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1 會贋訊第十八卷第四期贋贋 April

2 贋第 18 卷第 4 期 April 目錄 / / / / / / / / / / (02) / (02) / / 贋台灣郵政北台字第 3844 號執照登記為雜誌交寄行政院新聞局局版台誌第 8091 號 56

3 贋贋劉閔結

4 贋會訊第十八卷第四期贋贋贋贋贋贋理事長彭玉秋 4

5 贋會訊第十八卷第四期贋贋陳必綸 5

6 贋會訊第十八卷第四期贋贋贋 1. 贋贋贋贋傅立志 6

7 贋會訊第十八卷第四期張志麟 30 葉聖威贋贋陳玫秀 7

8 贋會訊第十八卷第四期 AAP AAP 2012 AAP 洪純正 2009 AAP 2014 AAP 8

9 贋會訊第十八卷第四期鄭冬慧贋 2003 贋許綺真 9

10 贋會訊第十八卷第四期 2014/12/06 贋 77 Chief complaint: Past medical history: Past dental history: Endo 10

贋會訊第十八卷第四期 Frontal view Facial asymmetry: nil Facial proportion:

Naso-labial angle: about 90 degree Lip incompetence: nil

view: no gummy smile upper dental midline to facial midline: on

dentition:15, 13to23, 38, 35 to 44, 47 Deep bite Peg lateral incisor,

11 贋會訊第十八卷第四期 Frontal view Facial asymmetry: nil Facial proportion: 1:1:1 Facial midline: on Lateral view Lateral profile: straight Naso-labial angle: about 90 degree Lip incompetence: nil Mentalisstrain: nil E line: upper lip 0mm, lower lip 0mm Smiling view: no gummy smile upper dental midline to facial midline: on Missing teeth:14, 16, 17, 24, 25, 26, 27, 36, 37, 45, 46 Present dentition:15, 13to23, 38, 35 to 44, 47 Deep bite Peg lateral incisor, 12, retained root with apical lesion 23 prepared tooth, 23, 33 s/p RCF 38, 47 mesial tilting 11

12 贋會訊第十八卷第四期 R't working Protrusion L't working Canine relationship: R't class II L't class II Overbite: 6 mm Overjet: 2.5mm Arch form: Upper- square Lower- ovoid Protrusion: incisor guidance Lateral excursion: R't canine guidance L't canine-incisor guidance 12

13 贋會訊第十八卷第四期 Missing teeth, 14, 16, 17, 24, 25, 26, 27, 36, 37, 45, 46 Retained roots, 13, 23 Caries, 13, 33, 34 Chronic apical periodontitis, 13, 33, 34 Generalized chronic periodontitis, FM Angle class II div. II malocclusion Max: Class I RPD with 13 X 15 survey bridge Mand: 35 X 38, 32 X 34, 31 X 42, 44 X 47 Bridge upper lower - Study cast mounting Evaluate occlusal vertical dimension 13

14 贋會訊第十八卷第四期 CO Working Balancing Provisional restoration delivery 14

15 贋會訊第十八卷第四期 - 贋 Provisional restoration delivery Metal coping try in Lucia jig, CR bite registration 15

16 贋會訊第十八卷第四期 Upper RPD fabrication Lab remounting and occlusal adjustment Removable and fixed prosthesis delivery 16

17 贋會訊第十八卷第四期 Oral hygiene instruction with brush, dental floss and Superfloss Follow up 3 months and then every 6 months Oral examination : take x-ray, occlusion, plaque index, periodontal charting, RPD soft tissue adaption 17

18 贋會訊第十八卷第四期 Q1 Class I RPDbalance occlusion? group function A1 bilateral free end ridge danger zonebalance occlusion Q2 fixed prosthesesrpddiagnostic waxupocclusion A2 interimdefinitive prosthesisinterim abutment occlusioninterim 18

贋會訊第十八卷第四期贋 Personal Data Chief Complaint Name: X Age: 57 y/o Gender: male Finance: good Cooperation : good Motivation: high Time factor: fair Occupation: freelance My gum is swollen repeatedly

19 贋會訊第十八卷第四期贋 Personal Data Chief Complaint Name: X Age: 57 y/o Gender: male Finance: good Cooperation : good Motivation: high Time factor: fair Occupation: freelance My gum is swollen repeatedly for months. I want to restore my teeth for better chewing function. Past Medical History All major systemic diseases were denied No known drug or food allergy Past Dental History Operative Dentistry treatment (+) Extraction (+) Prosthetic treatment : FPD (+); RPD(-) Periodontal therapy : Phase I therapy; #13 GTR; #24 resective surgery Personal Habits Alcohol drinking (+/-) Betel nuts chewing (-) Cigarette smoking (+), had quitted Parafunction habits (-) TMJ Examination Limitation of mouth opening (-) TMJ palpation pain (-) Muscle tenderness (-) Clicking or crepitation (-) 19

Archform: upper-ovoid; lower-ovoid Overjet: 5.

