牙周補綴之病例報告 ─以牙周補綴支持療法、Könus雙重套冠系統重建重症牙周炎合併咬合崩壞為代表─

Abstract

In 1974, Dr. Amsterdam(the professor of Pennsylvania University) pointed out “periodontal prosthesis＂ and defined it as “Those restorative prosthetic endeavors that are absolutely essential in the treatment of advanced periodontal disease. whereas specifically it refers to the treatment of the dentition mutilated by the ravages of periodontal disease, in general ,its concepts, principles and techniques may be employed in any restorative or tooth replacement service involving the nature dentition.＂However, periodontal prosthesis patients are characterized by loss of periodontium that usually results in unstable occlusion, and pathologic tilting, migration, occlusal discrepancy, gingival recession, multiple missing oh the teeth, tooth mobility caused by occlusal trauma...etc. It is such different from normal dentition, therefore, it is complicated to reconstruct the edentulous area in patients with severe destruction of periodontal apparatus. Therefore, periodontal prosthesis covers a wide spectrum of techniques from periodontal treatment, operative dentistry, endodontic therapy, orthodontics to oral surgery and prosthodontics. This paper presents 10 cases with gingivitis to advanced periodontitis. The periodontal treatments of these cases include various periodontal surgeries, such as flap operation, root resection, crown lengthening procedure, gingival augmentation , GTR and implants. The final prosthesis design depends on individual situation including economic condition and personality, from simple fixed bridge, clasp retained RPD to complex removable prosthesis, such as Konus telescopic denture, tooth supported overdenture and implant. And the most important things for patients would be keeping good oral hygiene and periodontal recall visit by doctors after prosthesis delivery to make sure the prognosis. Owing to limitation knowledge and experience, the longterm results must be observed.