Full mouth rehabilitation

全口康复
  • 文章类型: Journal Article
    引言颌骨植入物(ZIs)已成为修复严重上颌萎缩的完全无牙患者的有希望的选择。这些植入物固定在颧骨中,绕过广泛嫁接程序的需要。牙科和颅面种植手术的成功率可能受到几个手术因素的影响,包括缝合技术,襟翼设计,和治疗计划。该研究旨在介绍使用四合瘤方案(QZP)和解剖引导方法(AGA)进行修复修复的严重再吸收上颌骨患者的临床结果和并发症。注重长期评估。材料和方法本回顾性研究的数据从机构的患者数据库中提取,包括对患者记录的细致审查。这项全面的检查包括人口统计数据,术前评估,外科手术的细节,术后并发症,以及随后的后续评估。严重上颌骨缺损导致完全无牙的患者,由于前部和后部的骨质量和数量不足,被选中列入名单。排除标准适用于记录不完整或随访数据不足的个人,以及接受替代治疗方式或出现可能影响植入物结局的合并症的患者。选定的患者接受QZP治疗,每位参与者至少接受三年的随访。植入物的存活率,假肢成功,并发症,使用OHIP-14问卷评估与口腔健康相关的生活质量。结果在随访期结束时,涉及12例患者(8例男性,四名妇女),43个ZI-37个来自Neodent,诺贝尔生物中心的四个人,和两个来自诺里斯-平均持续时间为4.3年(范围:1.2-5.4),总体成功率为99.08%,42个植入物中只有1个失败.所有患者立即接受丙烯酸假体的装载,在98.2%的病例中证明有效。观察到的最常见的问题是局部软组织炎症(35.7%)和鼻窦炎症(12.5%),发生在平均1.2年和3.5年的随访期之后,分别。在12名患者中,OHIP-14问卷的平均得分为1.6±2.6,随访期为5±0.6年.结论QZP在修复严重缩小的上颌骨结构方面一直表现出长期的成功。立即加载方法可以通过跨弓支撑来帮助稳定ZI。
    Introduction Zygomatic implants (ZIs) have emerged as a promising option for rehabilitating completely edentulous patients with severe maxillary atrophy. These implants anchor into the zygomatic bone, bypassing the need for extensive grafting procedures. Success rates in dental and craniofacial implant surgeries can be influenced by several surgical factors, including suture techniques, flap design, and treatment planning. The research aimed to present the clinical outcomes and complications in individuals with severely resorbed maxillae who underwent prosthodontic rehabilitation using the Quad Zygoma Protocol (QZP) and the Anatomy-Guided Approach (AGA), focusing on long-term assessment. Material and methods Data for this retrospective study were extracted from the institution\'s patient database, involving a meticulous review of patient records. This comprehensive examination encompassed demographic data, preoperative assessments, details of surgical procedures, postoperative complications, and subsequent follow-up evaluations. Patients with severe maxillary bone deficiencies resulting in complete edentulism, due to inadequate bone quality and quantity in both anterior and posterior regions, were selected for inclusion. Exclusion criteria were applied to individuals with incomplete records or insufficient follow-up data, as well as those who underwent alternative treatment modalities or presented with comorbidities potentially impacting implant outcomes. The selected patients underwent treatment utilizing the QZP, with each participant subjected to a minimum three-year follow-up period. The implant survival rate, prosthetic success, complications, and Oral Health-Related Quality of Life using the OHIP-14 questionnaire were assessed. Results At the end of the follow-up period involving 12 patients (eight men, four women) with 43 ZIs - 37 from Neodent, four from Nobel Biocare, and two from Norris - with a mean duration of 4.3 years (range: 1.2-5.4), the overall success rate stood at 99.08%, with only 1 out of 42 implants failing. All patients received immediate loading with an acrylic prosthesis, proving effective in 98.2% of cases. The most common issues observed were localized soft tissue inflammation (35.7%) and sinus inflammation (12.5%), occurring after mean follow-up periods of 1.2 and 3.5 years, respectively. In 12 patients, the mean score of the OHIP-14 questionnaire was 1.6 ± 2.6, with a follow-up period of 5 ± 0.6 years. Conclusion The QZP has consistently demonstrated excellent long-term success in restoring severely reduced maxillary structures. An immediate loading approach could aid in stabilizing ZIs through cross-arch support.