I; L't- class I Molar relationship: unknown

#23#24,#33#34 Dental Multiple missing teeth

#35,#37,#34, #44,#45,#47 tilting and rotation

20 贋會訊第十八卷第四期 Extroral Findings Facial asymmetry(+) mild Facial proportion: equal Straight profile Nasolabial angle about 90 degrees Intraoral Findings Occlusal analysis Archform: upper-ovoid; lower-ovoid Overjet: 5.5; overbite:7 Canine relationship: R't- class I; L't- class I Molar relationship: unknown Lateral movement: R't - #14,#44; L't #23#24,#33#34 Dental Multiple missing teeth Deep overbite and overjet Lower anterior supra-eruption Obvious tooth wear #37 mobility Gr III and furcation involvement #35,#37,#34, #44,#45,#47 tilting and rotation #14,#24 elongation Torus palatinus Periodontal data(before periodontal treatment) 20

21 贋會訊第十八卷第四期 Panoramic Film Periodontal Examination 21

贋會訊第十八卷第四期 Tooth 14 13 12 11 21 22 23 24 Probing Depth Recession

431 533 332 110 011 100 002 221 000 022 211 100 000 000 000 000 000 012 4 5

32 33 34 35 37 Probing Depth Recession Masticatary Mucosa 535 334 433 333

5 232 233 111 121 001 100 333 000 222 245 333 000 000 010 000 000 000 231

22 贋會訊第十八卷第四期 Tooth Probing Depth Recession Masticatary Mucosa Mobility Furcation Inolvement Tooth Probing Depth Recession Masticatary Mucosa Mobility Furcation Inolvement BILI Periodontal Prognosis 22

23 贋會訊第十八卷第四期 Summary of Intra-Oral Findings Multiple missing teeth Deep overbite and large overjet Lower anterior supra-eruption #13~#23 severe tooth wear at cingulum #14,#24 supra-eruption and severe tooth wear at palatal side #37 mobility Gr III, furcation involvement #37,#35,#34, #44,#45,#47 tilting and rotation #24,#35 buccal cross-bite Torus palatinus Diagnosis Multiple missing teeth 18,17,16,15,25,26,27,28,38,36,31,41,46,48 Risk assessment: deficiency of stable occlusion Generalized moderate to severe chronic periodontitis Etiology: local factor dental plaque Predisposing factors: tea-caused stain, intragenic factor, malocclusion, and smoking Malocclusion Risk assessment: difficulty in cleaning access, wear of teeth; dilemma in prosthesis fabrication; deficiency of stable occlusion Attrition Etiology: insufficient posterior support, deep OB and porcelain occlusion Goal of Treatment Control of periodontal inflammatory disease Creating a favorable dental environment for maintenance of oral hygiene Therapeutic occlusion Posterior support build-up Shallow of OB and OJ Orthodontic intervention Curve of spee leveling and overbite decreasing Crowding relieving, up-righting and space redistribution Correcting #24,#35 buccal cross-bite 23

贋會訊第十八卷第四期 Cephalometric Film Tracing Analysis Skeletal class I with class II tendency Low MPA upper incisor procline; lower incisor in norm Treatment Options Option 1 with full mouth orthodontic

maxilla #14,#24 crown height reduction and crown fabrication intentional RCT may be needed I 15 X I 17, I 25 X I 27 implantation For mandible #37 extraction I 36 I 37, I 46 implantation #32x#42

24 贋會訊第十八卷第四期 Cephalometric Film Tracing Analysis Skeletal class I with class II tendency Low MPA upper incisor procline; lower incisor in norm Treatment Options Option 1 with full mouth orthodontic treatment For maxilla I 15 X I 17, I 25 X I 27 implantation For mandible #37 extraction I 36 I 37, I 46 implantation #32x#42 bridge re-fabrication Option 2 with lower arch orthodontic treatment For maxilla #14,#24 crown height reduction and crown fabrication intentional RCT may be needed I 15 X I 17, I 25 X I 27 implantation For mandible #37 extraction I 36 I 37, I 46 implantation #32x#42 bridge re-fabrication Option 3 without orthodontic treatment For maxilla #14,#24 crown height reduction and crown fabrication intentional RCT may be needed I 15 X I 17, I 25 X I 27 implantation For mandible #37,#35 extraction I35 XI37 implantation #32x#42 bridge re-fabrication #45x#47 ridge or I 45 XI 47 implantation option 2 24

