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  |  文章分类:修复浏览次数:2846  |  评论:
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

                  

 

图2                                                                       术前侧位咬颌照

 

图3                                                                       术前颌面照

 

图4                                                                   拆除原修复体牙列照

 

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

 

图6                                                                       拆除原修复体颌面照

 

图7                                                                           原烤瓷冠修复体

 

图8                                                                         治疗术后X光片

 

图9                                                                  去除腐质口内照 

 

图10                                                            冠延长术后照 

 


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

 

图12                                                                    临时牙颌面照


 

图13                                                                     牙体预备模型照

 

图14                                                                     临时牙

 

图15                                                                        临时牙咬合照

 

图16                                                                     口内临时牙咬颌照

 

图17                                                                      口内临时牙颌面照

 


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

 

 图19                                                                       牙体精修颌面照

 

图20                                                                 牙体精修咬颌照

 

图21                                                                            排龈

 

图22                                                                      烤瓷冠咬颌照

 


图23                                                                     烤瓷冠颊面观

 

图24                                                               烤瓷冠舌面观

 

图25                                                                         烤瓷冠颌面观

 

图26                                                                       下颌树脂冠颊面观

 

图27                                                               树脂冠舌面观

 

图28                                                             烤瓷冠颌面观

 

图29                                                                   术后颊面照

 

图30                                                                           术后颌面照

 

图31                                                                术后舌面照

 

图32                                                                 术后正中咬颌照

 

图33                                                                     术后连续侧方咬颌照

 

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临汾胜杰口腔医院周恒
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!
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