頜情.頜理:風險因素 蘋果日報 2018年02月28日

By Maymay05, 2018-03-02

頜情.頜理:風險因素   蘋果日報 2018年02月28日

植牙是將一些與身體能相容的物料,例如鈦金屬用手術的方法放進牙槽骨當中,待鈦金屬植體與牙骨接合後,便可在上面建造假牙。世界各地研究指出植牙的成功率大約是98%,即是說仍有2%病人是會失敗。事實上並非每個人都適合植牙,以下是植牙失敗常見風險因素。

牙周病

未受控制的牙周病患者或無法保持良好口腔衞生者,都不適合植牙,因這些病人口腔內細菌數量很高,大大提升了手術後感染的機率,之後亦會較容易出現植體周圍炎(Peri-implantitis)。所以病人在植牙前應先穩固牙周組織,以及植牙後定期到牙科醫生處覆檢及清洗,才確保植牙的成功和長遠健康。

吸煙

吸煙會減低白血球的活動能力,從而降低身體抵抗力,令傷口癒合延遲,增加感染風險。尼古丁會令血管收縮,抑制血小板及成骨細胞(osteoblasts)功能,直接影響植牙體與牙槽骨的隔合。多項研究顯示吸煙者植牙的存活率(implant survival rate)大約為94.4%,非吸煙者大概是98%,即吸煙者植牙的失敗機率高於非吸煙者。每天吸煙越多或吸食年期越長,植牙的失敗率就越高。研究亦指戒煙年期越長,植牙的存活率會相對地提高。

糖尿病

糖尿病是一種代謝性疾病,主要影響身體內葡萄糖的代謝令致血糖過高。高血糖會破壞微血管,減低牙齦血液循環,同時促進慢性炎症細胞的產生,破壞牙周組織,增加患牙周病及植體周圍炎的風險,故糖尿病患者植牙會有較高失敗率。倘若糖尿病人要接受植牙,應先接受糖尿病治療,確保血糖值已控制在安全範圍,並保持良好口腔衞生,避免植牙後傷口受感染及出現植體周圍炎。
病人在植牙前應與牙科醫生充份溝通,了解自身有沒有相關的風險因素,採取適當治療方案,增加植牙成功率。

隔周三刊出
撰文:香港口腔頜面外科學會委員周立強醫生

 

 

 

 

 

 

 

 2010 Jul;21(7):772-7. doi: 10.1111/j.1600-0501.2010.01912.x.

Long-term implant survival and success: a 10-16-year follow-up of non-submerged dental implants.

Abstract

OBJECTIVES:

The aim of the present study was to evaluate the long-term results of dental implants using implant survival and implant success as outcome variables.

METHODS:

Of the 76 patients who received 162 implants of the Straumann Dental Implant System during the years 1990-1997, 55 patients with 131 implants were recalled 10-16 years after implant placement for a complete clinical and radiographic examination, followed by a questionnaire that examined the degree of satisfaction. The incidence of biological and technical complications has been carefully analysed for each implant. Success was defined as being free of all these complications over the entire observation period. Associated factors related to peri-implant lesions were analysed for each implant.

RESULTS:

The long-term implant cumulative survival rate up to 16 years was 82.94%. The prevalence of biological complications was 16.94% and the prevalence of technical complications was 31.09%. The cumulative complication rate after an observation period of 10-16 years was 48.03%, which meant that substantial amounts of chair time were necessary following implant placement. The majority of implant losses and biological complications were concentrated in a relatively small number of patients.

CONCLUSION:

Despite a relatively high long-term survival rate, biological and technical complications were frequent. Patients with a history of periodontitis may have lower implant survival rates than patients without a history of periodontitis and were more prone to biological complications such as peri-implant mucositis and peri-implantitis.