贋會訊第十八卷第四期 Periodontal Condition after Phase I Treatment Tooth 14 13 12 11 21 22 23 24 Probing Depth Recession Masticatary Mucosa B 322 222 222 222 222 222 223 222 P 323 632 222 222 222 222 323 532

25 贋會訊第十八卷第四期 Periodontal Condition after Phase I Treatment Tooth Probing Depth Recession Masticatary Mucosa B P Mobility Furcation Inolvement Tooth Probing Depth Recession Masticatary Mucosa B P Mobility Furcation Inolvement BILI 13 Osteoplasty and ostectomy 25

26 贋會訊第十八卷第四期 Model Surgery & Diagnostic Wax-up Post Model Surgery Position Change (mm) Tooth Vertical M-D M1.5 M Transverse Change Surgical Stent Fabrication c r o s s mountdiagnostic wax up initial cast surgical stent 26

27 贋會訊第十八卷第四期 CBCT-Maxilla #17 #16 #15 27

28 贋會訊第十八卷第四期 #25 #26 #27 CBCT-Mandible 28

29 贋會訊第十八卷第四期 #36 #37 #46 29

贋會訊第十八卷第四期 Definitive Treatment Plan lower arch orthodontic treatment #37

be needed I 15 x I 17, I 25 I 26, I 36 I 37, I 46 implantation #32x#42 bridge

I 36 I 37 I 46 Width (mm) Length (mm) OP time 5.0 4.0s 4.5 4.5 4.5 4.5 5.

30 贋會訊第十八卷第四期 Definitive Treatment Plan lower arch orthodontic treatment #37 extraction #14,#24 crown height reduction and crown fabrication intentional RCT may be needed I 15 x I 17, I 25 I 26, I 36 I 37, I 46 implantation #32x#42 bridge re-fabrication Implant Placement-Astra tech OsseoSpeed Implant I 17 I 15 I 25 I 26 I 36 I 37 I 46 Width (mm) Length (mm) OP time s Working Cast 30

31 贋會訊第十八卷第四期 Before ortho tx Mid-tx: 2 month

32 贋會訊第十八卷第四期 Mid-tx: 4 Month Ortho Tx Completed: 13 Month

33 贋會訊第十八卷第四期 Orthodontic Treatment Course Post Ortho Cepa Analysis Mandible Lower anteriorflare OverbitemandibleSN-OP Impression, cross-mounting, wax-up for I 15 xi 17 ;I 46 screw-retained prosthesis 33

34 贋會訊第十八卷第四期 Impression, cross-mounting, wax-up for I 15 xi 17 ;I 46 screw-retained prosthesis 32x42 e.max press monolithic bridge Deliver Occlusal view 34

35 贋會訊第十八卷第四期 MI Protrusive and lateral excurtion Pre-treatment

36 贋會訊第十八卷第四期 36

37 贋會訊第十八卷第四期 Post-treatment

贋會訊第十八卷第四期 Q1 occlusal scheme A1 centric

compromised tooth13 A2 13142324 贋 13GTRangular

defect, pocket 13141314 splinting1314 贋 crown

38 贋會訊第十八卷第四期 Q1 occlusal scheme A1 centric occlusion Q2 13periodontal compromised tooth13 A 贋 13GTRangular bony defect provisional stagemobility, bony defect, pocket splinting1314 贋 crown splinting resin, wire centric occlusionloading 1314 splinting 38

39 贋會訊第十八卷第四期 Q3 cephalometric analysismandible A3 cephalometry Q4 anterior deep overbitevd periodontal compromisedteethperiodontal support A4 VDposterior support( )overbiteperiodontal compromised loading Q5 32x42 bridge temporary bridge32x42 A5 3 incisorsbolton's ratio 3 incisorsclass I occlusion 4incisors3 incisors 32, 42temporary bridge 32, 42pontic wirebridge temporary prosthesis 39

