下颌游离端义齿获得良好的压力分布是十分重要的。作者分析了功能性印模、一次性印模、基托重垫法,粘膜静态技术及应力中断设计等方法的优缺点。提出为使游离端义齿得到合理的负荷分布,必须满足以下3个条件:①基托的组织面,必须与静态牙槽嵴粘膜的表     

不同印模法对KennedyⅡ类牙列缺损修复时牙槽骨吸收的影响

目的：运用锥形束CT（cone beam CT,CBCT）评价解剖性印模法和功能性印模法修复下颌KennedyⅡ类牙列缺损患者牙槽骨吸收情况。方法选择下颌KennedyⅡ类牙列缺损患者16例,随机分为功能组和解剖组,每组8例。功能组采用功能性印模,解剖组采用解剖性印模。戴义齿前、正常使用义齿6个月后用CBCT分别测量末端基牙近中、远中牙槽骨及远中游离端剩余牙槽骨骨高度,并计算戴牙前、后的高度差值。结果正常使用义齿6个月后,解剖组末端基牙近中（t=0.742,P＜0.05）、远中牙槽骨高度差值（t=5.727,P＜0.05）明显高于功能组;功能组和解剖组的游离端剩余牙槽骨高度差值差异无统计学意义（P＞0.05）。结论应用功能性印模制作的可摘局部义齿有减少末端基牙近远中牙槽骨骨吸收的趋势,短期内对游离端剩余牙槽骨骨吸收影响不明显。     

牙列游离端缺损可摘局部义齿数字化制作流程初探

探讨牙列游离端缺失可摘局部义齿的数字化制作流程。选择2021年11月至2022年12月于第四军医大学口腔医学院口腔修复科就诊的牙列游离端缺损患者12例, 男性7例, 女性5例, 年龄(59±3)岁。采用口内扫描技术获取牙列、牙槽嵴及颌位关系的三维模型, 常规设计制作并试戴可摘局部义齿金属支架。金属支架就位于口内, 再次口内扫描获取牙列、牙槽嵴及金属支架的复合模型, 采用虚拟模型置换游离端牙槽嵴数字化印模的方法获取游离端修正模型。在游离端修正模型上设计栓体栓道式树脂基托及人工牙列三维模型, 并采用数字化切削技术制作基托及人工牙列树脂模型, 利用栓体栓道精准就位基托及人工牙列, 并用注塑树脂粘合金属支架、树脂基托及人工牙列, 打磨抛光后完成可摘局部义齿的制作。临床试戴后与设计数据对比, 结果显示在人工牙列、树脂基托与就位栓体连接杆的连接处以及人工牙列与树脂基托连接处存在0.4～1.0mm的误差, 面误差为0.03～0.10mm。12例患者戴用义齿后, 仅2例患者因压痛而复诊调磨, 其余病例未见任何不适。本项研究使用的可摘局部义齿数字化制作流程可基本解决游离端修正模型的数字化制取以及树脂基托...     

游离端义齿的生物力学研究

单侧、双侧游离端缺失是口腔临床修复的难点,不合理的设计不仅不能够恢复良好的咬合功能,还会对口腔硬软组织造成创伤。随着近年生物力学的发展,游离端义齿的研究已深入到生物力学领域。本文将国内外有关修复游离端缺失的可摘义齿、固定可摘联合义齿的生物力学研究结果进行综述,为临床游离端义齿的设计、制作提供一定参考。     

隐形义齿与铸造支架义齿修复单侧磨牙缺失的体会

目的　观察隐形义齿与铸造支架可摘局部义齿修复单侧磨牙缺失的临床效果。方法　单侧磨牙缺失患者90例,随机分为2组,将采用隐形义齿组45例列为治疗组,将采用铸造支架式可摘局部义齿45例列为对照组。对其固位不良、食物嵌塞、基牙和软组织疼痛发生情况进行比较。结果　治疗组固位不良1例,食物嵌塞0例,基牙和软组织疼痛3例。对照组固位不良6例,食物嵌塞5例,基牙和软组织疼痛1例。结论　隐形义齿修复单侧磨牙缺失临床效果优于铸造支架式可摘局部义齿。     

游离端可摘局部义齿修复的印模技术

游离端缺失可摘局部义齿修复的印模技术有其特殊性，并对义齿功能的发挥起着重要的作用。本文对于游离端缺牙的特点和存在的问题进行了分析，结合近年来的进展对于功能重衬法、模型置换印模技术、双重印模法以及选择性压力印模法逐一进行了介绍，分析了各种不同的印模法的优缺点和适应范围。     