PMID: 20636731 DOI: 10.1111/j.1600-0501.2010.01912.x

https://www.ncbi.nlm.nih.gov/pubmed/20636731

 

 

 

 

 

 

 

 

楊幽幽牙科醫生 Dr. Cecilia Young Yau Yau

本片授權於原文醫藥人健康雜誌 118 期 關於植牙的種種迷恩

本片授權於原文醫藥人健康雜誌 126 期 口腔植體周邊組織炎

本片授權於原文醫藥人健康雜誌 124期 植骨與植牙手術 先植骨後植牙

本片授權於原文醫藥人健康雜誌 125期 同時進行植骨與植牙

內容以全篇原文為準

關於植牙的方法,上期我們已經介紹了先植骨後植牙,今期繼續解釋植骨與植牙同時進行的方法……………………

**以上影片已得病人同意使用作公共衛生教育用途

影片內”我們” 或 “示範中的方法” 指牙醫業內一般做法或其中一種做法

本片只用作一般公共衛生教育用途,病人應該與醫生商量自己的處理方法。

所有牙醫均可進行公共口腔衛生教育,而公共衛生(Public Health )或社會牙醫科(Community Dentistry )更是牙科內的一個科目。

1.6 牙科/口腔健康教育活動
1.6.1 牙醫可以參與真確的牙科/口腔健康教育活動,例如演講及作
專業發表…………..

1.6.3 向公眾提供的資料應具權威性、合宜並與一般經驗相符。該等
資料應有事實根據、清楚易明及用詞淺白。

「公共衛生/社會牙醫科」是牙醫專科其中一項科目。

所有牙醫均可進行公共口腔衛生教育,而公共衛生(Public Health )或社會牙醫科(Community Dentistry )更是牙科內的一個科目。

香港牙醫管理委員會 香港牙醫專業守則
http://www.dchk.org.hk/docs/code_c.pdf

以下為公共口腔衛生教育系列關鍵字

Dr. Cecilia Young Yau Yau Oral Health Education series key words

阿士匹靈抗血小板劑抗凝血劑 抗生素 關節僵硬銀粉 矯正 植牙 膿腫 研磨劑 刷蝕牙齒 態度 撕脫 乳齒 細菌 口氣 咬 矯正器 好唔好腦膿腫 刷牙 緩衝作用 過氧化尿素齲齒檢查咀嚼 複合 牙套 牙冠增長手術 環孢素A 失智症 牙科 牙橋 牙科疾病 牙科脫牙牙科問題 牙髓 牙周膜 牙菌膜 矯齒根管治療 洗牙齒表面 矯齒 微電測試牙髓 預防性樹脂補牙 玻璃離子 牙腳尖 二手煙 敏感牙齒 吸煙 手術 鑽洞測試 水銀 成功牙齒氟化 發炎 楊幽幽淋巴核 神經 牙齒過度長出 酸鹼值 維他命C 智慧齒華法林 牙膏 牙刷 牙齒美白 牙齒漂白 口氣 失敗 補牙 牙線 外觀 咬合 橋體 牙冠 口腔種植周邊炎 含氟漱口水 漱口水 硝酸鉀 口腔黏膜發炎 尼古丁 口腔疾病 口腔感染 預防 牙袋 家庭主婦 感冒 象牙質 牙齒創傷 牙骨黏連 牙周膜位置骨化 磨蝕牙齒 牙齒正畸 氟素防蛀劑 牙紋防蛀劑好唔好 鑲嵌物 鑄造瓷貼片 楊幽幽 酸蝕牙齒 牙齒腫大 好唔好 漱口水 肝素 薄血藥 維生素C血栓栓塞 國際標準化比值 感染性心內膜炎 楊幽幽 琺瑯質 局部麻醉劑 三氯沙 空姐 空間固定器 進食次數用餐次數 全口假牙托, 琺瑯質形狀缺陷馬利蘭牙橋 咽喉炎 食物與牙齒健康 奶瓶齲齒 鎮靜 牙髓治療 氟素凝膠 牙腳斷裂 牙腳吸收 牙根整平術 早期兒童蛀牙 糖尿病 效用 測試 牙齦 牙齦組織 牙齦出血 雙氧水 免疫抑制劑 矯齒

