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缺牙一定要种植牙吗？没钱补怎么办？｜證據鏈

km 編輯部2026-08-13阅读约 55 分钟
#證據鏈#牙醫KM#台灣#植牙

本頁是〈缺牙一定要种植牙吗？没钱补怎么办？〉的事實單元帳：每一條主張對應的來源、證據等級、地域與期間、原文引句與限制，逐條攤開。

缺牙一定要种植牙吗？没钱补怎么办？｜證據鏈

F-Units（事实单元账）

  • F1｜confidence: verified｜basis: peer_reviewed（PMID 29476794，系统性回顾）｜period: PROSPERO CRD42017064851，2018 刊出｜geo: universal｜span: 「there is currently insufficient evidence to recommend one tooth replacement strategy over another in adult patients with reduced dentitions」「Ten articles were included in this systematic review. Of these, four were analyses of different outcomes from a multicentre randomized controlled trial in Germany, whilst one study was the pilot phase for this trial.」｜caveat: 人群限定＝短牙弓／牙列缩减之成年病人（标題为 shortened dental arches、结论句为 reduced dentitions），不涵蓋所有缺牙情境；纳入 10 篇，作者明言高品质随机对照試验数量不足。同錨 KM-DENTAL-34 之 F8，本卡摘述不重写
  • F2｜confidence: verified｜basis: clinical_guideline（PMID 35688447，EFP S3 等级临床实务指引）｜period: 2022 刊出，13 篇委託系统性回顾｜geo: universal｜span: 「which require additional interventions following completion of active periodontal therapy」「Prior to treatment planning, it is critically important to undertake a definitive and comprehensive diagnosis and case evaluation, obtain relevant patient information, and engage in frequent re-evaluations during and after treatment」「recommendations for different interventions, including orthodontic tooth movement, tooth splinting, occlusal adjustment, tooth- or implant-supported fixed or removable dental prostheses and supportive periodontal care」｜caveat: 該指引之适用人群为第 IV 期牙周炎病人，非所有缺牙者；本卡引用其治疗順序结构，未引用任何个别处置的疗效数字。2026-08-06 以 PubMed 标題栏位检索 periodontitis 与 S3 level，确认近三年仅一筆英国落地版（PMID 40555302），本篇为现行版
  • F3｜confidence: verified（状态查核）｜basis: withdrawn_publication／not_evidence（PMID 31425605）｜period: 2019-07-17 标記撤回；esummary pubtype 含 Retracted Publication｜geo: universal｜span: 「WITHDRAWN: Interventions for replacing missing teeth: partially absent dentition」｜caveat: 本条仅用于記录一件事——本題在 Cochrane 層级无现行有效结论；其任何结论一律不作临床证据使用。版本鏈以 CD003814 检索得 2 筆（22336794 为 2012 年版、31425605 为 2019 年撤回版），撤回者为版本鏈末端
  • F4｜confidence: verified｜basis: peer_reviewed（PMID 23062124，系统性回顾与统合分析）｜period: 2006 至 2011 检索，2012 刊出，纳入 46 篇｜geo: universal｜span: 「survival of implants supporting SCs at 5 years amounted to 97.2% (95% CI: 96.3-97.9%), and at 10 years amounted to 95.2% (95% CI: 91.8-97.2%)」「The survival of implant-supported SCs was 96.3% (95% CI: 94.2-97.6%) after 5 years and 89.4% (95% CI: 82.8-93.6%) after 10 years」「Technical complications reached a cumulative incidence of 8.8% (95% CI: 5.1-15.0%) for screw-loosening, 4.1% (95% CI: 2.2-7.5%) for loss of retention, and 3.5% (95% CI: 2.4-5.2%) for fracture of the veneering material after 5 years」「technical, biological, and aesthetic complications were frequent」｜caveat: 存活率非成功率，不等于个人预期。同錨 KM-DENTAL-34 之 F16；本卡 span 已依 2026-08-06 全線鐵則改为原文词序逐字，不沿用 #34 旧版倒置写法
  • F5｜confidence: verified｜basis: peer_reviewed（PMID 38762079，傘状回顾）｜period: 检索至 2023-10，PROSPERO CRD42024512408，2024 刊出｜geo: universal｜span: 「None of the associations were graded as convincing evidence」「Two associations, presence of periodontitis (OR = 3.84 [95 % CI 2.58,5.72]) and cigarette smoking (RR=2.07 [95 % CI 1.41,3.04]) were graded as highly suggestive」「Eight associations, diabetes mellitus, hyperglycaemia, lack of prophylaxis, history of chronic periodontal disease, ongoing or history of periodontal disease」｜caveat: 纳入 12 篇文章、41 个统合分析；为观察性研究之统合，关联不等于因果
