Kennedy Ⅰ-Ⅳ類牙列缺損.ppt

Kennedy-類牙列缺損的設(shè)計(jì),研究生潘領(lǐng)戰(zhàn)孟波林川指導(dǎo)老師肖茂春教授,Kennedy-類牙列缺損的設(shè)計(jì),活動(dòng)義齒臨床設(shè)計(jì)的思路Kennedy-類牙列缺損的修復(fù)設(shè)計(jì),Considerationsforremovableprostheses,DecidewhichofthemissingteetharetobereplacedandwhichsaddlesaretoberestoredDecidingonthenatureofthesupportDecidingontheformofthemajorconnectorDecidingonhowtheprosthesiswillberetainedPlanningforstabilityReviewofdesignwithhygieneandmaintenanceinmind,Decidingwhichofthemissingteetharetobereplacedandwhichsaddlesaretoberestored,planholistically“formulateatentativedenturedesignconcurrentwiththeformulationofthetreatmentplan.”,Decidingonthenatureofthesupport,ClassI:DenturesupportedbymucosaandunderlyingboneResultinDisplacemucosafurtherlossofalveolarboneClassII:DenturesupportedbyteethHelptomaintainalveolarbonemeansClassIII:Denturesupportedbyacombinationofmucosaandtooth-bornemeans.instabilityClassIV:Denturesupportedbyimplants,Cingulumrests,occlusalrests,Incisorrests,Overdenture,Decidingontheformofthemajorconnector,Maxillarycommonmajorconnectors,Palatalplate,Palatalstrap,Anteriororposteriorpalatalbar,Skeletaldesign,Horseshoedesign,Labialbar,Decidingontheformofthemajorconnector,Mandibularcommonmajorconnectors,Lingualplate,Lingualbar,Kennedybar.,Sublingualbar,Labialbar,Decidingonhowtheprosthesiswillberetained,Directretainers,OcclusallyapproachingclaspGingivallyapproachingclasp,thimblecrown,tooth-colouredpolymericmaterial,clasp,Decidingonhowtheprosthesiswillberetained,Directretainers,useofundercutsnotonbuccalorlingualofteeth,Useofbonyundercuts,e.glabialundercutsinteethanteriorboundedsaddles,Rotationalpathofinsertion.,Guideplanes,Decidingonhowtheprosthesiswillberetained,Directretainers,Precisionattachments,UseofresilientmaterialsSoftliner,Dentureadhesives,Planningforstability,indirectretention,Reviewofdesignwithhygieneandmaintenanceinmind,Kennedy牙列缺損分類法,第一類:雙側(cè)游離缺牙第二類:單側(cè)游離缺牙第三類:一側(cè)或兩側(cè)后牙缺失,鞍基前后都有基牙第四類:前部缺牙,Kennedy-類設(shè)計(jì)的基本原則,保護(hù)口腔組織健康良好的固位良好的穩(wěn)定性良好的支持作用達(dá)到一定的美觀要求堅(jiān)固耐用、方便取戴,Kennedy第一類牙列缺損,特點(diǎn)1.雙側(cè)后牙游離端缺失2.多設(shè)計(jì)為混合支持式義齒3.多采用大連接體連接兩側(cè)遠(yuǎn)中游離端鞍基,Kennedy第一類牙列缺損,設(shè)計(jì)要點(diǎn)1.雙側(cè)單個(gè)后牙游離端缺失(1)基牙選擇(2)支托設(shè)計(jì)(3)間隙卡環(huán)位置(4)人工牙設(shè)計(jì),Kennedy第一類牙列缺損,設(shè)計(jì)要點(diǎn)2.雙側(cè)多個(gè)后牙游離端缺失(1)基牙選擇(2)支托和卡環(huán)的設(shè)置(3)間接固位體(4)人工牙排列,Kennedy第一類牙列缺損,設(shè)計(jì)要點(diǎn)3.雙側(cè)后牙全部缺失,余留前牙條件差采用粘膜支持式尖牙上設(shè)計(jì)低位卡環(huán),Kennedy第一類牙列缺損,設(shè)計(jì)舉例,Kennedy第一類牙列缺損,設(shè)計(jì)舉例,Kennedy第一類牙列缺,設(shè)計(jì)舉例,Kennedy第二類牙列缺損,特點(diǎn)(1)單側(cè)后牙游離端缺失(2)多設(shè)計(jì)為混合支持式義齒(3)多設(shè)計(jì)為與牙弓對(duì)側(cè)相連,Kennedy第二類牙列缺損,設(shè)計(jì)要點(diǎn)(1)單側(cè)一個(gè)后牙游離缺失常規(guī)選擇兩個(gè)基牙,單側(cè)設(shè)計(jì),Kennedy第二類牙列缺損,設(shè)計(jì)要點(diǎn)(2)兩個(gè)以上后牙游離缺失牙弓對(duì)側(cè)設(shè)計(jì)直接固位體兩側(cè)用大連接體相連按固位,穩(wěn)定,美學(xué)原則加設(shè)間接固位體,Kennedy第二類牙列缺損,設(shè)計(jì)要點(diǎn)(3)牙弓一側(cè)全部牙齒缺失盡量利用牙弓對(duì)側(cè)基牙余留牙條件差時(shí),盡量用塑料基托相連,提高義齒固位,穩(wěn)定功能口內(nèi)僅留個(gè)別后牙時(shí),可不設(shè)合支托,Kennedy第二類牙列缺損,設(shè)計(jì)舉例,Kennedy第二類牙列缺損,設(shè)計(jì)舉例,Kennedy第二類牙列缺損,設(shè)計(jì)舉例,Kennedy第二類牙列缺損,設(shè)計(jì)舉例,Kennedy第三類牙列缺損,特點(diǎn)(1)牙弓一側(cè)或兩側(cè)有缺失牙(2)缺牙間隙兩側(cè)均有天然牙存在(3)多設(shè)計(jì)為牙支持式義齒,Kennedy第三類牙列缺損,設(shè)計(jì)要點(diǎn)(1)缺牙間隙較小，而兩端基牙條件較好時(shí)，在基牙上設(shè)計(jì)直接固位體即可。,Kennedy第三類牙列缺損,設(shè)計(jì)要點(diǎn)(2)缺牙間隙大，缺隙在牙弓一側(cè)，前方基牙又較弱者，可用大連接體，利用兩側(cè)牙弓支持，并在對(duì)側(cè)使用有間接固位作用的卡環(huán),Kennedy第三類牙列缺損,設(shè)計(jì)舉例,Kennedy第四類牙列缺損,特點(diǎn)(1)前牙缺失(2)多設(shè)計(jì)為混合支持式義齒,Kennedy第四類牙列缺損,設(shè)計(jì)要點(diǎn)(1)1個(gè)或2個(gè)前牙缺失,常選擇兩個(gè)基牙,基牙常為第一前磨牙(2)人工牙排列要避免深覆合,要與相鄰的天然牙協(xié)調(diào),與牙弓對(duì)側(cè)同名天然牙對(duì)稱,顏色盡量與天然牙一致,Kennedy第四類牙列缺損,設(shè)計(jì)要點(diǎn)(3)尖牙缺失,間隙小,合力不大的情況下,可在缺隙遠(yuǎn)中設(shè)置兩個(gè)固位體,單側(cè)設(shè)計(jì)義齒,使基托面積減小,便于發(fā)音(4)前牙缺失較多者,要增加基牙數(shù),防止義齒發(fā)生唇舌向轉(zhuǎn)動(dòng),Kenned