基于审美分析的口腔美容修复分类诊疗方案（一）：基本概念、决策树及临床路径

Classified diagnosis and treatment scheme of oral cosmetic restoration based on aesthetic analysis (part Ⅰ): basic concept, decision tree and clinical pathway

摘要

当前美容修复临床方案多基于欧美国家提出的口腔美感指标（简称欧美审美）制定，但机械地照搬欧美口腔美容修复方案，忽视了其与中国人口腔美感指标（简称中式审美）的差别，是无法有效支撑国人个性化口腔美容修复诊治的。另外，近年发展迅猛的美容修复新技术、新方案层出不穷，但不少热门概念的内涵混淆不清，也缺乏应有的分级诊疗规范，急需讨论明晰。本文从服务好口腔美容修复临床运用出发，探讨了中译词“美学”的不足与误用，美学与美容的区别与联系，美容修复与固定修复的相关关系，还讨论了前牙区、美学区与暴露区的差别、口腔审美分析的诊疗价值，以及脱敏、暗示等疗法在口腔疑难美容修复病例中的运用方法。进一步介绍了审美分析引导的暴露区牙位修复重建的决策树及临床路径，并案析介绍了审美分析评估临床流程、口腔美容修复临床三分类及相应的临床分类诊疗要点。

Abstract

At present, the commonly used clinical protocols of oral comestic restoration are mostly based on the aesthetic indicators proposed by Western developed countries (referred to as Western aesthetics). Mechanically copying the Western aesthetic scheme, ignoring the difference between it and the Chinese oral aesthetic indicators (referred to as Chinese aesthetics), is unable to effectively support personalized cosmetic restoration diagnosis and treatment. In addition, new technologies and new solutions for cosmetic restoration, which are developing rapidly in recent years, are emerging one after another, but many popular concepts are confusing and lack of proper hierarchical diagnosis and treatment norms, and there is indeed an urgent need for discussion and clarity. From the perspective of serving clinical application, this paper discusses the deficiencies of the Chinese translation of the word “aesthetics”, the diffe-rence and connection between aesthetics and cosmetology, and the relationship between cosmetic restoration and fixed restoration. It also discusses the difference between anterior teeth, esthetic zone and exposed zone, the diagnostic and therapeutic value of oral aesthetic analysis, as well as the application methods of desensitization, suggestion, and other therapies in difficult oral cosmetic restoration cases. We further introduce the decision tree and the clinical pathway for restoration and reconstruction of teeth in exposed zone guided by aesthetic analysis, and introduce the clinical process of aesthetic analysis and evaluation, the clinical triclassification of oral cosmetic restoration, and the corresponding clinical classification diagnosis and treatment points.

关键词

口腔美容修复 / 审美分析 / 分类诊疗临床路径 / 决策树 / 脱敏疗法 / 暗示疗法

Key words

oral cosmetic restoration / aesthetic analysis / the clinical pathway of classified diagnosis and treatment / decision tree / desensitization therapy / suggestion therapy

Author summay

于海洋，二级教授、博士研究生导师、一级临床专家。擅长显微美容修复、数字种植修复等。现任中华口腔医学会修复专业委员会主任委员、国家口腔医学中心修复分中心副主任、国家口腔医学质控中心口腔修复专业副组长、口腔修复国家临床重点专科负责人，主编出版规划教材《口腔固定修复学》《口腔医学美学》以及专著《数字引导式显微修复学》《引导式精准植入术》《口腔微距摄影速成》等30 部。提出口腔TRS 数论、美学修复形—色—心三要素四维辩证论，发明了“TRS 可测量种植导板”“备牙定深孔导板”等多项临床技术方案；研发的多项软件及医疗器械产品已经成功转化临床。E-mail：[e-mail]|于海洋，教授，博士，E-mail：[e-mail]