纯钛铸造支架可摘局部义齿在肯氏I类牙列缺损修复中的临床应用

目的：观察纯钛支架可摘局部义齿用于修复双侧牙列游离端缺损后的临床效果。方法：选择58例肯氏I类缺牙患者，用DENTAURUMTD2材料进行铸造支架可摘局部义齿修复，随访1-5年，对基牙状况、义齿使用情况等进行观察。结果：纯钛支架可摘局部义齿质量轻，异物感小，义齿配戴舒适，固位力持久，咀嚼功能恢复良好，无异味、无口腔黏膜过敏症状。结论：纯钛支架可摘局部义齿适用于肯氏I类缺牙的修复治疗，获得了良好的临床效果。     

数字化技术在可摘局部义齿基牙全瓷冠崩瓷后再修复中的应用1例

数字化技术有助于提升可摘义齿基牙再修复的精准性及简便性,避免患者重行可摘义齿修复或利用旧活动义齿行手工堆塑基牙冠形态造成的误差,报告1例数字化技术在可摘局部义齿基牙全瓷冠崩瓷后再修复中的应用,取得了满意的治疗效果。     

可摘局部义齿修复效果的调查

目的：研究可摘局部义齿的治疗结果并探讨与患者满意度有关的因素。方法：通过患者满意度的调查和临床检查，对63例戴可摘局部义齿5年以上的患者的治疗效果进行评价。结果：70％以上的患者对可摘局部义齿满意，约1／5的义齿需要修理，约1／3的修复体与基牙的龋患有关。结论：绝大多数患者戴可摘局部义齿5年后仍可使用修复体。     

The altered cast impression technique revisited

BACKGROUND: The altered cast impression technique of fabricating removable partial dentures, originally described more than 60 years ago, improves the residual-ridge-to-dentition relationship of the prosthesis. This potentially increases patient satisfaction while preserving the remaining supporting structures. LITERATURE REVIEWED: This article reviews research that evaluated abutment tooth movement as a result of the relationship of the denture base to the residual ridge, revealing that improved fit reduced tooth movement. Load distribution studies have shown that a well-fitting denture base distributes stresses favorably to the supporting bone and abutment teeth. Other studies showing that increased residual ridge coverage coupled with a well-fitting denture base reduces stress per unit area, potentially preserving the remaining supporting structures. CASE DESCRIPTION: The article describes a patient who had a unilateral distal extension removable partial denture that was fabricated after the failure of a 20-year-old partial denture due to extensive dental decay. The prosthesis was fabricated over the course of four appointments, and the prosthesis was delivered on the fifth appointment. The patient, who wears the prosthesis daily, expressed comfort and ease of use at a one-year recall examination. CLINICAL IMPLICATIONS: Distal extension edentulism can affect a patient's ability to function as a dentate person. A well-made removable partial denture that has appropriate extensions, borders and ridge-to-dentition relationship will benefit the partially edentulous patient by providing increased comfort and improved dental function.     

A clinical study of the periodontal status of abutment teeth supporting swinglock removable partial dentures—A pilot study

Eleven patients wearing mandibular swinglock bilateral distal extension removable partial dentures opposing maxillary complete dentures were studied for a period up to 2 years. They had moderate to advanced periodontal disease with retrograde mobility patterns. Periodontal therapy, as well as treatment of dental carious lesions, was completed before fabrication of the prosthesis. Recordings of the gingival status, pocket depth, plaque score, tooth mobility, and dental caries were made at the time of the placement of the prosthesis and thereafter at 6-month intervals. Final results were obtained at the end of 2 years in six patients (group A) and at 1/12 years in five patients (group B).Our findings show that both groups had a statistically significant increase in gingival inflammation. However, no differences in degree of inflammation were observed between the two groups with regard to the status of gingival tissues that were covered and uncovered by the components of the swinglock removable partial denture. Also, no statistically significant differences in pocket depths and plaque scores were found between the time of placement of the swinglock removable partial denture and the final recall visit. Of the 61 abutment teeth, 85.2% had no significant change in mobility, 11.5% showed a substantial decrease in mobility, and 3.3% showed a considerable increase in mobility.The patients were able to successfully wear the swinglock removable partial denture without clinically significant changes in the supporting structures of the abutment teeth.This report is part of an ongoing study to determine the efficacy of swinglock removable partial dentures.     

