什麼是鼻竇增高術？適合族群、手術流程、風險與費用

什麼是鼻竇增高術？適合族群、手術流程、風險與費用

by | 3 月 15, 2024

前言

鼻竇增高術後遺症、鼻竇增高術失敗是許多植牙患者擔心的事情，有關鼻竇增高術ptt版上也能看到很多相關的討論和疑問，甚至出現一些相關的迷思，關於鼻竇增高術費用更是讓人看的眼花撩亂。以下讓我們大叔來一一解答，希望對即將植牙的患者有些幫助。

鼻竇在哪？

鼻竇是位在頭部內部的數個空腔，分成四對，其中和植牙比較有關係的是上顎竇，也是今天鼻竇增高術的主角。上顎竇所在的位置，在全景X光片中大概位於後牙區，一般來說是第二小臼齒後面的區域，所以在上顎後牙區的植牙才會有機會遇到鼻竇增高術。

 

 我的鼻竇發生了什麼事？為什麼需要鼻竇增高術？

你可能會好奇，對，我知道鼻竇，但我是要植牙，關鼻竇什麼事？人類是個奇怪的東西，一但知道某些沒在用之後，他就會開始跟你耍廢，所以你可能聽過被拔掉牙齒的牙齦會萎縮。

在上顎後牙區，沒牙齒的牙齦不但會萎縮，在缺牙處上方的上顎竇還會氣室化，越變越低使得可用骨頭越來越少。你的上顎齒槽骨就像是一片夾心餅乾，不但牙齦會往上萎縮外，上面的鼻竇也會往下變大，兩者擠壓下讓中間可供植牙的齒槽骨越變越少。

 

上顎後牙區，植牙需要的齒槽骨高度一般建議至少要有8mm以上，齒槽骨高度不足時，就需要鼻竇增高術，讓植體周圍可以有骨頭。

鼻竇增高術的後遺症？

鼻竇增高術的術式

鼻竇增高術的術式通常分為兩種，一種是利用植體要植入的位置提升鼻竇，一種是從鼻竇側面開窗提升鼻竇。第一種的傷口較小，通常可以在植牙當下一起補骨，適用於齒槽骨吸收不是那麼嚴重的狀況，植牙區齒槽骨高度通常還有3-4mm以上。

第二種側面開窗的方式，傷口較大，一般需要先補完骨頭之後待一段時間才會再安排植牙手術，適用於齒槽骨吸收很嚴重的患者，植牙區齒槽骨高度通常只剩下1-2mm。

 

鼻竇增高術後遺症

一般來說，鼻竇增高術後遺症並不明顯，沒有太多不適。術後的兩週內可能會有手術區域腫脹、微出血、或發炎的狀況，屬於手術後的正常情形，其中側開窗鼻竇增高術的不適感會略大於植體位置的鼻竇增高術。配合一些傷口的照護措施，例如冰敷、服藥、二極體低能量雷射傷口照護、高壓氧艙，都可以減緩不是，增快傷口的恢復。

 

鼻竇增高術的禁忌症

鼻竇增高術的禁忌症跟一般植牙手術禁忌症相同：糖尿病、高血壓、抽菸、凝血功能不佳者，除此之外比較需要注意的則是如有感冒，尤其有鼻竇發炎、流鼻水、黃鼻涕、打噴嚏的症狀的話會建議將手術日期延後。

 

鼻竇增高術的費用

鼻竇增高術的費用，在臺南市牙醫師公會建議收費裡是一區5萬，一般來說大概介於1.5萬～5萬之間，視手術困難度、區域大小、骨粉所需多寡來決定。

 

不想做鼻竇增高術，有沒有其他的選擇？

醫師啊，我就不想手術啊，那有其他選擇嗎？

選擇一

如果你的上顎後牙缺牙區，前後都還有牙齒，植牙外的另一個選擇就是做傳統的牙橋。

選擇二

假如你還是想植牙，而且齒槽骨高度也沒有到太糟糕，介於6-8mm之間，那是有機會使用短植體，目前最短植體的長度是6mm，也就是說6mm以上的齒槽骨高度有機會可以不用作鼻竇增高術。

 

總結

植牙區齒槽骨高度>3mm，植牙和鼻竇增高術有機會可以一起做，少一次手術，手術範圍較小。

植牙區齒槽骨高度1~2mm，側開窗方式進行鼻竇增高，手術範圍較大，手術後一段時間才能安排植牙手術。

不想做鼻竇增高術：1.前後有牙，牙橋，2.齒槽骨高度>6mm，短植體。

『植體周圍維持一定的骨頭量，對於植體來說是很重要的一個保護，所以如果真的上顎後牙植牙區齒槽骨高度不足，鼻竇增高術這一步千萬不能跳過，對於植體日後的使用壽命是有很大的影響的。』

 

Preface

Sinus Lift Surgery Complications and Sinus Lift Surgery Failure are concerns for many dental implant patients. There are many discussions and questions about sinus lift surgery , and even some myths have arisen. The cost of sinus lift surgery is also a confusing topic. Let’s address these issues one by one to hopefully provide some assistance to patients preparing for dental implants.

Where are the sinuses?

The sinuses are several air-filled cavities located within the head. There are four pairs of sinuses, but the maxillary sinuses, which are related to dental implants, are the focus of today’s discussion. The maxillary sinuses are typically located behind the posterior teeth area, approximately behind the second molar. Therefore, sinus lift surgery may be necessary for dental implants in the posterior maxilla.

 

What happens to my sinuses? Why is sinus lift surgery necessary?

You might wonder why sinuses are relevant when you’re getting dental implants. Humans are peculiar creatures; once something is not in use, it starts to deteriorate. So, you may have heard that the gums recede after teeth are extracted.

In the posterior maxilla, where there are no teeth, the gums not only recede but the maxillary sinus above the edentulous area pneumatizes, gradually lowering and reducing the available bone. Think of your maxillary bone as a sandwich cookie; not only does the gum recede upward, but the sinus above also expands downward, reducing the available bone for implant placement.

 

For dental implant placement in the posterior maxilla, it’s generally recommended to have a bone height of at least 8mm. If the bone height is insufficient, sinus lift surgery is necessary to provide adequate bone around the implant.

 

What are the complications of sinus lift surgery?

Types of sinus lift surgery

Sinus lift surgery typically comes in two types: one involves lifting the sinus using the area where the implant will be placed, and the other involves lateral window access to lift the sinus.

