植牙的迷思及体验

Teeth Implants – Myths and Experiences

图文/刘耀国(Stephen Low)

当今世上, 不論貧与富, 是男或女, 長壽的人越來越普遍. 這里許多八, 九十歲, 甚至过百歲的長者依然活躍于各个社團中. 健康的人有持久耐用之身体器官配合, 只有牙齒是个例外.

成年人大約有 32 顆牙齒 (智齒長不出來者有28). 个别牙齒用了20多年後開始退化, 初時蛀、爛、崩等要牙医修、填、補;接下來是牙痛、牙鬆、牙脫落, 又要医生渡牙根、套冠、拔牙或做搭橋. 再过十多年, 当牙齒一排三隻沒有了的時候已不能搭橋, 以前唯一选擇是局部假牙.後來多了「種牙」的考慮.

以前也没有相熟的做过種牙手術, 但傳說紛紛, 說要在顎骨上鑽洞很困難很痛, 亞裔牙骨不夠厚,加果不成功手尾很長,收費昂貴, 種幾隻牙的價錢可以買到一輛名貴跑車等等, 聽起來十分嚇人.直到最近這幾年我們的旧同學,旧同事,朋友的親友等多人有了種牙經驗, 不是想像中那么可怕, 我們也去聽过植牙医學講座, 便决定探討其可行性.

Not too long ago, say 12 years ago, we all heard, in one time or another, horror stories about dental implant failures, how jawbones of Asians were not thick enough, how painful, extremely expensive and it was a new technology etc etc. But as we dig a little deeper, it turned out modern dental implants were around since the 1970s.

History

It was 1931 in Honduras, archaeologists found examples of endosseous implants dating back over 1,370 years in the Maya civilization. In 1970 with the help of radiographs, they conclude that the implants were placed during life.

As with many scientific advances, the discovery of what makes current dental implants successful was serendipitous. In 1952, an orthopedic surgeon noted that he could not remove a small titanium cylinder he had placed in a bone to study how bone healed. The special property that titanium has of fusing to bone, called osseointegration is the biological basis of modern implants’ success.

Dr. Leonard Linkow  of the U.S. placed his first dental implant in 1952, four months after he graduated from dental school. By 1992, Dr. Linkow had placed over 19,000 dental implants and stopped counting. He retired from private practice in 2002 leaving a body of work that included 12 books and 36 patents. Many implant dentists refer to Dr. Linkow as the father of modern implant dentistry.

1931年洪都拉斯出土頭骨中, 考古學家知道了瑪雅族早于一千三百多年前已懂得把硬物植入牙骨中. 到了五十年代, 矯形外科手術医生無意中發現金屬「鈦」titanium 能与骨愈合生長. 便是現代植牙技術之起源. 此後美國的利奧納医生成功替人植牙數十年,著作等身,被譽為現代植牙之父. 在加拿大, 七十年代已開始有植牙案例但普及化是近1020年之事.

种牙經歷第一階段:

与本人牙医李医生 (Dr.Li) 商量後獲介紹去見專科蔡医生 (Dr. Choi) 李医生原籍中山在香港出世, 童年在洪都拉斯渡过. 15歲來加讀中學, 後畢業於卑斯大學牙医學系. 現在的医务所設於本拿比,執業已33.曾是加華牙医學會會長,推進學術交流及社區活动不違餘力.

蔡医生在温哥華出世, 畢業於南加洲大學USC, 再到紐約攻讀牙医專科. 學成後回來任教UBC牙医學系. 目前医務所設於本拿比做植牙手術已有六年經驗. 成功率為 95%-97%. 初次見面時交費二百五十二元, 誏他推介他的服務, 兼看X-光鏡片在电腦顯示的影像, 牙骨厚薄, 神經綫位置, (神經線不能碰, 否則後果慘重!) 种牙兩顆的地方等等一覽無遺. 使我們信心大增. 手術那天預計90分鐘但60分鐘完成. 局部麻醉使割開牙肉鑽洞時不覺得痛. 回家後咬綿花到晚上止了血,無需食止痛藥, 以後幾天也不痛. 三个月後种下的金屬鈦空心螺絲与牙骨愈合了便可以放入柱子, 以便下一階段套上牙冠 crowns .

第二階段:

回李医生處「打牙印亅以為輕而易舉, 却因种牙附近的牙肉「復原」後生得太高, 需局部麻醉改低一點才能得到正确齒印送去假牙廠. 第二天面腫了需服食消炎藥10. 兩星期後如期安裝牙冠. 算是大功告成, 花了半年時間. 全部費用並非萬萬声. 若有牙医保健計畫, 牙冠部分自付三份之一. 視乎何種保險而定.

以上是个人經歷. 大家要明白各人情况不一, 例如顎骨需加厚 (用捐贈者牙骨) 就要用多幾倍時間. 也要知道凡手術必有風險. 考慮到各種因素後再与牙医及專科医生談談, 相信可以作出明智的決定.

植牙的迷思及体验

Highly efficiency secretary Mina-秘書小姐效率奇高. 次日的跟進电話更窝心. 土生妹能說流利粵語.

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A new look. Dedicated and happy on the job -. 新髮型判若兩人, 友善笑容依舊, 敬業樂業.

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Dr. Choi
Young looking with years of experiences.
蔡医生學 歷和手術經驗都丰富. 土生仔說流利粤語.

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Some of the implant tools. 植牙部分工具.

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Knowledgeable Assistant Melissa with new CD X-ray machine. 牙医助手小姐对三维全景X-光机操作滾瓜爛熟. 也說流利粵語.

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Hard working and helpful-另一助手工作認真.

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Operation completed-植牙手術完成. 兩顆螺絲位置清清楚楚.

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Everything new at Dr. LI’s  place-李医生医务所全新裝修, 所有器材也是新的. 也最先進.

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Ceiling TV- 手術椅上卧看电視.别開生面.

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Teeth model for the Lab. 牙齒模型. 下方是植牙位置.

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Back from the Lab-假牙做好整套模型的樣子.

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Two Crowns.  room for one more implant-兩颗牙冠 (說是假牙較易明白).是陶瓷及多种金屬的結合体. 仍有空位再种一顆.

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Crowns are now in place-牙冠安裝完成.

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The magnificent team from L to R-Pauline,  Dr. Li, Carine  and Alyssa 大合照. comments, please.


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