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  • 文章类型: Case Reports
    齿面损失(TSL)是多因素的,严重时,它会严重影响生活质量。虽然碳酸软饮料,它们的糖和酸含量很高,是TSL的常见原因,效果通常不要求全口康复。然而,当与其他因素结合时,如超常习惯或其他高消费驱动因素,TSL可能很严重。在这里,我们介绍了一名35岁男子的情况,该男子因侵蚀和磨损而在整个口腔中出现轻度至重度TSL。导致因素是哮喘引起的大量饮用软饮料多年来解渴,哮喘相关药物的副作用,和其他超功能习惯。八步方法尽可能微创,考虑到TSL的严峻表现,与以前提供的树脂基复合修复体相比,为患者提供了更持久的治疗选择。介绍这种情况使我们能够讨论TSL的原因,并通过间接修复来描述TSL在增加的咬合垂直尺寸下的全口康复。我们还演示了可移动和固定选项的集成,当推进复杂的恢复性案件时。
    Tooth surface loss (TSL) is multifactorial and, when severe, it can severely impact the quality of life. Although carbonated soft drinks, with their high sugar and acid content, are a common cause of TSL, the effects do not usually mandate full-mouth rehabilitation. Nevertheless, when combined with other factors such as parafunctional habits or other drivers of high consumption, TSL can be severe. Here we present the case of a 35-year-old man who presented with mild to severe TSL throughout the oral cavity caused by erosion and attrition. Causative factors were heavy consumption of soft drinks for years to quench thirst caused by asthma, side effects of asthma-related medications, and other parafunctional habits. The eight-step approach was as minimally invasive as possible, considering the severe presentation of TSL, and offered the patient a more durable treatment option than previously provided resin-based composite restorations. Presenting this case allows us to discuss the causes of TSL and also describe full mouth rehabilitation of TSL at increased occlusal vertical dimension with indirect restorations. We also demonstrate the integration of removable and fixed options, when progressing complex restorative cases.
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  • 文章类型: Journal Article
    背景:专业人士对全麻(GA)对儿科患者的价值的看法发生了变化,包括残疾人,医疗条件,严重的口腔问题,挑战行为。GA下的全口康复可以在一次访问中全面治疗所有口腔健康问题,而不需要孩子的积极参与。广泛的牙齿问题通常与严重的牙齿疼痛有关,会影响认知功能,包括感知,注意,记忆,推理,语言,通信,和执行功能。经历疼痛的个体倾向于在认知方面表现较差。
    目的:本研究旨在调查认知变化,大脑功能,以及在GA下接受广泛牙科康复的儿童的皮质改变。
    三十不合作,纳入了6-12岁有广泛牙科问题的健康儿童.治疗前使用FLACC和WBFPS量表评估疼痛水平,一周后,三个月后.认知评估,包括WCST,处理速度,数字跨度,和跟踪测试,以及脑电图测量,也表演了。
    结果:结果显示,牙科手术后儿童或其护理人员报告的疼痛程度有了显着改善,在一个星期和三个月。所有的认知测量,如数字跨度,处理速度,和WCST性能,治疗后表现出实质性改善。在牙科手术之前和之后,痕迹制作测试也显示出统计学上的显着变化。此外,MOCA测试显示治疗后认知技能有显著改善.此外,EEG功率比,每个频段内功率平衡变化的指标,牙科手术后显示出统计学上的显着差异。
    结论:这项研究的结果表明,GA下的全口康复可以改善疼痛管理,以及增强儿童的认知和大脑功能。
    结论:需要进行更多的临床研究,随访时间更长,儿童年龄范围不同,以研究脑功能与口腔修复之间的联系,涉及修复或闭塞问题。
    BACKGROUND: A change in professionals\' perspectives on the value of general anesthesia (GA) for pediatric patients, including those with disabilities, medical conditions, severe oral issues, and challenging behaviors. Full-mouth rehabilitation under GA allows for the comprehensive treatment of all oral health problems in a single visit, without requiring the child\'s active participation. Extensive dental problems are often associated with severe dental pain, which can impact cognitive function, including perception, attention, memory, reasoning, language, communication, and executive functions. Individuals experiencing pain tend to perform less optimally cognitively.
    OBJECTIVE: This study aimed to investigate changes in cognition, brain function, and cortical alterations in children who underwent extensive dental rehabilitation under GA.
    UNASSIGNED: Thirty uncooperative, healthy children aged 6-12 with extensive dental issues were enrolled. Pain levels were assessed using the FLACC and WBFPS scales before treatment, one week after, and three months later. Cognitive assessments, including the WCST, processing speed, digit span, and Trail Making Test, as well as EEG measurements, were also performed.
