不景氣中的明智選擇
缺牙真是個惱人的事情,一般說缺一顆做三顆,就是利用修磨兩旁的牙齒,連結支撐中間的缺牙區,製作成牙橋,近年來更流行所謂的人工植牙,優點就是完全不打擾兩旁其他的牙齒,直接利用缺牙區,植入人工牙根,支撐缺牙區的贋復體(單顆牙套或多顆牙橋),但是植牙的價格高又需手術植入,也大多需要相當的時間,等待齒槽骨組織對人工牙根的〝骨整合〞,才能放心受力,完成贋復製作,而傳統連三顆(或以上)的牙橋又都需要修磨兩旁牙齒,有不少人覺得不捨;想要回復缺牙區贋復咬合功能又不想連累犧牲兩旁齒質,而且又想更省點荷包的另一種選擇就是〝黏著性牙橋〞。
「黏著性假牙」在牙科的發展,源起自1981年,由美國馬里蘭大學,Dr. Von Thompson所創造設計的,坊間亦有些牙醫師稱之為「馬里蘭牙橋」,它的應用原理很簡單,即是利用兩旁牙齒表面琺瑯質適度的圍抱型態,製作出連繫中央缺牙部位而為一體成型的金屬架構,修復所缺損的牙齒,而主要的特性是藉強力牙科用黏著劑與兩旁齒質粘結架起,以回復美觀之外型和健全的咬合功能。
黏著性假牙的優點為:
1. 免削磨過多齒質、保存自然健康的齒質;
2. 免打麻藥、製作過程較為簡單;
3. 價錢便宜、省時省事;
4. 牙周環境容易清潔。
並且免除了傳統式牙橋的缺點,如:切削過多齒質,牙齒容易變弱;贗復體不易做到密合協調;易引起牙周問題及蛀牙;改變自然咬合不易回復;製作時常需打麻藥;費時費事,而且花費較高,做不好無法回復。
有關此類黏著技術之研究,各國牙醫界均有相當研發進展,分別向著金屬表面處理法和黏著劑本身化性作兩個不同方向的研究;對於金屬表面的處理,最普通的是電解酸蝕法,簡單的亦有噴砂處理法,其他如矽酸覆蓋法、熱處理法;目前來講技術都已相當純熟了。臨床上如果牙醫師和齒模技工能對所採用之技術充分瞭解精確處理,配以選用適當之金屬材質和黏著劑材料,效果都相當不錯,臨床追蹤已有二十年以上的使用案例,而據馬里蘭牙橋的創始人Dr. Von Thompson 於1989年所作的報告,依統計黏著性假牙的使用年限可在十八年以上。
黏著性假牙的應用範圍非常廣,並且可以使以往傳統做牙法較為困難的案例,簡化許多。最常見的適應症如拔牙後單顆缺牙的狀況,單顆缺牙又不想因要做牙橋犧牲過多的兩旁健康齒質時,黏著性牙橋免削磨過多齒質的優點,在此狀況益加顯出極大的對比優點,另外如齒列矯正後,為防止牙齒再度移位,亦可用此種黏著性牙橋黏於牙齒的舌側面,固位效果更為持久;而對於牙周病術後的病例,常因為剩餘牙齒不多稀疏散佈,加以牙周萎縮牙根裸露牙齒搖動,在傳統假牙製作處理時極為困難,而若以黏著技術配上固定式活動式假牙,設計上則變更為活潑簡單,且較能保存剩餘的牙齒了。
裕民牙醫診所
TEL:2396-3559
台北市濟南路二段38-2號2樓

請問醫師高雄有哪間在做黏著式牙橋
請問醫師高雄有哪間在做黏著式牙橋
洪凱駖藥師~ Solving a long-standing mystery about the desert’s rock art canvas Petroglyphs are carved in a material called rock varnish, the origins of which have been debated for years. Now, scientists argue it’s the result of bacteria and an adaptation that protects them from the desert sun’s harsh rays. By Nathan Collins 5923141600_1bc3f25867_k.jpg Rock art featuring human and animal forms and handprints Petroglyphs at Mesa Verde National Park, Colorado (Christine Fry & Peter Russo) Wander around a desert most anywhere in the world, and eventually you’ll notice dark-stained rocks, especially where the sun shines most brightly and water trickles down or dew gathers. In some spots, if you’re lucky, you might stumble upon ancient art – petroglyphs – carved into the stain. For years, however, researchers have understood more about the petroglyphs than the mysterious dark stain, called rock varnish, in which they were drawn. In particular, science has yet to come to a conclusion about where rock varnish, which is unusually rich in manganese, comes from. Now, scientists at the California Institute of Technology, the Department of Energy’s SLAC National Accelerator Laboratory and elsewhere think they have an answer. According to a recent paper in Proceedings of the National Academy of Sciences, rock varnish is left behind by microbial communities that use manganese to defend against the punishing desert sun. The mystery of rock varnish is old, said Usha Lingappa, a graduate student at Caltech and the study’s lead author. “Charles Darwin wrote about it, Alexander von Humboldt wrote about it,” she said, and there is a long-standing debate about whether it has a biological or inorganic origin. But, Lingappa said, she and her colleagues didn’t actually set out to understand where rock varnish comes from. Instead, they were interested in how microbial ecosystems in the desert interact with rock varnish. To do so, they deployed as many