The first type involves a smaller incision and can usually be performed concurrently with implant placement, suitable for cases where bone resorption is not severe, and there is still 3-4mm of bone height in the implant area.

The second type, lateral window access, involves a larger incision and generally requires bone grafting before implant placement. This method is suitable for patients with severe bone resorption, where only 1-2mm of bone height remains.

 

Complications of sinus lift surgery

Generally, complications after sinus lift surgery are not significant and involve minimal discomfort. Swelling, minor bleeding, or inflammation in the surgical area may occur within the first two weeks post-surgery, which is normal. However, discomfort may be slightly greater with lateral window sinus lift surgery compared to lifting the sinus using the implant site. Proper wound care measures such as ice packs, medication, low-level laser therapy, and hyperbaric oxygen therapy can alleviate discomfort and promote faster healing.

 

Can sinus lift surgery fail?

Possibility 1: Sinus membrane perforation

Sinus lift surgery, like any surgical procedure, carries the risk of failure. The primary reason for sinus lift surgery failure is perforation of the sinus membrane during the procedure. The thickness of each individual’s sinus membrane varies, making the surgery more challenging when the membrane is too thick or too thin, increasing the risk of perforation.

Although perforation can occur, there’s no need to panic. If the perforation is small, the torn sinus membrane can be sutured or avoided using surgical techniques, and reinforcement with a membrane can still allow the surgery to be successful. If the perforation is extensive and bone grafting cannot be completed during the same surgery, the flap will be sutured, and a waiting period will be necessary for the perforation to heal before proceeding with further surgery.

 

Possibility 2: Inadequate bone growth after grafting

Another reason for failure is inadequate bone growth after grafting. After surgery, the bone graft undergoes a conversion process to become natural bone, which may result in less bone formation than expected. If bone formation is inadequate, additional bone grafting may be required during implant placement. This situation is more likely to occur with lateral window sinus lift surgery, but with minimal bone grafting required during secondary bone grafting, it can be managed concurrently with implant placement, reducing the number of surgeries needed and minimizing concerns.

 

Contraindications for sinus lift surgery

The contraindications for sinus lift surgery are similar to those for general dental implant surgery: diabetes, hypertension, smoking, and impaired clotting function. Additionally, it’s essential to avoid sinus lift surgery during cold or sinus infections, especially if symptoms such as sinus inflammation, nasal discharge, yellow nasal mucus, or sneezing are present; in such cases, surgery should be postponed.

 

Cost of sinus lift surgery

The cost of sinus lift surgery, according to the Tainan Dental Association, typically ranges from 15,000 to 50,000 NT dollars, depending on the complexity of the surgery, the size of the area, and the amount of bone graft needed.

 

Alternatives to sinus lift surgery

If you prefer to avoid surgery, there are other options:

Option 1

If you have teeth both anterior and posterior to the edentulous area, traditional bridges are an alternative to implants.

Option 2

If you still want implants and the bone height is not severely compromised, ranging between 6-8mm, short implants may be an option. Currently, the shortest implants available are 6mm in length, meaning that bone heights above 6mm may not require sinus lift surgery.

 

Conclusion

For implant sites with bone height >3mm, sinus lift surgery may be performed concurrently with implant placement, reducing the surgical area and minimizing discomfort.

For bone heights between 1-2mm, lateral window sinus lift surgery is necessary, involving a larger surgical area and a waiting period before implant placement.

If you prefer to avoid sinus lift surgery: 1. If adjacent teeth are present, consider traditional bridges; 2. If bone height is >6mm, short implants may be an option.

“Maintaining a certain amount of bone around implants is crucial for their long-term success. Therefore, if bone height in the posterior maxilla is insufficient, sinus lift surgery should not be skipped, as it greatly impacts the longevity of implants.”

 

 

 

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My Invisalign 隱適美APP使用介紹，開始你的隱適美治療

My Invisalign 隱適美APP使用介紹，開始你的隱適美治療

by | 9 月 15, 2023

寫給剛開始做隱適美矯正，下載了APP確有點不知道如何開始設定，或是更改牙套提醒的人。“My Invisalign”是隱適美公司自有的APP，主要是用來提醒牙套更換時間，並且如果進度有延後，可以自己手動更改提醒。想要下載的可以在APP store或是Google play搜尋 My Invisalign

通常要收到牙套後，或是拿到由醫師提供的PID隱適美患者編號後才有辦法註冊跟登入。

“For those who have just started using Invisalign clear aligners and have downloaded the app but are unsure how to set it up or modify their brace reminders, “My Invisalign” is the official app provided by Invisalign. Its primary purpose is to remind you when it’s time to change your aligners. Additionally, if there are any delays in your progress, you can manually adjust the reminders.

To download the app, you can search for “My Invisalign” on the App Store or Google Play.

Usually, you will need to receive your aligners or obtain your patient ID (PID), provided by your orthodontist, before you can register and log in.”

 

Apple IOS下載 /Apple IOS Download

Android下載/Android Download

 

 

下載My invisalign 隱適美APP，打開都是英文怎麼辦？

隱適美APP裡面沒有語言更改選項，所以只能在手機裡設定。以Apple IOS 為例，請到設定裡找到 ”My Invisalign” App將裡面的偏好語言改成繁體中文，這樣APP重新打開後就會變成中文介面囉。

 

開始註冊我的隱適美 Begin registering my Invisalign

 

  1. 先準備好你的牙套，牙套上有你的總副數、英文姓名、和8碼的PID隱適美患者編號
  2. 點選建立帳戶
  3. 點選我收到牙套了

 

  1. Prepare your aligners. Your aligners should have your total count, your name, and an 8-digit PID (Patient Identification) Invisalign patient number on them
  2. Click on ‘Create Account.’
  3. Have you picked up  your aligners? Click on “Yes”

 

掃描輸入個人資料 Scan and input your personal information

 

有兩種輸入方式，一種是照相一種是手動輸入。

照相的方式很簡單，拿出你的牙套，將相機中的方框對準資訊欄，按下拍照鍵即可完成。

There are two input methods available: one is through taking photos, and the other is manual input.

The photo method is quite straightforward. Take out your aligners and align the camera’s frame with the information field, then press the capture button to complete the process.

 

 

手動輸入資料 Manually inputting data

需要輸入名字、姓氏、隱適美患者編號PID，電子信箱及密碼

密碼必須至少包含8個字母，包括1個大寫字母和1個數字

Requires entering your first name, last name, an 8-digit PID (Patient Identification) Invisalign patient number, email address, and password.