    RESULTS: The results showed a significant improvement in pain levels reported by the children or their caregivers after the dental procedures, both at one week and three months. All cognitive measures, such as digit span, processing speed, and WCST performance, demonstrated substantial improvements after the treatment. The Trail Making Test also exhibited statistically significant variations before and after the dental procedures. Additionally, the MOCA test revealed a notable improvement in cognitive skills following the treatment. Furthermore, the EEG power ratio, an indicator of changes in the power balance within each frequency band, showed a statistically significant difference after the dental procedures.
    CONCLUSIONS: the findings of this study suggest that full-mouth rehabilitation under GA can lead to improved pain management, as well as enhanced cognitive and brain functions in children.
    CONCLUSIONS: More clinical studies with a longer follow-up period and a different age range of children are required to investigate the connection between brain function and oral rehabilitation involving restorations or occlusion issues.
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  • 文章类型: Case Reports
    上颚病变的手术可能会导致口鼻/窦沟通,通过影响吞咽降低一个人的生活质量,演讲,和食物回流。这种闭孔假体的形状和尺寸可能会根据缺陷的严重程度而变化。该病例报告描述了COVID后毛霉菌病患者的假体康复以及使用闭孔和全口康复对牙齿的全身磨损。
    Surgery for palate lesions may result in oro-nasal/antral communication, which reduces a person\'s quality of life by affecting swallowing, speech, and food reflux. The shape and size of this obturator prosthesis might vary based on the severity of the defect. This case report describes the prosthetic rehabilitation of the patient with post-COVID mucormycosis and generalized attrition of teeth using an obturator and full mouth rehabilitation.
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  • 文章类型: Journal Article
    评估全口康复后患有严重早期儿童龋齿(ECC)的儿童的微生物区系变化。
    总共60个孩子,符合纳入和排除标准的3~5岁重度ECC患者被纳入研究.采集汇集的菌斑样品,并进行定量逆转录酶聚合酶链反应(PCR),以获得变异链球菌的基线平均值(S.mutans),索布林链球菌(S.sobrinus),白色念珠菌(C.albicans),和都柏林假丝酵母(C.dubliniensis)在全身麻醉下进行全口康复之前。在6、12和18个月收集治疗后样品。Wilcoxon符号秩检验用于比较变形链球菌的平均值,S.Sobrinus,C.白色念珠菌,和都柏林人在全口康复之前和之后。
    在6个月和12个月的随访中,共招募了60名患者。18个月时,55名患者返回,有5人因随访而丢失。与基线值相比,在6、12和18个月时在所有微生物中观察到统计学上显著的减少。在18个月时,变形链球菌略有增加,S.Sobrinus,看到了白色念珠菌。在全口康复后,在任何情况下都没有检测到都柏林梭菌。4例患者在18个月时出现龋齿复发。
    变形链球菌显著减少,S.Sobrinus,C.白色念珠菌,在6个月、12个月和18个月时观察到了C.dubliniensis。仅观察到杜布立尼梭菌的完全减少。变形链球菌的显著但不是永久的减少,S.Sobrinus,还有白色念珠菌.7.27%的患者在18个月时出现龋齿复发。
    马修MG,JeevanandanG,RathodNN.幼儿龋齿全口康复后口腔菌群变化评价[J].IntJClinPediatrDent2024;17(1):21-25。
    UNASSIGNED: To evaluate the change in microflora in children suffering from severe early childhood caries (ECC) after full mouth rehabilitation.
    UNASSIGNED: A total of 60 children, aged 3-5 years suffering from severe ECC who fulfilled the inclusion and exclusion criteria were included in the study. Pooled plaque samples were taken and subjected to quantitative reverse transcriptase polymerase chain reaction (PCR) to obtain baseline mean values of Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Candida albicans (C. albicans), and Candida dubliniensis (C. dubliniensis) before full mouth rehabilitation was done under general anesthesia. Posttreatment samples were collected at 6, 12, and 18 months. Wilcoxon signed-rank test was used to compare the mean values of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis before and after full mouth rehabilitation.
    UNASSIGNED: A total of 60 patients recruited for the study were present at the follow-up at 6 and 12 months. At 18 months, 55 patients returned, and five were lost due to follow-up. A statistically significant reduction was seen in all microorganisms at 6, 12, and 18 months compared to baseline values. At 18 months a slight increase in S. mutans, S. sobrinus, and C. albicans was seen. C. dubliniensis was not detected in any cases after full mouth rehabilitation. Caries recurrence was seen in four patients at 18 months.
    UNASSIGNED: Significant reduction of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis was seen at 6, 12, and 18 months. A complete reduction of only C. dubliniensis was seen. A significant but not permanent reduction of S. mutans, S. sobrinus, and C. albicans. Caries recurrence was seen in 7.27% of patients at 18 months.