40 贋會訊第十八卷第四期贋口腔植體學會專科醫師

41 贋會訊第十八卷第四期 Unworn 7.15Width Length W/L ratio Centra Incisor 9.10 mm mm 78 % Lateral Incisor 7.07 mm 9.75 mm 73 % esthetic checklist dental criteria proximal/incisal tooth wear Lombardi golden proportion 1:0.618 Preston golden number maillary arch Sterett Unworn 7.15Width Length W/L ratio Centra Incisor Lateral Incisor Canine 8.59 mm (M) 8.06 mm (F) 6.59 mm (M) 6.13 mm (F) 7.64 mm (M) 7.15 mm (F) mm (M) 9.39 mm (F) 8.70 mm (M) 7.79 mm (F) mm (M) 8.89 mm (F) 85 % (M) 86 % (F) 76 % (M) 79 % (F) 77 % (M) 81 % (F) Caucasians clinical crown Pascal Magne 2003 Canine 7.9 mm mm 73 % CEJ Stephen Chu 2007 relevant range mean distribution frequency 72% mm57% mm range Bolton's ratio idealistic realisticeconomically, Occlusally, Periodontally, Restoratively Procedure of alteration: Prosthetic: Crown contour modification, illusory perception Prosthetically compromised restorations (establish realistic treatment objective) Surgery: crown lengthening, APF, root coverage... Orthodontic: Intrusion, Extrusion, Axis correction, Space redistribution Alternatiove option: Snap on... 41

42 贋會訊第十八卷第四期 Case 1 11, ,12 Case CTG 42

43 贋會訊第十八卷第四期 Case 3 CLPIllusory perceptionline angle 21,22 43

贋會訊第十八卷第四期 References 1. Belser UC. Esthetics checklist for the fixed prosthesis. Part II: Biscuit-bake try-in. In: Schä rer P, Rinn LA, Kopp FR, editors.

44 贋會訊第十八卷第四期 References 1. Belser UC. Esthetics checklist for the fixed prosthesis. Part II: Biscuit-bake try-in. In: Schä rer P, Rinn LA, Kopp FR, editors. Esthetic guidelines for restorative dentistry. Chicago: Quintessence; p Lombardi RE. The principles of visual perception and their clinical application to denture esthetics. J Prosthet Dent 1973;29: Magne P, Belser U. Bonded porcelain restorations in the anterior dentition: A biometric approach. Quintessence Publ. Co. Inc, Chicago Sterrett JD, Oliver T, Robinson F, Fortson W, Knaak B, Russell CM: Width/ length ratios of normal clinical crowns of the maxillary anterior dentition in man. J Clin Periodontol 1999; 26: Magne P, Gallucci GO, Belser UC. Anatomic crown width/ length ratios of unworn and worn maxillary teeth in white subjects. J Prosthet Dent 2003;89(5): Stephen J. Chu. Range and mean distributeon of individual tooth width of maxillary anterior dentitionn. Pract Proced Aesthet Dent 2007;19(4):

贋會訊第十八卷第四期 The new vision of all ceramic veneer

$Feldspathic porcelain veneer Refractory die veneer$

45 贋會訊第十八卷第四期 The new vision of all ceramic veneer 1988~ ~ ~ Straumann 贋 e.max Empress / CAD/CAM e.max Feldspathic porcelain a. b. c. Feldspathic porcelain CreationC.C Feldspathic porcelain veneer Feldspathic veneer Feldspathic porcelain veneer Refractory die veneer Veneer Feldspathic porcelain Refractory die Veneer a b c 45

$Refractory die$ material Solid

46 贋會訊第十八卷第四期 Mock up Preparation Silicone index Mock up a. b. c. d. e. f. 0.6mm~0.8mm Laminate Veneer Alveolar modle Refractory die Refractory material Solid model try in a b c f d e Alveolar model Alveolar model Diemargin a. b. c. d. e. a b 46

$Refractory die$

47 贋會訊第十八卷第四期 c d e Duplication Polyvinyl Siloxan Duplicate Heavy body and light body a. b. c. d. a b c d Alveolar model Refractory die Alveolar model Degas Refractory die 47

$贋會訊第十八卷第四期 Refractory material GC G-CERA VEST$ $heavy body and light body Refractory die$ $Refractory die degas a b a b c Degas GC Refractory$ powder to 7.

