牙周病与牙体种植

访谈简介

牙周病是人类最古老、最普遍的疾病之一。牙周病特指发生在牙周支持组织的各种疾病。主要包括两大类即牙龈病和牙周炎。现在一般认为牙周炎约占拔牙原因的 30%-44%。是造成牙体缺失的首要原因。口腔医学中很多的疾病和治疗工作与牙周组织有密切关系,且均应在牙周组织健康的基础上进行。而且牙周病与全身健康和疾病有着双向的密切关联。牙周健康如此重要,面对牙周疾病我们该如何进行治疗和预防呢?
 
而牙体种植是指将无机的异体材料锚固在颌骨内,为缺失牙的修复体提供支持和固定,因此牙种植包括种植体的外科植入、义齿的制作及戴入和种植修复完成后的维护等一系列过程。牙体种植的成功与否受多种因素影响,那么牙周疾病对于牙体种植都有哪些影响?我们临床中又应该注意哪些问题?
 
本期微访谈,丁香园口腔时间特邀加拿大不列颠哥伦比亚大学口腔医学院教师、牙周专科执业医生@杨毅同大家一起探讨「牙周病与牙体种植」,欢迎大家的加入。
 
@杨毅(yiy345):加拿大不列颠哥伦比亚大学口腔医学院资深教师、牙周专科执业医生,于 2010 年在加拿大不列颠哥伦比亚大学牙科学院修得博士学位,有丰富的口腔颌面外科临床经验。主要研究方向为:牙周疾病及牙体种植术。

