Zhang Yu-Qiang, Yu Hai-Yang
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2021 Apr 1;39(2):233-237. doi: 10.7518/hxkq.2021.02.018.
When design an implant restoration for edentulous patients, many doctors ignore the sufficiency of the interarch distance (vertical distance) or horizontal distance of the patient to accommodate the superstructure and restoration before designing the implant plan. However, the connotation of measuring the interarch distance or horizontal distance has not been clarified in clinical practice. It is often based on visual estimation after operation, and the decision-making path of implant restoration is inverted, resulting in many mistakes regarding the restoration after implantation. The main reason is the lack of standardized paths and practical methods to use before surgery. This article recommended initially establishing a maxillo-mandibular relationship based on natural teeth, old dentures, or new ones and then using the height and horizontal distance or angle of the target restorative space, which was easier to grasp as the measured index. The minimum vertical distance (including the height of the gingival surface and the bone surface) and the horizontal distance (or the angle from the bone or gingival surface to the proposed occlusal plane) should be measured before operation. A decision tree of edentulous jaw restoration guided by the values of the repair space was established based on the measured values. This article clarified the measuring points and planes and thus provided a quantitative relationship basis for the design of implant restoration.
在为无牙颌患者设计种植修复体时,许多医生在制定种植计划前,忽略了患者的颌间距离(垂直距离)或水平距离是否足以容纳上部结构和修复体。然而,在临床实践中,测量颌间距离或水平距离的内涵尚未明确。通常是术后凭视觉估计,导致种植修复的决策路径颠倒,在种植后修复方面出现诸多失误。主要原因是术前缺乏标准化的路径和实用的方法。本文建议首先基于天然牙、旧义齿或新义齿建立上下颌关系,然后采用目标修复空间的高度、水平距离或角度作为测量指标,这些指标更容易掌握。术前应测量最小垂直距离(包括牙龈面和骨面的高度)和水平距离(或从骨面或牙龈面到拟咬合平面的角度)。根据测量值建立以修复空间值为导向的无牙颌修复决策树。本文明确了测量点和测量平面,从而为种植修复设计提供了定量关系依据。