顎咬合學3.0: 牙科跨領域在美學、功能性與與長期穩定性的探討

顎咬合學3.0: 牙科跨領域在美學、功能性與與長期穩定性的探討

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講者:Dr. Nazzareno Bassetti – CTD, DDS, MSc

題:顎咬合學3.0: 牙科跨領域在美學、功能性與與長期穩定性的探討
Gnathology 3.0 Aesthetic, Function and Long-Term Stability

大綱:

複雜功能性失調和非功能性失調病例的治療計劃需要一種跨學科的方法,涉及了牙科的各學科。本課程根據Slavicek教授和Sato教授的理念,以功能性咬合概念的矯正及贋復治療方式規劃治療。由於嚴重齒列磨損的病例有越來越多的趨勢,因此,這樣的方法非常重要。

測顱描記法(cephalometric tracing),可以分別紀錄垂直高度和咬合面的改變。若垂直高度的變化是可預期的話,將可以在手術、根管及修形上有效的降低侵入性。同時,新的垂直高度將在兩個牙弓之間提供足夠的空間,從而確保重建材料的機械抗性。此外,使用咬合板或顳顎相關的暫時性前治療可以使得疼痛症狀緩解,且可以測試舒緩疼痛的治療位置。

隨後再以Sato的MEAW(Multiple Edgewise Arch Wire)原理進行齒顎矯正治療,就可以重新打開缺齒的空間、增加垂直高度、調整矯正咬合面的傾斜度,並進行三維下顎重新定位。另一方面,植體療法可以讓您獲得後方支撐、垂直高度的控制,並引導下顎在矢狀和橫向平面的重新定位(3D)。

Bassetti的OMRT(Occlusal Mandibular Repositioning Technique)技術:通過重新組裝咬合器上的臨時牙冠、評估RP(參考位置/reference position),以及以樹脂填補進行校正達到TP(治療位置/Therapeutic Position),來驗證治療位置的正確性。

植體的位置、隨之而來的骨組織管理,以及隨後的贋復重建,都是在顎咬合學的指導下進行的。而通過控制垂直高度和咬合面的個別傾斜度,將可以在治療位置(TP)中,對下顎進行三維重新定位。

Bruxchecker則是強調了Slavicek的咬合概念,並且能夠控管異常功能(磨牙)的咬合。這種類型的方法對於複雜修復的長期穩定性很重要。

KEY POINTS

  • 治療風險的降低和控管
  • 診斷步驟
  • 功能障礙的症狀和徵兆
  • 面部美學
  • 垂直高度的變化
  • 下顎重新定位的RP或TRP概念
  • SLAVICEK的咬合概念和蠟型
  • 咬合平面的控制
  • 數位功能微笑設計(DFSD)
  • Bassetti的下顎咬合重新定位技術(OMRT)
  • 臨時治療
  • 贋復前的齒顎矯正治療
  • 臨床案例

The plan for the treatment of complex dysfunctional and non-dysfunctional cases requires an interdisciplinary approach that involves the most common branches of dentistry and an orthodontic, prosthetic approach respecting a functional-occlusal concept according to the philosophy of Professor Slavicek and Professor Sato.
This type of approach today is essential because of the growing number of cases with severe dental destructions (worn dentition).
The cephalometric tracing allows the variation of the vertical dimension and the occlusal plane individually.
The possibility to change the vertical dimension predictably decreases the invasivity of the treatment by avoiding or reducing surgery, endodontics, and dental preparations.
At the same time, the new vertical dimension gives sufficient space between the two arches that guarantees mechanical resistance to reconstruction materials.
The pre-therapy with an occlusal splint or with diagnostic temporary allows the Algic symptomatology to be resolved and to test the therapeutic position.
The subsequent orthodontic therapy using Sato’s MEAW philosophy allows for the spaces of the missing teeth to be reopened, the vertical dimension to be increased, the inclination of the occlusal plane to be corrected and the mandible to be repositioned three-dimensionally.
Implant therapy will allow you to have the back support, the control of the vertical dimension, and to guide the mandible in a sagittal and traversal reposition (3D).
OMRT Technique Bassetti:
proceed and verify the therapeutic position by reassembling the temporary crowns in the articulator and valuate the R.P. (reference position) and any corrections to be made on the resin to reach the Therapeutic Position (TP).
We can say that the position of the implants, the consequent bone tissue management, and the subsequent prosthetic reconstructions are gnathological guided.
The control of the vertical dimension and the individual inclination of the occlusal plane allow the three-dimensional repositioning of the mandible in the Therapeutic Position (TP).
The Bruxchecker highlighted an occlusion that respected the occlusal concept of Slavicek and was able to control the parafunction(BRUXISM).
This type of approach is shown important for the long-term stability of complex rehabilitations.
This type of approach is shown important for the long-term stability of complex rehabilitations.

KEY POINTS
• REDUCTION AND CONTROL OF THE THERAPEUTIC RISK
• DIAGNOSTIC STEPS
• SIGNS AND SYMPTOMS OF DISFUNCTION
• AESTHETICS OF THE FACE
• VARIATION OF THE VERTICAL DIMENSION
• RP OR TRP CONCEPT OF MANDIBULAR REPOSITION
• SLAVICEK OCCLUSAL CONCEPTS AND WAX UP
• OCCLUSAL PLANE CONTROL
• DIGITAL FUNCTIONAL SMILE DESIGN (DFSD)
• OCCLUSAL MANDIBULAR REPOSITION TECHNIQUE OMRT Bassetti
• THERAPEUTIC TEMPORARY
• PRE-PROSTHODONTIC ORTHODONTICS
• CLINICAL CASES’

講者介紹:

Dr. Nazzareno Bassetti – CTD, DDS, MSc

Master Course at Donau University Krems (Austria) on Orthodontic Therapy in Dysfunctional Patients with Prof S. Sato.

Title of Academic Expert in Orthodontics awarded to Donau University Krems (Austria) with Prof S. Sato, 2007.

Member of The Italian Society of Dental Orthopedics.

Participant of The International Implanthology Team.

Associate at Ascoli Piceno Clinic primarily focusing at orthodontic problems, prosthetics, implanthology and integrated rehabilitation with the use of an interdisciplinary approach to treatment of patients with dysfunctions.

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