Management of loading forces on mandibular distal-extension prostheses. Part I: Evaluation of concepts for design

The viscoelastic reaction of ridge mucosa and abutment teeth, by virtue of their periodontal ligaments, is a necessary dimension in the evaluation of design concepts for removable partial dentures for patients with distal-extension ridges. The possible modalities are (1) removable partial dentures with flexible denture bases (stressbreakers), (2) use of a floating denture base impression technique, (3) use of a mucofunctional impression technique to relate the denture base to the framework, and (4) use of an endosseous implant. An evaluation of each modality has been made.     

Influence of clasp design of distal extension removable partial dentures on the periodontium of the abutment teeth

Three removable partial denture designs were investigated to determine the effect of minor connector configuration on the periodontal health of abutment teeth. Twenty-five patients wore three different removable partial dentures for 19 weeks each. The first removable partial denture placed a tilting force on the abutment teeth; the second was stress-releasing; and the third collected the least amount of plaque. Plaque accumulation, the condition of the periodontium, migration of the abutment teeth, deformation of the clasp arms, retention of the prosthesis, and patient preferences were assessed. The results demonstrated that the partial denture retentive design did not affect plaque formation. The prosthesis designed to place a tilting force on the abutment teeth appeared to cause the least mobility and migration of the abutments and had the greatest acceptance by the patients.     

A loading impression technique for semiprecision and precision removable partial dentures

The rationale of designing a semiprecision or precision distal-extension removable partial denture and the justification of ridge loading in distal-extension ridge impression techniques have been presented. The effectiveness of existing impression techniques in securing firm seats for abutment castings, accurate border extension of the denture base, and loading of the ridge mucosa has been evaluated.A technique has been described that overcomes the limitations of existing impression techniques for semiprecision and precision distal-extension removable partial dentures.     

冠外附着体在游离端牙列缺损修复中的临床应用及近期观察

目的：探讨游离端牙列缺损患者进行冠外附着体义齿修复的临床效果。方法：对18例游离端牙缺失的患者,设计5种冠外附着体作为固位体进行修复治疗。随访1～3年,观察患者对义齿使用的满意情况,复查检查基牙和修复体的情况。结果：患者对冠外附着体义齿的美观非常满意,对义齿的固位稳定效果和咀嚼功能均满意。临床检查未见基牙松动,1年后,出现2例基牙牙龈炎,1例附着体阳性构件松动;2年后,出现2例义齿松动和1例义齿下沉;3年后,出现1例基牙牙龈炎,3例义齿松动和2例义齿下沉。所有出现异常的患者经对症治疗后义齿均能继续使用。结论：对于游离端牙缺失的患者,采用冠外附着体义齿修复可获得良好的临床效果。     

心理干预对老年患者佩戴可摘局部义齿修复满意度的影响

目的：探讨修复前心理干预对初次佩戴复杂活动义齿的老年患者修复满意度的影响。方法：选择门诊80例初次进行复杂活动义齿修复的老年患者，实验组40例，修复前进行心理干预，对照组40例，常规修复，术后分别调查患者修复后第一个月和第三个月的义齿修复满意度。结果：实验组和对照组相比，第一个月和第三个月的舒适性、咀嚼、语音差异均有统计学意义（P〈0．05）。结论：初次进行复杂活动义齿修复的老年患者修复前心理干预可提高其义齿修复的满意度。     

Complete denture with a removable palatal lift prosthesis: a case report and clinical evaluation.

The palatal lift prosthesis is used to alleviate rhinopharyngeal closure dysfunction. It is generally problematical to use in edentulous patients, because the palatal lift prosthesis requires secure retention of the denture base and is difficult for the patient to retain while eating. This article describes the fabrication of a complete denture with a removable palatal lift prosthesis and a clinical evaluation of the denture's stability. A sprue pin and tube were used as a connecting attachment between the removable palatal lift prosthesis and the denture base. The force required for lifting the soft palate and the denture's stability were measured in the clinical evaluation. The prosthesis required an average retentive force of 0.26 N for each 1 mm of soft palate lift. The force required to dislodge the denture was measured with and without the palatal lift prosthesis in place. The force required to dislodge the conventional complete dentures of five healthy individuals was also measured as a reference. The denture was 24.4% less stable when the palatal lift prosthesis was in place and was generally easier to dislodge than were conventional dentures. This denture with a removable palatal lift prosthesis is useful for patients with dysfunction of the soft palate involving hypernasal speech who have difficulty in retaining the prosthesis while eating.