The password must be at least 8 characters long and include at least 1 uppercase letter and 1 digit.”

 

 

恭喜完成牙套註冊，設定牙套更換提醒

Congratulations on completing the aligner registration and setting up the aligner replacement reminders

 

輸入資料後就註冊完畢，接下來要使用APP最重要的功能就是提醒更換牙套。要如何不要忘記換牙套？第一個秘訣是如果你是7天換一副的，你可以設定在一個特定的日期換牙套，例如禮拜天晚上或是星期一早上，這樣較容易記得。第二如果換牙套的天數不是一星期，例如5天或是10天的，可以利用APP，允許APP通知你時間到了該換牙套。

設定牙套提醒總共有五大項需要設定：

  1. 牙套總副數：請參考牙套包裝。
  2. 每一副配戴天數：一般來說是7天，但也有5天或是10天，請參照醫師指示。
  3. 現在佩戴牙套：忘記的話可以看看牙套上的小字，會有標示第幾副牙套。
  4. 下次更換日期：在第一次設定時，這個部分請千萬記得要自己計算及手動更改，APP要先設定下次更換日期後下次才會自動計算並提醒你更換牙套。
  5. 每日提醒時間：可以設定在一個自己比較容易注意到的時間，例如上床睡覺前。

After entering your information, your registration is complete. Now, the most crucial function of the app is to remind you to change your aligners. How can you avoid forgetting to switch to a new set? The first tip is, if you change your aligners every 7 days, you can set a specific day for the aligner change, such as Sunday evening or Monday morning, making it easier to remember. The second tip, if your aligner change schedule is not weekly, such as every 5 or 10 days, you can use the app to allow notifications when it’s time to change your aligners.

There are five key settings for aligner reminders:

  1. Total number of aligners: Refer to the aligner packaging.
  2. Duration for each set: Typically 7 days, but it can be 5 or 10 days as per your orthodontist’s instructions.
  3. Current aligner: If you forget, check the small print on your aligners; it will indicate which set you are currently using.
  4. Next change date: During the initial setup, remember to calculate and manually change this. The app will start automatically calculating and reminding you to change your aligners from the next cycle once you set this date.
  5. Daily reminder time: You can set a time that suits you best, such as before bedtime, to receive daily remind

 

 

 

隱適美APP介面介紹 Introduction to the Invisalign App Interface

 

左上圓圈為你正在配戴的副數

右上圓圈為你更換下一副牙套的倒數天數

中下圓圈為計時器。有兩個功能：1.計算沒配戴時間：當你拿下牙套時可以開始計時，裝上後再按暫停，主要是用來計算一天有多少小時沒有佩戴牙套。2.，提醒你拿下後記得戴上，可以自己設定30分、1小時或更久，倒數時間到會提醒你記得戴牙套。牙套建議一天配戴20~22個小時。

點選任一圓圈即可進入牙套提醒設定

 

The circular icon in the upper left corner represents the number of aligners you are currently wearing.

The circular icon in the upper right corner shows the countdown to when you should change to the next set of aligners.

The circular icon in the middle at the bottom is a timer. You can start the timer when you remove your aligners and pause it when you put them back in. This timer is mainly used to calculate how many hours in a day you haven’t been wearing your aligners. It is recommended to wear aligners for 20-22 hours a day.

Simply click on any of these circles to access the aligner reminder settings

 

 

取得隱適美禮物卡 Obtaining an Invisalign Gift Card

 

除了通過上述介紹的方式更改，你也可以通過設定頁面來更改牙套提醒。

另外在設定頁面，隱適美也有提供禮物卡，如果你有朋友使用你的推薦碼進行隱適美矯正，你跟你朋友都可以各自獲得一定金額的禮品卡用來兌換隱適美的東西。

In addition to the methods mentioned above, you can also modify your aligner reminders through the settings page.

Furthermore, in the settings section, Invisalign offers gift cards. If your friends use your referral code for Invisalign treatment, you and your friends both can receive a certain amount of gift card credit to redeem Invisalign-related items.

 

 

 

 

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醫師，我牙齒斷了，有救嗎？斷牙怎麼辦

醫師，我牙齒斷了，有救嗎？斷牙怎麼辦

by | 6 月 6, 2023

那一天，看診的時候，大叔突然接到一個緊急任務。老患者王先生車禍撞到門牙，跑來大叔的門診，很緊張地詢問怎麼辦？是不是牙齒撞斷了就要拔掉植牙？

On that day, during a professional consultation, I suddenly received an urgent mission. An elderly patient named Mr. Wang had a car accident and knocked his front tooth. He came to my clinic anxiously and asked me what to do. He was worried whether the tooth needed to be extracted and replaced with a dental implant.

什麼狀況容易牙齒斷裂？There are several factors that can cause teeth to fracture

 

我們可以分為三方面來討論 some of the common reasons include:

 

外力External forces

車禍、外力撞擊、咬到硬物、或是平常喜歡咬硬物或是嚼食檳榔是常見的牙齒斷裂原因。

Car accidents, impact from external forces, biting hard objects, or habitual chewing of betel nut are common causes of tooth fractures.

病理性因素Pathological factors

太深的蛀牙或牙齒磨耗會造成牙齒齒質的受損、咬肌發達咬力過重容易超過牙齒能承受的力量，這兩項也可能造成牙齒斷裂。

Deep cavities or teeth wear can cause damage to the tooth structure, and overdeveloped biting muscles and excessive biting force can exceed the strength that teeth can bear, both of which can lead to tooth fractures.

咬合因素Malocclusion factors

不正常的咬合關係，例如深咬或錯咬，常會有額外的力量施加在某部分的牙齒上造成這些牙齒有比一般高的斷裂風險。

Abnormal Malocclusion relationships, such as deep bites or crossbites, often exert additional force on certain teeth, resulting in a higher risk of fracture than normal teeth.

 

 

牙齒斷了還有救嗎？Is there still a way to save a broken tooth?

 

我們可以把牙齒斷裂分為幾種情況We can categorize tooth fractures into several types 

1.斷裂面在牙齦上方Fracture above the gumline:：

如果斷裂面全都在牙齦上方，那這顆牙齒有蠻大的機會留下來。斷裂面積小的可以使用樹脂填補。斷裂面積大的則會建議以假牙來做修復，如斷裂部位有傷害到神經，則需要合併根管治療。

If the fracture is above the gumline, there is a good chance that the tooth can be saved. For small fractures, resin filling can be used for repair. For larger fractures, a dental prosthesis may be recommended for repair. If the fracture has damaged the pulp, root canal therapy may be required in conjunction with the repair.