48 贋會訊第十八卷第四期 Refractory material GC G-CERA VEST REFRACTORY DIE MATERIALPowderLiquid a. b.7.7cc100g VeneerInlay Onlay a. b. c.heavy body and light body Refractory die Refractory die degas a b a b c Degas GC Refractory material Item Value Powder / liquid ratio 33g powder to 7.7ml liquid Setting time 7 minutes Compressive strength (after baking) 52MPa (7,500psi) ~ degas 48

$Refractory die$ CPConnected

$Refractory$ material a b c

49 贋會訊第十八卷第四期 Refractory die CPConnected Paster CP a. b. c. d. CP Connector Paste Refractory die Refractory die Refractory material a b c Margin d a b CreationC.C c GC Initial 49

$Refractory$ 5mm~1mm

50 贋會訊第十八卷第四期 Refractory die veneer0.5mm~1mm Feldspathic porcelain Chroma a. b. c. d. a b c d Bur 1~2 bar path way a. b. veneer GC/LF porcelain 770 veneer a b c 50

51 贋會訊第十八卷第四期 Feldspathic veneer ~100 Mpa Feldspathic veneer 0.6mm~1.2mm 3. Cement 4. Solid model 51

52 贋會訊第十八卷第四期 Pressable veneerplatinum foil veneersfeldspathic veneers Feldspathic porcelain Refractory die Alveolar modle Connected pastercp Feldspathic veneer Chroma Platinum foil veneers Pressable veneer 52

53 中華民國贋復牙科學會會訊第十八卷第四期奇美醫院贋復牙科簡介作者張瑞忠醫師台南奇美醫院贋復牙科主任復牙科門診區開診前短暫的寧靜在贋復學會的訓練機構中奇美醫院贋復牙科是屬於比較年輕的在前主任彭玉小小的櫃子足以供應材料所需復科門診秋醫師的規劃下以及醫院的支持從添購奇美醫院贋復牙科在硬體的設備方設備補強技工室的功能引進新的材料面為了在有限的空間下發揮最大的功能符合臨床的需要加強臨床基本知識的講不管在技工室或是治療診間設備方面都是授吸引年輕的住院醫師投入贋復牙科的工採取精速實儉的原則精包作在原先的規模基礎加上大家的努力經括選購最常用的設備及材料以提高使用的過贋復學會的認可成為台南地區唯一的贋效率速包括臨床動線的規畫取用材復牙科訓練機構料的過程以及選擇近距離的技工所以方便模型的收受及溝通實則是定期淘技工室一隅所有設備一定物盡其用汰少用的材料減少庫存的壓力及成本技工室一隅灌模的好地方 53

54 中華民國贋復牙科學會會訊第十八卷第四期品酒會也要考試交換育兒經驗的好時機儉則是該用則用該省則省每個月評也因為距離相近跨科的會診可以馬上完估材料及技工費的支出加強成本的概念成減少病人等待的時間無論是在診間面以減少不必要的浪費簡而言之硬體設備對的臨床問題或是在治療計畫的雙向討論方面以符合學會的訓練機構的要求為主方面有限的診療空間卻也是受訓醫師與再以實用及使用效率為輔主治師之間最近的溝通管道在臨床教學方面則是著重垂直與水忙碌的診療時間之外贋復科當然也平方面的溝通垂直方面包括定期的文獻有輕鬆的一面師承彭玉秋醫師對紅酒的品回顧及臨床病例討論以提升訓練醫師基本味贋復科的成員也自組品酒會對於各種學識及臨床診斷能力由於治療診間彼此不同國家的葡萄酒的品種與風味提出自己相近臨床上遭遇的問題可以馬上尋求的觀感有時候還得找資料做筆記儼然是協助看診的空檔更是討論病例的最佳時對葡萄酒的文獻回顧及專業知識講授刻水平方面科與科之間的聯繫與討論在墾丁玩得太high了清境農場的聚會 54

55 中華民國贋復牙科學會會訊第十八卷第四期日月潭的科遊一次科遊邀請的對象不僅是贋復科的成員及家屬也包括其他科的醫師藉著接近大自然的機會舒解在綠島被關的經驗為了聯絡成員之間的感情贋復科一年固定舉辦平日上班的壓力眷屬之間也在科遊時互相認識由於大家的年紀相近小孩也都在同樣的年齡層趁著科遊的機會彼此交換馭夫妻術育嬰技巧及教育方法也算是另一種除了牙科以外的跨科討論會吧奇美贋復牙科的成員雖然年年都有人員的異動但共同擁有受訓期間的甘苦回憶卻把每一個人的心緊緊地連在一起所以遇到無論是工作或是生活上的難題即使在不同的工作場所大家還是會彼此幫忙因為曾經一起共事的情感是不會隨著時間而改變的在綠島享受海鮮美食 55

