| Summary: | 碩士 === 高雄醫學大學 === 牙醫學研究所碩士在職專班 === 95 === Dr. Amsterdam (U. Penn., 1974) defined periodontal prosthesis as “Those restorative prosthetic endeavors that are absolutely essential in the treatment of advanced periodontal disease. Whereas specifically it refers to the treatment of the dentition mutilated by the ravages of periodontal disease, in general, its concepts, principles and techniques may be employed in any restorative or tooth replacement service involving the nature dentition”. Periodontal prosthesis patients are usually described as loss of periodontim that results in gingival recession, mobility, pathologic migration, anterior teeth flare out, posterior bite collapse, spacing and elongation. It is necessary to establish multidisciplinay treatment modalities to manage these patients. Therefore twenty first century treatment is an integrated treatment which emphasizes on cooperation of different fields.
This report contains 9 cases with moderate to advanced periodontitis, treated with phased-in comprehensive care treatment plans, and restored articulation, chewing and esthetics. There are some simple cases like subgingival curettage and crown lengthening. There are also complicated cases such as full mouth periodontal treatment, occlusal rehabilitation, matching magnetic attachment with CSCTD or removable partial denture and how to manage problem due to implant. Making a good treatment plan is important. Various treatment plans offer the option of sequential therapy of endodontics, periodontics, orthodontics and prosthodontics.
It is important to control periodontitis and eliminate occlusal trauma before practice of any resoration and prosthesis. The control of periodontitis included surgical and nonsurgical therapy. Nonsurgical therapy primarily accompanied with ultrasonic scaling. According to the report of Kaldahl WB, Kalkwarf et al. in 1990, the short-term result of surgical therapy may reduce more probing depth than nonsurgical therapy; but there was no significant statistic difference for both probing depth and clinical attachment level in the long-term result. The therapy of occlusal trauma included many items such as occlusal adjustment, occlusal plate and splintitng.
All treatments done in these cases are effective so far in terms of satisfying patients’ needs for chewing, articulation and esthetics. Therefore all cases can be used as reference or similar treatments. Frequent hygiene recalls and prosthetic maintained are necessary to achieve a long-term prognosis.
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