2.斷裂面在牙齦下

如果牙齒斷裂面有一部分在牙齦下，要判斷牙齒留不留得住第一步通常是以牙冠牙根比來做考量。從斷裂面下2mm到牙齒頂端為牙冠長度，到根尖為牙根長度，牙冠牙根長度比決定牙齒的去留。

如果牙冠牙根比<1:1，代表你的牙根比牙冠長，這樣牙齒才會穩固。如果牙冠牙根比>1:1，代表你的牙冠比牙根長，可能會出現頭重腳輕的狀況，這時候就建議拔除，考慮牙橋或是植牙的治療方式。從Ｘ光上就可以大致判斷牙冠牙根的比例來決定這顆牙齒的去留。

If part of the tooth fracture is below the gingival, the first step in determining whether the tooth can be saved is usually to evaluate the ratio of the tooth crown to root (Crown/root ration).From the fracture surface 2mm below the tooth crown to the top of the tooth is the tooth crown length, and from the root tip is the tooth root length. The ratio of tooth crown length to tooth root length determines the retention or loss of the tooth.The proportion of the crown and root can be roughly determined from an X-ray to decide whether to keep or remove the tooth.

If the tooth crown/root ratio is <1:1, it means that your tooth root is longer than the tooth crown, which makes the tooth more stable. If the tooth crown to root ratio is >1:1, it means that your tooth crown is longer than the tooth root, and there may be a risk of instability. In this case, it is recommended to extract the tooth and consider treatment options such as a dental bridge or dental implant.

3.斷裂面長且橫跨牙根Fracture line is long and transverse across the root of the tooth

當發生這個狀況時，通常牙齒就得拔掉了。這時候可以考慮以植牙或是牙橋來回復功能及美觀。

When this situation occurs, the tooth usually needs to be extracted. At this point, dental implants or bridges can be considered to restore function and aesthetics.”

 

 

牙冠牙根比例對於預後的影響Impact of Crown-to-Root Ratio on Prognosis

 

正常前況下，牙冠（就是露出在牙齦外的部分）一定是比牙根（牙齦裡的部分）短的，這樣才不會頭重腳輕。當我們牙齒斷裂，為了假牙的包覆性，會把假牙邊緣往牙根方向延伸，造成牙冠變長，牙根變短而改變牙冠牙根比，目前來說極限的比例就是1:1，大於這個比例就表示牙冠比牙根長，容易造成根基不穩，牙齒晃動，

所以斷掉的牙齒能不能留，牙冠牙根的比例是重點考量之一，如果你的牙根天生比別人長，那就有更多機會保留這顆牙齒。

 

Under normal circumstances, the crown of a tooth (the part that is visible above the gumline) is always shorter than the root (the part within the gum). This ensures a balanced structure. When a tooth fractures, in order to provide adequate coverage for a dental prosthesis, the margin of the prosthesis is extended towards the root, resulting in a longer crown and a shorter root, thereby altering the crown-to-root ratio. Currently, the maximum acceptable ratio is considered to be 1:1. Ratios greater than this indicate that the crown is longer than the root, which can lead to instability and tooth mobility.

Therefore, when considering whether a broken tooth can be saved, the crown-to-root ratio is one of the key factors to consider. If your roots are naturally longer than those of others, you have a greater chance of preserving the tooth.

 

 

什麼是牙冠增長術，斷牙的救星？What is Crown Lengthening, the Savior for Broken Teeth?

 

如果牙冠牙根比沒有太糟的斷牙，通常可以搭配牙冠增長手術，來讓斷裂的齒質露出牙齦，在做假牙保護起來達到斷牙復形的目的。

牙冠增長術通常分為兩種：1. 單純手術，沒有搭配矯正。 2. 搭配矯正，先矯正後再手術。

Crown lengthening surgery is typically classified into two types: 1. Purely surgical approach without orthodontic treatment. 2. Combination with orthodontic treatment, where orthodontic alignment is performed prior to the surgical procedure.

 

牙冠增長術，沒有加上矯正 Crown Lengthening Procedure, Without Orthodontic Treatment

 

單純手術，將牙齒周圍的軟硬組織往牙根方向降低，露出足夠的齒質來做牙齒。牙冠變長，牙根變短，該顆牙齒的牙齦線比左右兩顆牙齒低，較適合用在非美觀的區域。

Purely surgical, the procedure involves lowering the surrounding soft and hard tissues around the tooth towards the root, exposing sufficient tooth structure for restoration. The crown of the tooth becomes longer while the root becomes shorter, resulting in a lower gum line compared to the adjacent teeth. This technique is more suitable for non-aesthetic areas where the appearance of the gum line is less critical.

牙冠增長術，加上矯正 Crown Lengthening Procedure, With Orthodontic Treatment

在手術前搭配矯正做治療，目的是先將牙齒拉高，再將周圍軟硬組織降低，來達到與周圍牙齒牙齦線一樣高度的目的。會建議使用在美觀區，除了較美觀外，牙冠牙根比例也會比單純手術的比例好，缺點是時間較長，與需要額外的矯正費用。

In conjunction with orthodontic treatment, the purpose of combining it with surgery is to first elevate the teeth and then lower the surrounding soft and hard tissues to achieve a gum line that matches the height of the surrounding teeth. This approach is recommended for aesthetic areas where achieving a harmonious gum line is important. In addition to improving aesthetics, the crown-to-root ratio is also likely to be more favorable compared to a purely surgical approach. However, it is important to note that this treatment option requires a longer duration and additional orthodontic costs.

