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0
Patient Assessment
- 0.1 Patient demand
- 0.2 Overarching considerations
- 0.3 Local history
- 0.4 Anatomical location
- 0.5 General patient history
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0.6
Risk assessment & special high risk categories
- 5.1 Risk assessment & special high risk categories
- 5.2 age
- 5.3 Compliance
- 5.4 Smoking
- 5.5 Drug abuse
- 5.6 Recreational drugs and alcohol abuse
- 5.7 Parafunctions
- 5.8 Diabetes
- 5.9 Osteoporosis
- 5.10 Coagulation disorders and anticoagulant therapy
- 5.11 Steroids
- 5.12 Bisphosphonates
- 5.13 BRONJ / ARONJ
- 5.14 Radiotherapy
- 5.15 Risk factors
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1
Diagnostics
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1.1
Clinical Assessment
- 0.1 Lip line
- 0.2 Mouth opening
- 0.3 Vertical dimension
- 0.4 Maxillo-mandibular relationship
- 0.5 TMD
- 0.6 Existing prosthesis
- 0.7 Muco-gingival junction
- 0.8 Hyposalivation and Xerostomia
- 1.2 Clinical findings
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1.3
Clinical diagnostic assessments
- 2.1 Microbiology
- 2.2 Salivary output
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1.4
Diagnostic imaging
- 3.1 Imaging overview
- 3.2 Intraoral radiographs
- 3.3 Panoramic
- 3.4 CBCT
- 3.5 CT
- 1.5 Diagnostic prosthodontic guides
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1.1
Clinical Assessment
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2
Treatment Options
- 2.1 Mucosally-supported
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2.2
Implant-retained/supported, general
- 1.1 Prosthodontic options overview
- 1.2 Number of implants maxilla and mandible
- 1.3 Time to function
- 1.4 Submerged or non-submerged
- 1.5 Soft tissue management
- 1.6 Hard tissue management, mandible
- 1.7 Hard tissue management, maxilla
- 1.8 Need for grafting
- 1.9 Healed vs fresh extraction socket
- 1.10 Digital treatment planning protocols
- 2.3 Implant prosthetics - removable
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2.4
Implant prosthetics - fixed
- 2.5 Comprehensive treatment concepts
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3
Treatment Procedures
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3.1
Surgical
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3.2
Removable prosthetics
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3.3
Fixed prosthetics
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3.1
Surgical
- 4 Aftercare
护牙颌器
Key points
- 护牙颌器可保护牙科修复体,并显著延长其使用寿命
- 对于夜间磨牙症患者,硬护牙颌器通常比软护牙颌器更有效
- 对于咬牙症患者,软护牙颌器通常比硬护牙颌器更有效
牙齿的选择
使用树脂或烤瓷人造义齿带来了与夜间异常功能相关的不同难题。配戴保护性的护牙颌器可以缓解较高的咬合力。树脂牙在经过一段时间后可能会出现磨损且/或脱离义齿基托。通常情况下,树脂牙比烤瓷牙更易调整和修复。不过,有时临床医师认为烤瓷牙具有美观效果和纹理方面的优势。与树脂牙相比,烤瓷牙不太可能出现磨损,其对机械过载的反应是断裂,此时可能需要更换整个修复体。
治疗方案设计
如果已知患者有磨牙或咬牙等异常功能,应通过适当选择修复体设计和材料在治疗计划中考虑到这种情况。对于此类患者,应在最初的治疗计划中纳入护牙颌器。
护牙颌器设计注意事项
护牙颌器覆盖在人造义齿上,提供了居间物质,使相反侧的牙齿在其上施加作用力,从而保护人造义齿。护牙颌器起到吸收和分散咬合力的作用。通常情况下,与硬护牙颌器相比,软护牙颌器的耐受性更好,因此患者依从性更高。软护牙颌器对咬牙症患者尤其有效,咬牙症患者表现出轴向的咬合力。夜间磨牙症患者在其异常活动中表现出牙齿的横向运动,此类患者最好使用具有良好耐磨损性能的硬护牙颌器。