| Summary: | 碩士 === 高雄醫學大學 === 牙醫學研究所碩士在職專班 === 93 === Abstract
So called "periodontal prosthesis", Dr. Amsterdam (Univ. Pen, 1974) shared his view with us. He defined periodontal prosthesis as "Those restoration prosthetic endeavors that are absolutely essential in the treatment of advanced periodontal disease". Recently, many periodontal treatment technology was improved. By using the GTR, GBR, and periodontal plastic surgery, the prognosis of periodontal treatments are more predictable, and the teeth survival rates are elevated. However, periodontal prosthesis patients are characterized by loss of periodontium that usually results in unstable occlusion, and pathologic tilting, migration, such as pathologic 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.
However, all of periodontal prosthesis patients have moderate to advanced periodontitis. They loss their periodontal support, and sites and numbers of missing teeth, current periodontal conditions, patient''s needs and economic conditions are different, their treatment plans should be different. Based to the concepts of periodontal prosthesis, the treatment goals of the prosthesis design should be decreased plaque deposition, improved occlusal interferences, provided stable occlusion, and evened occlusal force to the abutment teeth. Combined periodontal treatment, orthodontic, endodontics therapy, and implant let different periodontal prosthesis patient’s received ideal treatment plans, and restored function, health and esthetics.
This paper presents 10 cases with moderate to advanced periodontitis. The periodontal treatments of these cases include various periodontal surgeries, such as flap operation, root resection, autogeneous bone graft regeneration, crown lengthening procedure, free gingival graft, GTR and implants. The final prosthesis design depends on individual situation including economic condition and personality, from simple fixed bridge, clasp-retained RPD, single denture to complex removable prosthesis, such as Konuskrone 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 long-term results must be observed .
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