兩種牙冠增長術的比較Comparison of Two Types of Crown Lengthening Procedures

  1. Purely Surgical Approach without Orthodontic Treatment:
  • Purpose: The primary goal is to lower the surrounding soft and hard tissues to expose more tooth structure for restoration.
  • Suitable Areas: This approach is typically recommended for non-aesthetic areas where the appearance of the gumline is less crucial.
  • Crown-to-Root Ratio: The crown-to-root ratio may not be significantly improved compared to the initial state of the broken tooth.
  • Procedure: The surgery involves removing excess gum tissue and, if necessary, reshaping the underlying bone to achieve the desired gumline height.
  • Advantages: The procedure is relatively straightforward, and the treatment duration is usually shorter compared to the combined approach.
  • Disadvantages: The aesthetic outcome may be less optimal, and the crown-to-root ratio may not be significantly improved.
  1. Combination with Orthodontic Treatment:
  • Purpose: The objective is to first reposition the teeth orthodontically to achieve proper alignment and then perform the surgical procedure to create an aesthetically pleasing gumline.
  • Suitable Areas: This approach is recommended for aesthetic areas where achieving an ideal gumline height is crucial.
  • Crown-to-Root Ratio: The crown-to-root ratio is typically improved compared to the initial state of the broken tooth, resulting in a more favorable outcome.
  • Procedure: The treatment involves orthodontic treatment to align the teeth properly, followed by surgical crown lengthening to adjust the gumline.
  • Advantages: The aesthetic result is generally superior, and the crown-to-root ratio is often improved.
  • Disadvantages: The treatment duration is longer due to the sequential nature of orthodontic and surgical procedures, and there may be additional costs associated with orthodontic treatment.

Ultimately, the choice between the two approaches depends on the specific case, the aesthetic considerations, and the desired outcome. Consulting with a dental professional can help determine the most appropriate approach for crown lengthening based on individual circumstances.

 

牙齒斷了，有救嗎？Can a Broken Tooth Be Saved?

When a tooth is broken, several factors need to be considered to determine if it can be saved:

  1. Condition of the Broken Tooth: The extent of the tooth fracture and the presence of any underlying decay or infection will be assessed. If the damage is minimal and the tooth’s structure can be restored, there is a higher chance of saving the tooth.
  2. Cause of the Tooth Fracture: Understanding why the tooth broke is crucial in preventing future fractures. Common causes include trauma from accidents, biting into hard objects, or weakened tooth structure due to decay or previous dental treatments.
  3. Evaluation of the Overall Bite: The alignment and occlusion (bite) of the teeth play a role in determining the prognosis of a broken tooth. If the bite is misaligned or there is excessive force on the affected tooth, it may be more prone to further damage.

By considering these factors, a dentist can determine the appropriate treatment plan to save the broken tooth. This may involve procedures such as dental bonding, dental crowns, root canal treatment, or in severe cases, extraction followed by a prosthetic replacement. Regular dental check-ups and maintaining good oral hygiene are essential in preventing future tooth fractures and preserving oral health.

 

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MRC是什麼？一次搞懂兒童隱適美和MRC的5個差別

MRC是什麼？一次搞懂兒童隱適美和MRC的5個差別

by | 3 月 7, 2023

了解隱適美和MRC是什麼
Do you know the difference between Invisalign and Myobrace?

Invisalign（隱適美）和Myobrace（MRC）都是時下很夯的矯正治療工具，兩者皆可以幫助矯正牙齒，改善咬合，今天讓牙醫大叔來帶你了解一下兩者到底差異在哪裡吧？

隱適美適用的年齡層較廣，從兒童到成年都可以使用，一般兒童隱適美早期矯正可以開始的最小年齡大概在7~8歲，視小朋友生長速度而有所差異。MRC適用年齡層較窄，官網資料建議5~15歲，以兒童到青少年為主。雖然這兩個都是矯正的工具，但是第一次聽到的人還是會不了解這兩種的差別，最常的困惑也是『那我到底要幫我的小朋友選擇哪一種方法？』首先你要先了解『隱適美』是眾多隱形矯正中的一個品牌，就如『MRC』也是眾多肌功能矯正中的一個品牌，其餘類似的還有Preortho、EFline，肌功能矯正各家產品在作用原理上大同小異，但是細節上略有不同。

Invisalign and Myobrace are two popular orthodontic treatment tools that can help correct teeth and improve bites. Today, let me explain the differences between the two.

Invisalign is suitable for a wider age range, from children to adults. Early Invisalign treatment for children usually starts at the age of 7 to 8, depending on the child’s growth rate. Myobrace is suitable for a narrower age range, recommended for children aged 5 to 15, mainly for children and adolescents. Although both are orthodontic tools, people who hear about them for the first time may not understand the difference between the two. The most common confusion is “Which method should I choose for my child?” First, you need to understand that “Invisalign” is one brand among many clear aligners, and “Myobrace” is one brand among many myofunctional orthodontic products. Other similar products include Preortho and EFline. Although the myofunctional orthodontic products have similar principles of action, there are slight differences in details.

 

 

隱適美作用原理
The principle behind Invisalign

隱適美牙套是客製化的矯正裝置，以衣服來比喻的話，有點像訂製的西裝，和牙齒非常服貼。每副牙套按順序會有些微差異，藉由這些差異將牙齒慢慢移動到我們想要的位置。牙醫師會在軟體上規劃每顆牙齒的位置，所以隱適美矯正可以很明確的知道將來牙齒矯正後排列的外觀與位置。

Invisalign is a custom-made orthodontic device that is comparable to a tailored suit for your teeth. Each set of aligners has slight differences that gradually shift the teeth into the desired position. The dentist plans the position of each tooth on the software, so Invisalign can clearly predict the appearance and position of the teeth after orthodontic treatment.

MRC作用原理
The principle behind Invisalign

MRC矯正的正確名稱應該是肌功能矯正，主要針對口腔肌肉去做訓練。MRC和隱適美牙套不同，是幾套不同尺寸去做挑選，有點像成衣，依照牙弓大小去挑選適合的MRC牙套尺寸。作用原理也和隱適美略有不同，MRC周圍有一些『翼』，主要是來阻擋臉頰和舌頭的肌肉來降低對齒列的不好影響，搭配口腔肌肉和舌頭肌肉的練習，利用牙齒周圍肌肉的力量、舌頭的力量加上軟性的牙套來讓牙齒達到一個平衡的狀態。

The correct name for MRC correction should be myofunctional correction, which mainly focuses on training the muscles in the oral cavity. Unlike Invisalign braces, MRC uses several sets of different sizes to choose from, which is a bit like ready-to-wear clothing. The appropriate MRC brace size is selected based on the size of the dental arch. The working principle of MRC is slightly different from Invisalign; MRC has some “wings” around it, primarily to block the muscles of the cheeks and tongue and reduce their negative impact on the dental arch. By practicing exercises for the muscles in the oral and tongue areas and utilizing the power of the muscles surrounding the teeth and tongue, along with the flexibility of the braces, the teeth can achieve a state of balance.