56 中華民國贋復牙科學會會訊第十八卷第四期築夢踏實我的學習之路 ~ 高醫附設醫院牙科部補綴科簡介 ~ 作者受訓醫師方煥華高醫附設醫院牙科部補綴科醫師今年年初接到指導老師通知說要寫一份學習心得才突然驚覺時光飛逝我在高醫補綴科受訓竟也將屆滿三年了從剛退伍時的懵懵懂懂一步步從頭學習漸次深入補綴學廣博豐富的世界這些年來的酸甜苦辣一幕幕地快速湧現眼前在高醫補綴科報到的第一天是充滿期待興奮與不安的對於新環境的強烈好奇感讓我充滿著期待但一方面卻很怕自己的狀況外會影響老師與學長姐們日常工作的進行因此顯得小心翼翼很感謝我的指導老師藍鼎勛醫師從訓練初期即循循善誘以嚴謹的態度輕鬆的方法帶著我快速地融入這個新家庭在頭一年的受訓期對我來說就是不斷累積臨床基本技能與專業知識的打底期持續地進行臨床病例資料收集包含主訴過去病史參與2014 AAP 貼示報告留影紀念 study cast color photo以及x-ray 與分析準確與符合病情的治療計畫擬定臨床操作確實地執行與再確認都是培養我在未來能獨立完成病例的能力受訓期間大量地參與跨科晨間討論會科內討論會與讀書會加強了我對本科知識的深度與跨科整合的廣度尤其在科內討論會時總能得到來自於李惠娥醫參與AAP 晚宴留影紀念 56

57 中華民國贋復牙科學會會訊第十八卷第四期料到正式假牙使用的材質幾乎都能第一手嘗試另外許多臨床操作上改良甚或顛覆傳統的想法與作法也能在指導老師與技工所的支持下化理想為可能隨著訓練期的推進我在站穩腳步之餘老師們也放手讓我指導實習醫師的臨床技能並督促我參與每年贋復學會與牙周補綴學會貼工作與休閒並進與指導老師讀書會夥伴一同出遊示報告的發表在每一次教學與整師王震乾醫師王兆祥醫師洪純正醫理報告中我能有機會去反芻過去可能囫圇吞棗式的技能與知識重新消化與師陳人豪醫師杜哲光醫師與藍鼎勛醫師吸收後更能有系統地成為自己的想法與作等諸位老師中肯詳實地批評與指導讓我在法這種教學相長的經驗對我的學習過面對臨床與學術討論問題時思考模式能逐程是非常寶貴的步面面俱到在三年前要挑戰補綴專科醫師資格在訓練期的後兩年指導老師讓我更對我來說就像遙不可及的夢想甚至我對於頻繁接觸全口重建的病例除了大幅加深本自己能否順利撐到完訓都曾存疑但憑著當科知識與技能的磨練更加強在跨科整合治初一股不想認輸的傻勁指導老師的諄諄教療時的協調能力臨床操作上在模型分析誨勉力提攜與高醫補綴科豐沛的資源與診斷蠟型重建時大量搭配面弓轉移咬我現在相信我一定能築夢踏實美夢成真合器 gothic arch tracer 與咬合平面分析儀對於觀預後等多面向整體思考讓我在面對越來越多疑症難症時能旁徵博引有憑有據地理出一條清晰的思路來而在高醫補綴科隨時都有最新最特別的牙科材每周固定招開的讀書會是統整當周臨床學習的最佳時刻病例的分析從功能美料能做臨床應用舉凡印模耗材臨時假牙材 57

Intra-Oral Examination Dentition: Midline: on Occlusion : Canine Class I, R't molar- Class I Overjet: 3 mm, overbite: 3 mm Crowding over 31~44 24 mesi

Intra-Oral Examination Dentition: Midline: on Occlusion : Canine Class I, R't molar- Class I Overjet: 3 mm, overbite: 3 mm Crowding over 31~44 24 mesi 2 28 Personal habits 2 : No Smoking: No Alcohol: No Betel nut chewing: No Front facial view: Symmetry TMJ pain and click: No Facial profile: concave Jaw deviation: No Lip line: average Bruxism: No The

贋 第 18 卷第 4 期 April 目錄 / / / / / / / / / / (02) / (02) / /

贋第 18 卷第 4 期 April 目錄 / / / / / / / / / / (02) / (02) / /