  • F6｜confidence: verified｜basis: peer_reviewed（PMID 40512526，傘状回顾）｜period: 2025-09-26 刊出｜geo: universal｜span: 「Ten relevant patient-related risk factors for peri-implantitis were identified. While some of them are modifiable (smoking, bleeding on probing, plaque control, number of sites with PPD ≥ 5 mm, recall frequency, and occlusal overload), others are not (history of periodontitis, implant location, number of teeth lost, and systemic diseases)」「or to forgo implant therapy in high-risk conditions」｜caveat: 該回顾本身指出各系统性回顾间的相对影響差异甚大、易被高估；本卡不引用任何單一风险因子的效应量。此篇较 F5（2024）为新，兩者并陳而非取代
  • F7｜confidence: verified｜basis: clinical_guideline（PMID 37271498，EFP S3 等级临床实务指引）｜period: 2023 刊出，13 篇委託系统性回顾｜geo: universal｜span: 「Once the implants are loaded and in function, a supportive peri-implant care programme should be structured, including periodical assessment of peri-implant tissue health」「Prevention of peri-implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded」｜caveat: 指引对象为临床医師之处置建议，本卡仅引用其「植体需長期支持性照护」的结构性事实，不作疗效宣称
  • F8｜confidence: verified｜basis: peer_reviewed（PMID 25935732，系统性回顾与统合分析）｜period: 2006 至 2013 检索，2015 刊出｜geo: universal｜span: 「Forty studies reporting on 1796 metal-ceramic and 1110 all-ceramic FDPs fulfilled the inclusion criteria」「an estimated 5-year survival rate of metal-ceramic FDPs of 94.4% (95% CI: 91.2-96.5%)」「the survival rate of densely sintered zirconia FDPs was 90.4% (95% CI: 84.8-94.0%) in 5 years of function」「A significantly higher incidence of caries in abutment teeth was observed for densely sintered zirconia FDPs compared to metal-ceramic FDPs」「Significantly more framework fractures were reported for reinforced glass ceramic FDPs (8.0%) and glass-infiltrated alumina FDPs (12.9%) compared to metal-ceramic FDPs (0.6%) and densely sintered zirconia FDPs (1.9%) in 5 years in function」「The estimated survival rate of reinforced glass ceramic FDPs was 89.1% (95% CI: 80.4-94.0%), the survival rate of glass-infiltrated alumina FDPs was 86.2% (95% CI: 69.3-94.2%) and the survival rate of densely sintered zirconia FDPs was 90.4% (95% CI: 84.8-94.0%) in 5 years of function.」｜caveat: 多單位固定假牙；材料别差异大。同錨 KM-DENTAL-34 之 F17
  • F9｜confidence: verified｜basis: peer_reviewed（PMID 23062127，经济面向系统性回顾）｜period: 2012 刊出｜geo: universal｜span: 「Initial costs for single implant crowns and FDPs on teeth were similar, but varied between tariff systems」「Failure rates reported with single implant crowns and FDPs on teeth were similar」「The utility for the patient to keep healthy adjacent teeth unprepared makes the implant crown more economic」｜caveat: 费用制度依各国而异，本卡不引用任何金额，也不把該结论转換成台湾情境。同錨 KM-DENTAL-34 之 F18
  • F10｜confidence: verified｜basis: peer_reviewed（PMID 34761421，系统性回顾）｜period: 1966 至 2020 检索，2022 刊出｜geo: universal｜span: 「Two retrospective studies indicated that RDPs increased the risk of tooth loss compared to FDPs in patients with a history of periodontitis」「Several studies indicated that RDP increased plaque accumulation」「There is no strong evidence that RDPs per se will cause periodontal destruction including tooth loss」｜caveat: 资料异质未做统合分析；人群限牙周炎病人。同錨 KM-DENTAL-34 之 F15
  • F11｜confidence: verified｜basis: peer_reviewed（PMID 26066662，系统性回顾）｜period: 2003 至 2014 检索，2015 刊出｜geo: universal｜span: 「Comminution or mixing ability in subjects with (E)SDA was 28-39% lower compared to that of subjects with complete dentitions」「distal-extension RDPs could compensate this reduction partially (some 50%)」「more artificial teeth in RDPs resulted in better performance」｜caveat: SDA＝3 至 5 对后牙咬合、ESDA＝0 至 2 对；纳入研究数少。同錨 KM-DENTAL-34 之 F14
  • F12｜confidence: verified｜basis: peer_reviewed（PMID 17002745，文献回顾）｜period: 1966 至 2005-11 检索，2006 刊出｜geo: universal｜span: 「no clinically significant differences between subjects with shortened dental arches of three to five occlusal units and complete dental arches regarding variables such as masticatory ability, signs and symptoms of temporomandibular disorders, migration of remaining teeth, periodontal support, and oral comfort」｜caveat: 敘事性回顾（非统合分析），主要纳入單一研究群作品。短牙弓的完整討论属 KM-DENTAL-34，本卡仅摘述