 

我們可以從下列5點來了解隱適美和MRC的差異
We can understand the differences between Invisalign and MRC from the following five points:

 

配戴時間 wearing time

  • 配戴時間：隱適美所需配戴時間較長，要戴20~22小時，時間越長效果越好。MRC配戴時間為白天至少1個小時，晚上就寢時整晚配戴。
  • 配戴舒適度：隱適美配戴舒適度較佳，分為上下兩顎服貼牙齒的牙套，因為服貼所以配戴起來異物感小。MRC為上下顎一體類似拳擊手保護牙齒的裝置，整體體積較大，由於目的是訓練肌肉，對於一些嘴唇肌力較弱的小朋友，一開始配戴會比較辛苦。
  • 美觀：隱適美近乎隱形，配戴時不易被發現。MRC外觀明顯，在學校配戴時容易引起注意。

 

  • Wearing time: The Invisalign treatment requires a longer wearing time of 20 to 22 hours per day, with longer wearing time resulting in better outcomes. The Myobrace System (MRC) requires a minimum of 1 hour per day during daytime and all night while sleeping.
  • Comfort: Invisalign aligners provide better comfort as they are made of two custom-fitted aligners that fit snugly on the upper and lower jaws, causing less discomfort during wear. MRC is a device that covers both jaws and resembles a boxing mouthguard, making it bulkier. Since the primary aim is to train the muscles, some children with weaker lip muscles may find it more challenging to wear initially.
  • Aesthetics: Invisalign is almost invisible, making it less noticeable when worn. MRC is more visible, and wearing it in school may attract attention.

 

原理 Principle

  • 隱適美兒童早期矯正：在軟體上規劃好牙齒位置，由透明牙套依照規劃順序推著牙齒前往設計好的位置。
  • MRC兒童早期矯正：藉由訓練舌頭、口腔肌肉、軟式的牙套讓口腔肌肉達到平衡，進而影響牙齒，讓牙齒排列整齊。牙齒的周圍圍繞著臉頰及舌頭，所以可以把現在牙齒位置視為臉頰肌肉力量與舌頭力量相互推擠達到平衡的一個結果。造成現在牙齒位置不良的原因可能是因為口呼吸造成的舌頭肌力微弱或是舌頭位置不對喜歡前頂牙齒，MRC的目的就是對牙齒周圍的肌肉重新進行訓練，藉由牙齒兩側肌肉達到平衡來讓牙齒移動到合適的位置，所以這就是為什麼在MRC裡面，口腔肌肉訓練和鼻呼吸訓練是很重要的一環。

    • Invisalign for children’s early orthodontic correction: Tooth positions are pre-planned on software, and transparent aligners gradually move the teeth to their predetermined position.
    • MRC for children’s early orthodontic correction: Tongue, oral muscles, and soft aligners are trained to achieve muscle balance, which, in turn, affects tooth alignment, resulting in properly aligned teeth. The muscles around the teeth are associated with the cheeks and tongue, so the current position of teeth can be viewed as a result of the balance between cheek muscle and tongue strength. The reason for poor teeth positioning may be weak tongue muscles caused by mouth breathing or incorrect tongue placement, and MRC aims to retrain the muscles around the teeth to achieve balance and move the teeth to the right position. Therefore, oral muscle and nasal breathing training are vital aspects of MRC treatment.

     

    牙齒位置 Teeth positioning

    • 隱適美兒童早期矯正由於是在軟體上設定牙齒將來的位置，所以無論牙齒的角度、方向、上下位置都可以很準確地控制。
    • MRC兒童早期矯正是口腔內肌肉力量平衡的結果，一般來說治療完後牙齒可以達到整齊的效果，但在更精細的排列上，例如：個別牙齒的角度、上下位置，可能會有稍許偏差，無法做到如隱適美那般精準。

    • Invisalign children’s early orthodontic correction can accurately control the angle, direction, and vertical position of teeth as they are pre-set on software.
    • MRC children’s early orthodontic correction is the result of muscle balance inside the mouth. Although it can generally achieve well-aligned teeth after treatment, there may be slight discrepancies in more detailed tooth alignment, such as individual tooth angles and vertical positions, making it less precise than Invisalign.

     

    注意事項 Precautions

    由於兩者都是活動式的矯正工具，不若傳統金屬矯正器是黏在牙齒上的，所以兩者都要很注意配戴時間。MRC的另一個重點是口腔肌肉訓練，單純只配戴MRC效果較差，平日一定要努力的做口腔肌肉練習。

      Both Invisalign and MRC are removable orthodontic appliances, unlike traditional metal braces, which are attached to teeth. Thus, both require careful attention to wearing time.Another crucial aspect of MRC treatment is oral muscle training, and merely wearing the MRC device alone is less effective. Consistent oral muscle exercises are essential for optimal results.

       

      適用年齡 Age suitable

      • 隱適美兒童早期矯正的最低年齡是在上下正中門牙、側門牙及第一大臼齒皆萌發出來後，一般年齡在7~8歲，視小朋友生長速度而有所不同，但實際情況是否需要早期矯正介入還是要諮詢醫師後才會比較準確。
      • MRC兒童早期矯正在官方的適應年齡是5~15歲，一樣實際情況是否需要早期矯正介入還是要諮詢醫師後才會比較準確。

       

      • Invisalign early orthodontic treatment is suitable for children with upper and lower central incisors and first molars that have fully erupted.
      • MRC early orthodontic treatment is suitable for children aged 3 to 15 years old, who still have baby teeth or have a mixture of baby teeth and permanent teeth.

       

      MRC治療療程
      MRC treatment course

       

      影片中的幾個重點，MRC希望改善小朋友的「口呼吸習慣」「嘴巴無法閉合」「舌頭位置不對」等幾個不良的口腔習慣。不對的舌頭位置和不容易閉合的嘴巴有時候是因為口呼吸而造成，MRC治療時會強調舌頭的置放位置，希望小朋友將舌頭擺放在正確的位置「頂在上顎」，還有練習正確的吞嚥動作。你需要在晚上睡覺時整晚需配戴MRC。白日則是在學校時、在家寫功課時或是看電視或打電動時選擇一個時段配戴一個小時的MRC裝置。

      MRC治療通常分為幾個階段：1.矯正壞習慣，養成好習慣。2.擴張上顎牙弓。3.排齊牙齒。4.維持矯正成果。

      Several key points in the video emphasize that MRC aims to improve several negative oral habits in children, such as “mouth breathing habits,” “inability to close the mouth,” and “incorrect tongue placement.” Incorrect tongue placement and difficulty in mouth closure are sometimes caused by mouth breathing, so MRC treatment emphasizes proper tongue placement, encouraging children to place their tongue in the correct position “on the roof of the mouth,” and practice proper swallowing movements. The MRC device needs to be worn throughout the night while sleeping. During the day, it is recommended to wear the MRC device for one hour during school, homework, watching TV, or playing video games.