访谈时间: 10月31日 09:00 - 11:00

   嘉宾回答(共28个问题,28个回复)
  1. 丁香园口腔频道  :本次微访谈圆满结束,谢谢各位站友的踊跃提问,并十分感谢杨老师的精彩回答。
  2. yiy345  :Thank you all for your excellent questions. I enjoyed the interaction with all of you. Hope to see you again soon.
  3. xtingclever
    xtingclever  :@yiy345 提问:请问杨老师牙齿损伤到何种程度需要做牙体种植,牙体种植会不会对牙龈造成一定的损伤,种植后该如何维护,如果效果好,大约可以维持多长时间?谢谢~
    yiy345  : 1) When the tooth is not salvageable, or has hopeless prognosis, perhaps this tooth needs to be removed. For assigning the prognosis to individual tooth, please refer the question by another person a little bit earlier than you came in. Sometime, for strategic treatment...查看详细>>http://dxy.me/BVz6Fb
  4. zhongnzl
    zhongnzl  :@yiy345 提问:请问杨老师为什么治疗牙周病要照全口的X-ray? X-ray的暴露量会不会太高?
    yiy345  : The simple answer to this question is that we can not see bone with our naked eyes. Bone level is an important perimeter to evaluate the periodontal destruction as well as a factor for prognosis assignment. For your information, using digital x-ray, full mouth x-ray dose is 0.15 mSv, this is equivalent to the dose that one receives from the environment in a few days or the dose that one is exposed from taking a flight from coast to coast in USA. Hope this answered your question.
  5. hellen127
    hellen127  :@yiy345 提问:杨老师您好,请问牙周病患者种植后是否易产生种植体周围炎,如果是的话,什么程度的牙周病患者不应考虑种植。
    yiy345  : Controlled periodontitis is not a contraindication for implant placement. However, uncontrolled periodontitis is not a good indication for implant treatment, due to translocation of the bacteria. The clinical judgment is not by the degree of periodontal destruction, but by Controlled or Uncontrolled disease. Hope this answered your question.
  6. 米汀
    米汀  :@yiy345 提问:杨老师您好。选择修复性牙冠延长术前,我们必须排除禁忌证,但除常规牙周手术的禁忌证外,临床医师还须考虑的原则性问题有哪些?
    yiy345  : On top of systemic conditions that do not allow periodontal surgeries, the following local conditions are contraindications as well: 1) maxillary anterior single tooth need crown lengthening, 2) Poor crown root ratio after surgery, 3) bone loss approaching the apical 1/...查看详细>>http://dxy.me/bu67vi
  7. axun_dxy
    轻舞飞扬VIP  :@yiy345 提问:请问杨老师如何准确判断牙周病患者个别及全口牙的整体预后?以便制定治疗计划,有专门的风险评估体系么?
    yiy345  : Yes. There are two very good articles talking about the prognosis. One is by McGuire and Nunn (PubMed ID 8832476) and the other is by Kwok and Caton (PubMed ID 17970671). In general, prognosis is assigned to overall mouth and in particular individual tooth. The prog...查看详细>>http://dxy.me/qq6nYv
  8. caroline1028
    caroline1028  :向@yiy345 提问:对于智齿是拔除好还是不拔除好?
    yiy345  : It depends 1) degree of impaction, 2) tooth position, 3) Whether causing problem or not Either extract the tooth to solve the problems, or leave it if there are no symptoms whatsoever. The other point to keep in mind is that: wisdom tooth can provide stem cells th...查看详细>>http://dxy.me/EBJv6n
  9. 不要逼我丁睿
    不要逼我丁睿  :@yiy345 提问:老师好,现在的牙体种植术和镶烤瓷牙是一个概念么,一颗牙的使用寿命是多久?对蛀牙引起的牙周病除了刷牙还有别的防止方法吗?
    yiy345  : NO, Implant is different from ceramic or porcelain crown. Are you asking what is the life span of natural tooth or implant or ceramic/porcelain crown? For natural tooth, when properly maintained, tooth will last the same time as one's life span, For implant, when ...查看详细>>http://dxy.me/ABVFfa
  10. sanerboy
    sanerboy  :@yiy345 提问:杨老师您好!请问,牙周炎该如何治疗?可以完全治疗好么?牙体种植是不是需要把牙周炎只好才可以种?
    yiy345  : The treatment for periodontitis follows the general principle: 1) Oral hygiene instruction, 2) eliminate risk factors, such as smoking and diabetes (to control) and other contributor factors, such as defective restoration, caries control, occlusion adjustment etc when i...查看详细>>http://dxy.me/qmAZvq
  11. lzb130200007
    lzb130200007  :@yiy345 提问:老师我想问下,假如下颌第二磨牙的压根被阻生智齿压迫吸收,那么第二磨牙还有保留的意义?可否把拔掉第二磨牙,把智齿摆正代替第二磨牙?应该如何操作?
    yiy345  : I assume that in your scenario, the second molar distal root has external root resorption. The treatment option depends on certain factors 1) if the second molar roots are well separated, you may finish root canal then amputate the distal root, maintain the medisal r...查看详细>>http://dxy.me/IreQNz
  12. 青葱岁月2015
    青葱岁月2015  :@yiy345 提问:请问种植体代替不了牙周膜也没问题吗?
    yiy345  : Excellent question !!! It is true that implant does not possess periodontal ligament, however, it does show osseointegration which serves the purpose to replace the missing tooth for function and esthetics. However, due to lack of PDL and associated mechanoreceptor, ...查看详细>>http://dxy.me/vyUBZn
  13. changxiulin123
    changxiulin123  :@yiy345 提问:高压氧有助于牙周病患者种植修复吗?
    yiy345  : I assumed that you are asking whether patient had previous radiation therapy may need hyperbaric oxygen treatment prior to implant surgery. Because there is no indication for any given periodontal patient to receive hyperbaric oxygen for the purpose of implant placement...查看详细>>http://dxy.me/3IZNRz
  14. aa4707
    aa4707  :@yiy345 提问:杨医生您好,我朋友前两天打篮球把门牙撞断,一颗全断,一颗断一半,如何治疗比较好呢?
    yiy345  : It is hard to determine from your description how the fracture was like. The treatment depends on whether it is a horizontal fracture, or vertical fracture? where the fracture line is? how old is your friend? If you may provide pictures and X-ray with additional information such as age of the patient, systemic health of the patient, I will be able to provide a more detailed suggestion. Hope this answered your question.
  15. sorocker
    sorocker  :向@yiy345 提问:请教几个实用的上颌窦提升方法(非手术法),就是你在日常工作中常用到的,以及配套的工具,谢谢!
    yiy345  : Can you please clarify the question? Did you mean Non-surgical sinus augmentation? If this is your question, I am afraid that I am not aware any technique that does not require surgery for the purpose of sinus augmentation.

关闭提示