Li Jian, Xue Shenghao, Li Ke, Huyan Tianyi, Jiang Ting
Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
Department of Dental Laboratory Center, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
Case Rep Dent. 2024 Oct 21;2024:9962990. doi: 10.1155/2024/9962990. eCollection 2024.
This study is aimed at detailing a technique for digitally fabricated fixed restoration for both immediate replacement after extraction and splinting of the adjacent mobile teeth. Demand for a fixed restoration of the missing teeth in the mandibular anterior region is very common but sometimes problematic for dentists. It often happens that there is significant loosening of the remaining teeth adjacent to the missing tooth, which should be splinted. This case report describes a digitally fabricated fixed restoration for both replacing lost teeth and splinting periodontally compromised mobile teeth. With the CAD-CAM technique, patients can receive the restoration immediately after the extraction. The digital design and fabrication of the restoration were elaborated using the restorative process of a patient with a mandibular anterior tooth to be extracted and multiple loose lower anterior teeth. The immediate restoration process and the pontic modification when the extraction socket had healed were also described. The digital process avoids the nudging of the loose tooth by the traditional impression technique, improves the accuracy of the restoration, and avoids undue stress on the loose tooth when the restoration is in place. In addition, this method allows the patient to obtain a fixed restoration immediately after extraction, and if damage occurs after the restoration has been cemented, such as fracture or debonding, a new restoration can be prepared before the patient's return visit. This minimally invasive restorative method achieved the fixation of loose teeth while restoring the missing teeth, but the success of the treatment needed long-time observation.
本研究旨在详述一种数字化制作固定修复体的技术，用于拔牙后即刻修复以及对相邻松动牙进行夹板固定。下颌前牙区缺失牙的固定修复需求非常普遍，但对牙医来说有时存在问题。通常会出现缺失牙相邻的其余牙齿明显松动的情况，需要进行夹板固定。本病例报告描述了一种数字化制作的固定修复体，用于替代缺失牙和对牙周状况不佳的松动牙进行夹板固定。借助计算机辅助设计与计算机辅助制造（CAD-CAM）技术，患者在拔牙后即可立即获得修复体。利用一名下颌前牙待拔除且多颗下前牙松动患者的修复过程，详细阐述了修复体的数字化设计与制作。还描述了拔牙窝愈合后即刻修复过程以及桥体的修改。数字化流程避免了传统印模技术对松动牙的挤压，提高了修复体的准确性，并且在修复体就位时避免了对松动牙施加过大压力。此外，这种方法使患者在拔牙后即可立即获得固定修复体，如果修复体粘结后出现损坏，如折断或脱粘，可在患者复诊前制备新的修复体。这种微创修复方法在修复缺失牙的同时实现了松动牙的固定，但治疗的成功需要长期观察。