    UNASSIGNED: Mathew MG, Jeevanandan G, Rathod NN. Evaluation of Changes in Oral Microflora in Children with Early Childhood Caries after Full Mouth Rehabilitation. Int J Clin Pediatr Dent 2024;17(1):21-25.
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  • 文章类型: Journal Article
    目的:这项前瞻性队列研究旨在评估临床成功,龋齿复发,在全身麻醉下接受全口康复治疗的儿童早期龋齿和口腔健康相关的生活质量。该研究旨在了解这些干预措施对幼儿龋齿(ECC)管理的长期影响。
    方法:该研究包括300名3至6岁被诊断为ECC的儿童,需要在全身麻醉下进行全口康复。评估包括各种牙科治疗的临床成功,龋齿复发率,和口腔健康相关的生活质量使用早期儿童口腔健康影响量表在基线,12个月,治疗后24个月。实施了专门的龋齿预防方案,包括口腔卫生教育,提醒,和营养指导。
    结果:272名儿童参加了为期12个月的随访,其中11名儿童有新的龋齿病变。据报道,有105名儿童接受了24个月的随访,其中19名儿童报告了新的龋齿病变。发现治疗的临床成功率很高。口腔健康相关的生活质量从基线到12个月显示出显着和持续的改善,并在治疗后24个月进一步改善。
    结论:全身麻醉下的全口康复是管理幼儿ECC的有效方法,具有较高的临床成功率和超过两年的口腔健康相关生活质量的显著改善。预防性口腔健康策略对于维持这些积极成果和改善受影响儿童的整体福祉是必要的。
    OBJECTIVE: This prospective cohort study aimed to assess the clinical success, caries recurrence, and oral health-related quality of life of children undergoing full mouth rehabilitation for early childhood caries under general anesthesia. The study sought to understand the long-term impact of these interventions on early childhood caries (ECC) management.
    METHODS: The study included 300 children aged three to six years diagnosed with ECC requiring full mouth rehabilitation under general anesthesia. The assessment included clinical success of various dental treatments, caries recurrence rates, and oral health-related quality of life using the Early Child Oral Health Impact Scale at baseline, 12 months, and 24 months post-treatment. Specialized caries preventive protocols were implemented, including education on oral hygiene, reminders, and nutritional guidance.
    RESULTS: 272 children attended the 12-month follow-up, out of which 11 children had new carious lesions. Two hundred fifty-two children were reported for the 24-month follow-up, in which 19 children reported new carious lesions. The clinical success rate of treatment was found to be high. The oral health-related quality of life showed a significant and sustained improvement from baseline to 12 months and further improvement at 24 months post-treatment.
    CONCLUSIONS: Full mouth rehabilitation under general anesthesia is an effective approach for managing ECC in young children, with high clinical success rates and significant improvements in the oral health-related quality of life over two years. Preventive oral health strategies are necessary to maintain these positive outcomes and improve the overall well-being of affected children.
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  • 文章类型: Case Reports
    成釉细胞不全症是一种罕见的遗传性疾病,会干扰正常的牙釉质形成。在釉质发育不全症的4种主要类型中,发育不良(1型)是最普遍的,以牙釉质的定量变化为特征。牙釉质的点蚀或厚度减少会导致全身过敏,对龋齿和感染的易感性增加,自然减员,以及遮挡垂直维度的损失。这些患者的修复治疗不仅在功能上和修复上都具有挑战性,而且从情感和社会心理的角度来看。本临床报告描述了两名患有发育不良(1型)牙釉质发育不全的年轻成年兄弟姐妹的修复治疗和康复。
    Amelogenesis imperfecta is a rare genetic disorder that interferes with normal enamel formation. Of the 4 main types of amelogenesis imperfecta, hypoplastic (type 1) is the most prevalent, characterized by a quantitative alteration in enamel. The pitting or reduced thickness of the enamel results in generalized hypersensitivity, increased susceptibility to caries and infection, attrition, and a loss in vertical dimension of occlusion. Prosthodontic management of these patients can be challenging not only functionally and restoratively, but also from an emotional and psychosocial standpoint. This clinical report describes the prosthodontic management and rehabilitation of two young adult siblings with hypoplastic (type 1) amelogenesis imperfecta.