  • F13｜confidence: verified｜basis: peer_reviewed（PMID 29316570，多中心随机对照試验 10 年结果）｜period: 2018 刊出｜geo: universal｜span: 「The number of teeth lost was higher than expected」「The results suggest an overestimation of the influence of the prosthetic management of the bilateral SDA」「In treatment decisions, patient preferences should be considered with appropriate weight」｜caveat: 152 人中 82 人達 10 年检查，流失率高。同錨 KM-DENTAL-34 之 F13
  • F14｜confidence: verified｜basis: peer_reviewed（PMID 37001792，系统性回顾）｜period: 检索至 2022-11-06，2023 刊出｜geo: universal｜span: 「No significant difference was recorded in the nutritional status of patients rehabilitated using the SDA concept compared with RPDs」「Higher costs for treatment provision and maintenance for patients in the RPD group was found when compared to SDA treatment」「SDA therapy may be considered as a feasible treatment concept in older adults especially in those with complex medical statuses and limited finances」｜caveat: 仅 4 篇报告（來自 2 个研究），未能统合分析；成本结论不可转換为任何地区价格；原文语氣为 may be considered（可被考虑），本卡不得改写成「适合」或「建议」，且人群限年長者。同錨 KM-DENTAL-34 之 F11
  • F15｜confidence: verified｜basis: peer_reviewed（PMID 40552466，系统性回顾）｜period: PROSPERO CRD42024584113，2025-06-24 刊出｜geo: universal｜span: 「Out of 1,876 initial records, 12 studies met inclusion criteria: 7 cohort studies, 4 case-control studies, and 1 randomised controlled trial」「Both RCT and DIs demonstrated high survival rates, with RCT slightly outperforming DIs in terms of success」「Failure rates ranged from 0.7% to 12.0%, with no significant differences between treatments. DIs were associated with a higher frequency of postoperative interventions and complications」「The decision between treatments should consider clinical factors, patient preferences, cost, accessibility, potential complications, and patient-centred outcomes. Shared decision-making is essential for optimal patient care」｜caveat: 因异质性未能统合分析，结果为质性合成；DIs＝dental implants、RCT 在該文中指 root canal therapy
  • F16｜confidence: verified｜basis: peer_reviewed（PMID 38443242，系统性回顾）｜period: 检索至 2023-07，2025-03 刊出（电子版 2024-03-04）｜geo: universal｜span: 「Three included studies revealed no difference in survival rate between endodontically treated teeth and implant-supported prostheses during the first 3 years, but the survival of endodontically treated teeth declined over time with a higher failure rate than implant-supported prostheses」「In contrast, the other 3 included studies reported lower survival rate for implant-supported prostheses and more complications」「Whether implant-supported prostheses or endodontically treated teeth are better in terms of survival outcome is unclear」｜caveat: 8 篇观察性研究（3 篇回溯性世代、5 篇病例对照），无随机对照試验
  • F17｜confidence: verified｜basis: clinical_guideline（PMID 32383274，EFP S3 等级临床实务指引）｜period: 2020 刊出，15 篇委託系统性回顾；PubMed 註記有 2021 年勘误（J Clin Periodontol 2021;48:163）｜geo: universal｜span: 「pre-established stepwise approach to therapy that, depending on the disease stage, should be incremental, each including different interventions」「Consensus was achieved on recommendations covering different interventions, aimed at (a) behavioural changes, supragingival biofilm, gingival inflammation and risk factor control; (b) supra- and sub-gingival instrumentation, with and without adjunctive therapies; (c) different types of periodontal surgical interventions; and (d) the necessary supportive periodontal care to extend benefits over time」｜caveat: 适用人群为第 I 期至第 III 期牙周炎；本卡引用其阶梯式疗程结构，不引用任何个别处置的疗效数字