      MRC treatment typically consists of several stages:

      Stage1. Habits correction,  Stage2. Arch development,  Stage3. Dental alignment,  Stage4. Retension

       

      矯正壞習慣，養成好習慣 Stage1. Habits correction

      為第一階段療程。有幾個動作希望小朋友要在這個階段練習：1. 練習從口呼吸轉成鼻子呼吸。2.訓練舌頭放在正確的位置上。3.練習正確的吞嚥動作。4.沒有在吃飯或講話時，閉緊嘴唇。希望藉由這些動作來促進上下顎的生長，減少將來長大後二次矯正的機率。

      這階段會給予第一階段的MRC牙套，晚上睡覺可配戴全程而MRC不會掉出時即可進入下一階段。

      This is the first stage of the treatment. There are several actions that we want children to practice during this stage: 1. Practice switching from mouth breathing to nasal breathing. 2. Train the tongue to be in the correct position. 3. Practice the correct swallowing movement. 4. Keep lips closed when not eating or speaking. By doing these actions, we hope to promote the growth of the upper and lower jaw, reducing the likelihood of requiring orthodontic treatment in the future.

      During this stage, we will provide the first stage MRC appliance, which can be worn throughout the night and must not fall out before moving on to the next st

       

      擴張上顎牙弓 Stage2. Arch development

      為第二階段，是否需要視小朋友狀況而定。這階段會使用BWS上顎擴張裝置，搭配MRC牙套一起使用。目的是讓上顎擴張獲得更多的空間來讓牙齒排列整齊，通時也能促進中臉部的發育。

      This is the second stage, which may vary depending on the child’s condition. In this stage, a BWS maxillary expansion device is used in conjunction with the MRC orthodontic appliance. The goal is to create more space in the upper jaw for the teeth to align properly, while also promoting development of the midface.

      BWS上顎擴張器

       

      排齊牙齒 Stage3. Dental alignment

      這時會給予第二副的MRC牙套，材質會比第一副再稍微堅硬一點，讓牙齒可以順著MRC牙套的牙弓外型進行排列。第二副牙套日常配戴時間和第一副一樣，會持續配戴到牙齒排列整齊為止。

      At this stage, a second set of MRC braces will be provided. The material will be slightly harder than the first set, allowing the teeth to align along the MRC brace arch shape. The daily wearing time for the second set of braces will be the same as the first set, and will continue to be worn until the teeth are properly aligned.

       

      維持期：維持矯正成果 Stage4. Retension

      第三副MRC牙套目的是為了維持矯正的成果，小朋友會建議一直配戴直到生長完畢，約12~14歲視生長速度有所不同。在這階段由於小朋友持續長大，有可能MRC維持器戴著戴著就會磨到牙齦，這時候就需要再替換成一般的傳統維持器或是更大尺寸的MRC維持器。

      The purpose of the third set of MRC appliances is to maintain the orthodontic correction achieved in the previous stages. Children are advised to continue wearing the appliance until they have finished growing, which can vary depending on growth rate, typically around 12-14 years old. During this stage, as children continue to grow, it is possible for the MRC retainer to rub against the gums, and at that point, it may need to be replaced with a conventional retainer or a larger MRC retainer.

       

      MRC費用與隱適美費用比較
      Comparison of MRC and Invisalign Costs

      MRC治療中最常被問到的就是MRC費用問題了，到底MRC兒童早期矯正與隱適美兒童早期矯正在費用方面誰高誰低呢？

      答案是視狀況而定，隱適美兒童早期矯正費用通常是包套，在治療期間如果有牙齒跟不上牙套進度，或是更改治療計畫，對牙醫師來說沒有額外的技師成本，所以對患者而言比較少額外的衍生費用。MRC兒童早期矯正則不然，是以單副MRC來計算，對於牙醫師來說小朋友無論牙套遺失或是牙套磨損破裂，只要更換一副新的牙套就會有額外的成本在，所以對患者而言治療期間可能會有額外的衍生費用。

      MRC兒童早期矯正如果順利，MRC費用一般會比隱適美兒童矯正費用略低，但是有幾個狀況會有額外的MRC費用產生：

      1. MRC牙套遺失。
      2. 小朋友會磨牙或粗魯配戴，造成MRC牙套破損要更換新的MRC牙套。
      3. 需要額外的上顎擴弓裝置。
      4. 隨著年齡長大，牙弓跟著變大，第一副MRC維持器戴不下，需重新給予較大尺寸的MRC維持器。

      如果有以上幾個狀況發生，牙醫師都必須重新收取新牙套的費用，多疊加幾次後MRC費用並不一定會比隱適美兒童早期矯正便宜。

      The most frequently asked question regarding MRC treatment is about the cost of MRC. Which is more expensive between MRC early orthodontic treatment for children and Invisalign early orthodontic treatment for children?

      The answer depends on the situation. The cost of Invisalign early orthodontic treatment for children is usually bundled. During the treatment period, if the teeth cannot keep up with the progress of the aligners or if the treatment plan needs to be changed, there are no additional technician costs for the dentist. Therefore, there are fewer additional costs for the patient. In contrast, MRC early orthodontic treatment for children is calculated based on a single set of MRC appliances. If a child loses or damages the appliance, the dentist will need to replace it with a new one, incurring additional costs for the patient.

      If MRC early orthodontic treatment progresses smoothly, the MRC cost is generally slightly lower than the cost of Invisalign early orthodontic treatment. However, there are several situations that may result in additional MRC costs:

      1. Loss of MRC appliances.
      2. Grinding or rough handling of the appliances by the child, causing damage that requires replacement of the MRC appliances.
      3. Need for additional maxillary expansion devices.
      4. As the child grows older, the dental arch also increases in size, making the first set of MRC retainers unfit, requiring a larger size of MRC retainer.

      If any of the above situations occur, the dentist will need to charge for a new set of MRC appliances, and after multiple occurrences, the MRC cost may not be cheaper than Invisalign early orthodontic treatment.

       

      總結 Summery

      阿說了這麼多，我還是不知道我小孩適合哪一種啊？別急，你可以先從以下幾點來做決定。

      先評估是否真的需要兒童早期矯正？Evaluate if early childhood correction is really necessary.