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  • 文章类型: Case Reports
    这份临床报告详细介绍了一名63岁严重牙齿磨损的男性患者的成功康复,减少了遮挡的垂直维度,和审美问题。Hobo双阶段手术解决了这些问题,同时改善了患者的口腔健康和生活质量。在确保适当的口腔卫生后,治疗从缩放和根规划开始,其次是诊断印象。制作了一个咬合夹板,然后是诊断蜡和牙齿准备。使用添加的硅弹性体印模材料制成预备牙齿的全拱形印模,和椅子上的临时皇冠被制造出来。工作铸件安装在半可调的铰接器上,在用瓷器建造之前,对金属覆盖物进行了尝试。患者取得了成功的结果,并对治疗表示满意。Hobo双阶段技术和瓷熔金属冠可以恢复牙齿的形式和功能,同时增强患者的口腔健康和美学。然而,定期随访和良好的口腔卫生维护对于治疗的长期成功至关重要。
    This clinical report details the successful rehabilitation of a 63-year-old male patient with severe tooth wear, a reduced vertical dimension of occlusion, and esthetic concerns. The Hobo twin-stage procedure addressed these issues while improving the patient\'s oral health and quality of life. After ensuring adequate oral hygiene, the treatment began with scaling and root planning, followed by diagnostic impressions. An occlusal splint was fabricated, followed by a diagnostic wax-up and tooth preparation. Full-arch impressions of prepared teeth were made using the addition of silicon elastomeric impression material, and chairside provisional crowns were fabricated. The working casts were mounted on a semi-adjustable articulator, and the metal copings were tried on before being built up in porcelain. The patient achieved successful outcomes and expressed satisfaction with the treatment. The Hobo twin-stage technique and porcelain-fused-to-metal crowns can be viable approaches for restoring the teeth\'s form and function while enhancing the patient\'s oral health and esthetics. However, regular follow-up appointments and good oral hygiene maintenance are essential for the long-term success of the treatment.
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  • 文章类型: Journal Article
    目的:本文介绍了使用可流动的可注射复合树脂来促进复杂的完全口腔康复的过渡治疗。
    方法:一些患者需要紧急和复杂的口腔完全康复,时间和成本都很高。经济因素可能会阻止一些患者寻求治疗。这可能导致口腔疾病随着时间的推移而恶化并损害牙齿的长期预后。
    结论:可注射复合树脂可用作复杂情况的过渡粘合材料,使用注射成型技术,利用从诊断性打蜡获得的清晰指数。这允许在一次预约中进行全口康复,产生即时结果。
    结论:在这种情况下证明的使用可注射复合材料的过渡将立即以具有成本效益的方式稳定恶化的情况,并允许患者在过渡到更耐用的瓷修复时解决经济或时间限制的现实。
    This article describes the use of flowable injectable composite resins to facilitate transitional treatment of a complex complete mouth rehabilitation.
    Some patients require urgent and complex complete mouth rehabilitations that are time and cost intensive. Financial considerations can prevent some patients from pursuing treatment. This can result in the oral conditions worsening over time and compromising the long-term prognosis of the teeth.
    Injectable composite resins can be used as a transitional bonding material for complex cases using an injection molding technique utilizing clear indices obtained from a diagnostic waxing. This allows for a full mouth rehabilitation to be performed in a single appointment, producing instant results.
    Transitioning with injectable composite as demonstrated in this case will immediately stabilize an otherwise deteriorating situation in a cost-effective way and allows patients to address the realities of financial or time constraints when transitioning to more durable porcelain restorations over a period of years.
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  • 文章类型: Case Reports
    牙科植入物是治疗无牙症的可靠替代方法。在临床情况下,牙列受到部分性牙症的严重影响,高级磨损,或者牙周病,建立重要的咬合元素,如咬合平面,切面引导,在诊断阶段,美学很难可视化。诸如3D扫描仪和CAD/CAM系统之类的现代数据采集技术允许精确制造适用于修复治疗的任何阶段的高度复杂的设备。本临床报告提出了一种评估预测的人造牙齿关系的替代技术,垂直尺寸,通过使用3D打印的覆盖模板,严重削弱牙列的患者的咬合平面。
    Dental implants are a reliable alternative to treating edentulism. In clinical situations where the dentition has been severely affected by partial edentulism, advanced wear, or periodontal disease, establishing important occlusal elements such as the occlusal plane, incisal guidance, and esthetics can be hard to visualize at the diagnostic stage. Contemporary data-acquisition technologies such as 3D scanners and CAD/CAM systems permit the precise manufacture of highly complex devices applicable to any stage of restorative treatment. The present clinical report presents an alternative technique for evaluating the projected artificial tooth relationships, vertical dimension, and occlusal plane in patients with severely weakened dentition by using a 3D-printed overlay template.
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