细节决定成败

千里之行,始于足下;千里之堤,毁于蚁穴”,细节决定成败给以我们启迪,但愿我们能够真正进入“细节时代”,在岗位上兢兢业业,实现自我,让时代因细节而精彩!

烤瓷桥再修复

发布时间:2016-12-20 11:46:09  |  文章分类:全瓷二氧化锆浏览次数:2408  |  评论:50
关键字: 氧化锆    金属烤瓷牙  

患者    郭某某    女   55岁

主        诉:右上后牙修复体崩瓷,松动两个月左右

现 病 史:患者两个月前右上后牙修复体边缘不密合,松动崩瓷,近期不适加重要求重新修复,来诊

既 往 史:否认全身系统疾病史

检        查:15 16 17 烤瓷冠修复体,崩瓷,边缘不密合,食物嵌塞,龈下牙石II°,冷热诊无不适,叩诊(+),牙龈轻微红肿

                        14  残冠,位于龈下2mm,牙龈颜色正常,叩诊(-)

                         46  颌面充填体近中有悬突,PD:10mm,根分歧III°,阴影较大,叩诊(+),牙龈轻微红肿

                         13  近中有充填物,叩诊(-),冷热诊无不适,牙髓活力未见异常,牙龈颜色正常

                         47  颌面有充填物,叩诊(-),冷热诊无不适,牙髓活力未见异常,牙龈颜色正常

X          示:15  根管透射,根尖有阴影

                         14  根管阻射,恰填,无异常

                         46  根管阻射,恰填,根分叉骨密度降低,近中根尖阴影较大

诊        断:上颌牙列缺损

治疗计划:15 16 17拆冠

                        15  17  牙髓治疗,重新修复(观察三个月后在修复)

                         14  冠延长术

                         46  建议拔除,患者要求试保留,临时冠修复

治疗过程:   如图

 

图1                                                   术前X光片

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图2                                                                       术前侧位咬颌照

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图3                                                                       术前颌面照

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图4                                                                   拆除原修复体牙列照

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图5                                                                        拆除原修复体侧位咬合照

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图6                                                                       拆除原修复体颌面照

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图7                                                                           原烤瓷冠修复体

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图8                                                                         治疗术后X光片

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图9                                                                  去除腐质口内照 

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图10                                                            冠延长术后照 

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图11                                                               术后一个月纤维桩修复  牙体预备

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图12                                                                    临时牙颌面照


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图13                                                                     牙体预备模型照

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图14                                                                     临时牙

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图15                                                                        临时牙咬合照

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图16                                                                     口内临时牙咬颌照

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图17                                                                      口内临时牙颌面照

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图18                                        14  15   三个月后X光片(根尖阴影减小)

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 图19                                                                       牙体精修颌面照

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图20                                                                 牙体精修咬颌照

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图21                                                                            排龈

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图22                                                                      烤瓷冠咬颌照

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图23                                                                     烤瓷冠颊面观

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图24                                                               烤瓷冠舌面观

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图25                                                                         烤瓷冠颌面观

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图26                                                                       下颌树脂冠颊面观

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图27                                                               树脂冠舌面观

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图28                                                             烤瓷冠颌面观

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图29                                                                   术后颊面照

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图30                                                                           术后颌面照

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图31                                                                术后舌面照

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图32                                                                 术后正中咬颌照

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图33                                                                     术后连续侧方咬颌照

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