techniques as they could come up with: DNA sequencing, mineralogical analyses, electron microscopy, and – aided by Stanford Synchroton Radiation Lightsource (SSRL) scientist Samuel Webb – advanced X-ray spectroscopy methods that could map different kinds of manganese and other elements within samples of rock varnish. “By combining these different perspectives, maybe we could draw a picture of this ecosystem and understand it in new ways,” Lingappa said. “That’s where we started, and then we just stumbled into this hypothesis” for rock varnish formation. Among the team’s key observations was that, while manganese in desert dust is usually in particle form, it was deposited in more continuous layers in varnish, a fact revealed by X-ray spectroscopy methods at SSRL that can tell not only what chemical compounds make up a sample but also how they are distributed, on a microscopic scale, throughout the sample. That same analysis showed that the kinds of manganese compounds in varnish were the result of ongoing chemical cycles, rather than being left out in the sun for millennia. That information, combined with the prevalence of bacteria called Chroococcidiopsis that use manganese to combat the oxidative effects of the harsh desert sun, led Lingappa and her team to conclude that rock varnish was left behind by those bacteria. For his part, Webb said that he always enjoys a manganese project – “I’ve been a mangaphile for a while now” – and that this project arrived at the perfect time, given advances in X-ray spectroscopy at SSRL. Improvements in X-ray beam size allowed the researchers to get a finer-grained picture of rock varnish, he said, and other improvements ensured that they could get a good look at their samples without the risk of damaging them. “We’re always tinkering and fine-tuning things, and I think it was the right time for a project that maybe 5 or 10 years ago wouldn’t really have been feasible.” The research was supported by the National Science Foundation, the National Institutes of Health and the National Aeronautics and Space Administration. SSRL is a DOE Office of Science user facility. Citation: Usha F. Lingappa et al., Proceedings of the National Academy of Sciences, 22 June 2021 (10.1073/pnas.2025188118) For questions or comments, contact the SLAC Office of Communications at communications@slac.stanford.edu. SLAC is a vibrant multiprogram laboratory that explores how the universe works at the biggest, smallest and fastest scales and invents powerful tools used by scientists around the globe. With research spanning particle physics, astrophysics and cosmology, materials, chemistry, bio- and energy sciences and scientific computing, we help solve real-world problems and advance the interests of the nation. SLAC is operated by Stanford University for the U.S. Department of Energy’s Office of Science. The Office of Science is the single largest supporter of basic research in the physical sciences in the United States and is working to address some of the most pressing challenges of our time. X-ray Science X-ray Spectroscopy Stanford Synchrotron Radiation Lightsource (SSRL) 我看色獄心機~時~我好像在監獄裡睡覺~我要叫~我要大叫~