Dr. Cecilia Young Yau Yau Oral Health Education series key words

嵌塞 牙縫刷 腎病 致命牙齒脫位 膿 退縮 戒煙 骨質疏鬆 腫脹 四環素染色 楊幽幽牙科醫生 更薄的牙齒 刮舌板 牙齒長出 牙齒不可逆性牙髓炎 水氟化
X光對生育期內婦女的影響, 什麼年紀最適合箍牙, 假牙, 傷口處理, 公共衛生教育, 剝牙, 副作用, 口腔種植, 成人矯齒成效如何, 止血, 正確刷牙及使用牙線方法, 楊幽幽牙科醫生口腔教育系列 注意事項, 洗牙流血點解, 活動假牙托, 流血不止, 滿口牙套可以箍牙嗎, 漂牙, 空姐, 牙周病, 牙周病患者是否可以箍牙. 透明牙箍有用嗎, 牙柱, 牙橋, 矯齒, 牙痛, 牙瘡, 牙肉流血, 牙醫, 牙骹, 種牙, 空姐接觸的宇宙射線會否影響胎兒, 笑容, 箍牙會唔會失敗, 脫牙, 蛀牙, 關節 好唔好

Dr. Cecilia Young Yau Yau Oral Health Education series key words

abrasion, abrasives, abscess, abutment tooth, aligners, amalgam, ankylosis, antibiotics, anticoagulation, antiplatelet, aspirin, attitude, attrition, avulsion, baby teeth, bacteria, bad breath, biting, bleaching, bleeding, bracing, brain abscess, bridge, brushing, buffering effect, carbamide peroxide, caries, check-up, chewing,
Dr. Cecilia Young Yau Yau Oral Health Education series key words

chlorhexidine, composite, crown, crown lengthening, cyclosporine A, dementia, Dental, dental bridge, dental decay, dental disesase, dental extraction, dental problem, dental pulp, dental scaling, dental trauma, dentine, denture, diabetes

Dr. Cecilia Young Yau Yau Oral Health Education series key words

mellitus, diagnosis, early childhood caries, effectiveness, electric pulp test, enamel, erosion, esthetics, examination, extraction, failure, fever, fillings, fissure sealant, flight attendant, flossing, fluoride gel, fluorosis, gaps, gingiva, Gingival hypertrophy, gingival tissue, glass ionomer, gum bleeding, gum disease, halitosis, Heparin, housewife, hydrogen peroxide, hypoplasia, immunosuppressant, impaction, implant, infective endocarditis, inflammation, inlay, interdental brushing, international normalizing ratio INR, Kidney disease, lethal, local anaesthesia, look, luxation, lymph node, mechanical cleansing, mercury, mouthrinse, mucositis, nerve, nicotine,

Dr. Cecilia Young Yau Yau Oral Health Education series key words

number of meals, nursing bottle syndrome, occlusion, onlay, oral disease, Oral Health Education, oral infection, orthodontic treatment, osteoporosis, overeruption, peri-implantitis, periodontal disease, periodontal membrane, pH value, plaque, pocket, pontic, porcelain veneer, post, post and core, potassium nitrate, prevention,
preventive resin restoration, pus, recession, removable appliance, removable denture, root apex, Root Canal Treatment, root fracture, root planning, root resorption, scaling, second hand smoking, sensitive teeth, side effect, smile, smoking, smoking cessation, successful, surgery, swelling, test cavity, tetracycline staining, thinner teeth, thromboembolism, tongue scrapper, tooth bleaching, Tooth bracing, tooth decay, tooth eruption, tooth whitening, tooth. Irreversible pulpitis, toothache, toothbrush, toothpaste, triclosan, vitamin C, warfarin, washing effect, water fluoridation, wisdom tooth, wound handling complete Denture space maintainer
Maryland Bridge, pharyngitis, sedation, Pulpotomy

Dr. Cecilia Young Yau Yau Oral Health Education series key words

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