上下颌牙列缺损老年患者的多学科综合治疗1例

doi:10.12337/zgkqjxjyzz.2023.04.007

中国口腔医学继续教育杂志 ›› 2023, Vol. 26 ›› Issue (4): 284-293.DOI: 10.12337/zgkqjxjyzz.2023.04.007

上下颌牙列缺损老年患者的多学科综合治疗1例

高璐¹, 许桐楷¹, 丁茜², 张一¹, 廖宇¹, 安娜^1,*

¹北京大学口腔医学院·口腔医院综合二科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心;
²北京大学口腔医学院·口腔医院口腔修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心

出版日期:2023-07-31 发布日期:2023-11-29
通讯作者: *安娜,联系方式：010-82195672,电子邮箱：anna@pkuss.bjmu.edu.cn,通讯地址：北京市海淀区中关村南大街22号,100081
基金资助:
北京大学教学改革项目（项目编号：JG2023153）

A Case of Comprehensive Dental Care of An Elderly Patient with Maxillary and Mandibular Dentition Defect

Lu Gao¹, Tongkai Xu¹, Qian Ding², Yi Zhang¹, Yu Liao¹, Na An^1,*

¹Department of General Dentistry II, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P.R. China;
²Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P.R. China

Online:2023-07-31 Published:2023-11-29
Contact: Na An. Tel: 010-82195672. Email: anna@pkuss.bjmu.edu.cn. Address: No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, P.R. China
Supported by:
Peking University Teaching Reform Project (JG2023153)

摘要/Abstract

摘要： 目的: 本病例报道1例上下颌牙列缺损老年患者的多学科诊疗。诊治经过： 63岁女性患者,进行口腔颌面外科、牙周科、牙体牙髓科及口腔修复科的综合治疗。各项治疗按病情需求穿插进行。疾病预防控制期拔除无望保留的患牙,对慢性牙髓炎、慢性根尖周炎患牙完善根管治疗或根管再治疗,期间贯穿牙周基础治疗,拆除口内原有修复体,补充余留牙治疗计划,完成相应诊治;功能美观恢复期首先进行修复前复查,确定为余留牙固定修复方案,进行可摘局部义齿设计,完善余留牙修复前治疗与固定修复,最终完成上下颌可摘局部义齿修复;维护期定期复查。结果： 经过口腔多学科综合治疗,患者牙周维护状况较治疗前明显改善,口腔卫生维护意识明显增强;余留牙进行固定修复者佩戴修复体咬合舒适,复查未见异常;树脂充填治疗牙齿维护良好,无继发龋坏;上下颌可摘局部义齿固位好,戴用舒适,咬合运动无干扰。结论： 老年患者缺牙数量多导致咬合关系不稳定,需通过咬合重建以恢复合理舒适的咬合关系。对于老年患者口腔疾患进行多学科综合治疗、提高患者口腔卫生维护意识,可帮助实现满意的诊治效果。

关键词: 牙列缺损, 多学科综合治疗, 咬合重建, 老年患者, 覆盖义齿

Abstract: Objective: This case reports the multidisciplinary diagnosis and treatment of an elderly patient with maxillary and mandibular dentition defect. Diagnosis and treatment: The oral and maxillofacial surgery, periodontal, endodontic, and prosthodontic treatments were carried out interleaved according to the requirements. During the disease prevention and control period, the hopeless teeth were extracted. For the teeth with chronic pulpitis and chronic periapical periodontitis, the root canal treatments or root canal retreatments were completed. Periodontal treatment and follow-up were done alongside the whole treatment process. During the functional and aesthetic recovery period, pre-restoration review was conducted first, and the design of removable partial denture was carried out to determine the fixed restoration scheme of the remaining teeth. Then, the pre-restoration treatment and fixed restoration of the remaining teeth were carried out. Finally, the maxillary and mandible removable partial dentures were completed, and regular review and follow-up were conducted during the maintenance period. Results: After multidisciplinary diagnosis and treatment, the periodontal maintenance and the awareness of oral health maintenance of the patient were significantly improved. Teeth extraction sockets healed well. The fixed prosthesis of the remaining teeth were completed, and the patient felt comfortable occlusion. No abnormalities were found in the follow-up examination. For teeth with caries, there was no secondary caries after resin filling treatment. For maxillary and mandible removable partial dentures, the retention were well, and the patient felt comfortable with the occlusal movement without interference. Conclusions: Multidisciplinary comprehensive diagnosis and treatment for elderly patients with oral diseases can help improve patients' compliance and awareness of oral health maintenance, and also achieve satisfactory treatment effect. If more missing teeth in elderly patients lead to unstable occlusal relationship, it is necessary to restore correct and comfortable occlusal relationship through occlusal reconstruction when necessary.

Key words: dentition defect, comprehensive dental care, occlusal reconstruction, elderly patients, overdenture

高璐, 许桐楷, 丁茜, 张一, 廖宇, 安娜. 上下颌牙列缺损老年患者的多学科综合治疗1例[J]. 中国口腔医学继续教育杂志, 2023, 26(4): 284-293.

Lu Gao, Tongkai Xu, Qian Ding, Yi Zhang, Yu Liao, Na An. A Case of Comprehensive Dental Care of An Elderly Patient with Maxillary and Mandibular Dentition Defect[J]. Chinese Journal of Stomatological Continuing Education, 2023, 26(4): 284-293.

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上下颌牙列缺损老年患者的多学科综合治疗1例

A Case of Comprehensive Dental Care of An Elderly Patient with Maxillary and Mandibular Dentition Defect

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