      在大叔的觀點兒童早期矯正的好處是可以降低將來正顎手術或是拔牙矯正的機率。除這些情況外，建議等到都換牙完畢再矯正評估即可，這也是為什麼有的家長問醫師得到矯正的時間點是12歲有的是6歲的原因。

      From the perspective of the dentist, the benefit of early childhood correction is that it can reduce the probability of future corrective jaw surgery or tooth extraction. Unless these situations exist, it is recommended to wait until all the teeth have fully grown before evaluating correction, which is why some parents receive a correction time of 12 years old while others receive 6 years old.

       

      小朋友本身的動機強不強？How strong is the child’s motivation?

      MRC兒童早期矯正比起隱適美兒童早期矯正，需要小朋友本身更高的動機與配合度，畢竟每天都要做口腔運動，在配戴上並不如隱適美那麼舒適。如果小朋友想改變牙齒的動機不強或是自律性不高，隱適美早期兒童矯正會比MRC兒童早期矯正更讓小朋友容易適應一些。

      MRC early childhood correction requires a higher level of motivation and cooperation from the child compared to invisible orthodontics. After all, daily oral exercise is required, and the device is not as comfortable as invisible orthodontics. If the child’s motivation for changing their teeth is weak or their self-discipline is low, invisible orthodontics may be easier for the child to adapt to.

       

      家長對整齊度的要求高不高？Are the parents demanding of precision?

      前面有提到MRC是讓牙齒自動排列，所以在排列上無法做到如隱適美般的精確，如果家長認爲個別牙齒的稍微不整齊並不影響只是希望改善小朋友的咬合狀況及呼吸習慣，那麼MRC就會很適合。

      As mentioned earlier, MRC allows teeth to be aligned automatically, so it cannot achieve the same precision as invisible orthodontics. If parents think that slightly uneven teeth will not affect their child and only want to improve their child’s bite and breathing habits, then MRC may be suitable.

       

      費用的考量 Cost considerations

      一般來說MRC的費用還是比隱適美低一點點，但是有時候也是有例外。

      Generally speaking, MRC is slightly less expensive than invisible orthodontics, but there are exceptions.

       

      時間上的考量 Time considerations

      一般來說MRC的矯正時間會比隱適美略長一點，不過通常也要視情況而定。

      Generally, the correction time for MRC is slightly longer than that of invisible orthodontics, but it depends on the situation.

       

      希望以上這五點有幫助到大家在決定開始兒童早期矯正治療前要選用哪一套系統。

      We hope that these five points will help you decide which system to use for early childhood correction treatment.

       

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      缺牙影響外觀，但植牙好嗎？植牙4大好處與3缺點

      缺牙影響外觀，但植牙好嗎？植牙4大好處與3缺點

      by | 2 月 20, 2023

      成人拔牙後若沒有補上牙齒，還可能會延伸出其他蛀牙、牙齦萎縮等許多問題，長久下來甚至會影響臉部外形。因此需要藉由植牙、假牙補上空缺，植牙好處、缺點眾說紛紜，你該如何依照自身狀況做出最合適的判斷？大叔常常遇到患者指著牙根還完好的牙齒說要植牙，或是空無一物的無牙牙脊說不想植牙，但要做固定式的假牙。植牙與假牙的差異，常常是初次缺牙的患者感到迷惑的問題，這次讓我們來好好了解一下吧。

      植牙是什麼？唯有牙根健在才能裝上假牙！

      一顆牙齒的組成，可以簡單的分成三個部分，牙冠、牙冠與周圍的齒槽骨。以蓋房子來類比，齒槽骨是土地，牙根是地基，牙冠是房子。傳統假牙就好比在地基完好的情況下，房子有破損只需修理房子就可以，而植牙就是地基已損壞，需要重新植入新的地基才有辦法在上面重新蓋房子。當我們牙齒的牙根都還在的時候，上面的牙冠受損，只需要裝上假牙即可。如果連牙根都被拔除，則需植入人工牙根，待人工牙根穩固後才能在上面重建牙冠。

       

       

      為什麼要植牙？

      缺牙會導致牙齒位移、產生牙縫 缺牙造成的空間如果不理他，可能會導致缺牙處前後與對側相鄰的牙齒位移，產生牙縫跟咬合平面不平的現象，所以遇到缺牙的狀況，醫師都會建議即早以牙橋或是植牙的方式來修復。如果缺牙的位置是位於齒列的末端，或是連續缺牙大於三顆牙齒，這時候選擇植牙會比牙橋來的更合適。

      植牙好處、壞處有哪些？一表比較植牙、牙橋優缺點

      牙醫大叔與您分析植牙好處、壞處：

       

      哪些人需要進行植牙？

      因為多顆缺牙而無法以牙橋方式重建咬合的患者，如果希望有較好的生活品質，可以考慮植牙。多顆缺牙的重建方式一般來說有植牙或是活動假牙的方式，活動假牙主要是由軟組織去承受咬合的壓力，咀嚼力量只剩正常牙齒的1/3，在咀嚼方面比較有限制。

      出現哪些情形不適合植牙？

      植牙其實就是手術，所以身體狀況不好，系統性疾病：如糖尿病、高血壓控制不良的患者宜避免。另外牙周病、抽煙也是植牙的大忌，建議在牙周病治療和戒菸一段時間後再考慮植牙。

      植牙很貴嗎？

      費用大約為多少？ 植牙的費用相對於假牙或是活動假牙來的高，各縣市衛生局都有牙科收費標準表可以供民眾參考。該注意的是植牙除了人工牙根跟牙冠外，有時會有一些衍生的費用，例如補骨及補皮的費用。一顆能長治久安的植牙，需要在植體周圍有足夠硬組織與軟組織保護。缺牙的患部久了會發生軟、硬組織的萎縮，所以有時植牙會需要合併軟硬組織的重建。

       

      植牙小叮嚀：

      如何延長植牙壽命？ 缺牙不補，初期可能沒什麼問題，隨著時間可能伴隨牙齦萎縮與牙齒位移，之後得花更多時間與金錢才能重建回來。如果等到這些都發生了才考慮植牙，手術範圍跟術後不舒服感會比拔牙初期就植牙來的大。 植牙看似美好，其實也是需要細心呵護，除了不會蛀牙外，一樣會有牙周病或是斷裂的問題。牙齒重建的同時，增進自己的潔牙程度也是延長植牙使用壽命的重點之一。

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