  • F18｜confidence: verified｜basis: peer_reviewed（PMID 33648772，系统性回顾）｜period: 2022 刊出｜geo: universal｜span: 「Three studies (4396 extractions in total) could be included for the risk of bias assessment and qualitative data synthesis」「caries with the proportion of all extractions ranging from 36.0% to 55.3%, periodontitis from 24.8% to 38.1%, trauma from 0.8% to 4.4%, periapical disease from 7.3% to 19.1%」｜caveat: 仅 3 篇纳入；該文另指出「非牙科与非医疗動机之拔牙」缺乏可靠估计，本卡未引用該段。同錨 KM-DENTAL-30
  • F19｜confidence: verified｜basis: peer_reviewed（PMID 33053198，Cochrane 系统性回顾 CD004346.pub5）｜period: 检索至 2020-01-17，2020-10-14 刊出｜geo: universal｜span: 「We included two studies with data from 1736 participants」「there is little to no difference between risk-based and 6-month recall intervals in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period (high-certainty evidence)」「The available evidence on recall intervals between dental check-ups for children and adolescents is uncertain. The two trials we included in the review did not assess adverse effects of different recall strategies」｜caveat: 版本鏈以 CD004346 检索得 4 筆（15846709／17943814／24353242／33053198），pub5 为现行版，pubtype 无撤回标記；受試者限规律回诊者（成人試验定义为前兩年内至少就诊一次），不可外推到長期未就医者；該回顾未研究未补綴缺牙区的追踪间隔，本卡不得以它支持任何缺牙追踪频率
  • F20｜confidence: verified｜basis: peer_reviewed（PMID 42131949，系统性回顾与统合分析）｜period: 2026-05-14 線上先行刊出｜geo: universal｜span: 「Fifty articles comprising 55 population-based cohorts (287 750 participants from 37 countries) were included」「Individuals with nonfunctional dentition had approximately twice the odds of impaired OHRQoL compared with those with functional dentition [pooled adjusted odds ratio (OR) = 2.08; 95% CI 1.72-2.52; I2 = 70.6%]」「Certainty of evidence for OHRQoL outcomes was rated as moderate」｜caveat: 多数纳入研究为横断面设计，关联不等于因果；epubdate 2026-05-14 早于本卡日期。同錨 KM-DENTAL-30
  • F21｜confidence: verified｜basis: peer_reviewed（PMID 33345687，系统性回顾与统合分析）｜period: 2009 至 2019 检索，2022 刊出（电子版 2020-12-21）｜geo: universal｜span: 「individuals who were completely edentulous or who lacked functional dentition had a 21% increased likelihood of being at risk of malnutrition or being malnourished, as compared with those who were dentulous or had functionally adequate dentition (risk ratio, 1.21; 95% CI, 1.11 to 1.32; I2 = 70%)」「Findings were limited by heterogeneity, risk of bias, and overall quality of the studies reviewed」｜caveat: 人群限居住于已开发国家、年龄 60 岁以上者；7 篇纳入、6 篇進入统合分析
  • F22｜confidence: verified｜basis: peer_reviewed（PMID 34210202，系统性回顾）｜period: 2022 刊出（电子版 2021-07-02）｜geo: universal｜span: 「41 studies were included in the synthesis (14 rated good quality, 20 fair, and 7 poor)」「The balance of data supported a positive impact of wearing full (5/7 studies) or partial (3/3 studies) dentures (vs. no dentures) on nutritional status, though no clear direction of effect was detected for the impact of dentures on dietary intake」「The balance of data clearly showed that objective measures of eating function were compromised in full (14/15 studies) and partial (6/7 studies) denture wearers as compared with the dentate」｜caveat: 以计票法与敘事合成，未做统合分析；纳入研究品质不一
  • F23｜confidence: verified｜basis: peer_reviewed（PMID 37837498，系统性回顾）｜period: 2023 刊出（电子版 2023-10-14）｜geo: universal｜span: 「Of the 1517 articles identified in the initial search, 12 were selected for the final review」「a consistent pattern of improvement in nutritional status was not observed when they did not receive dietary advice」「Isolated prosthetic rehabilitation may not have the effect of exerting a change in nutritional status of edentulous elderly patients」｜caveat: 人群限 60 岁以上、追踪至少 1 个月之随机临床試验；结论限无牙年長者
  • F24｜confidence: verified｜basis: peer_reviewed（PMID 17559530）｜period: 2007 刊出｜geo: universal｜span: 「Supraeruption was found in 92% of subjects' unopposed teeth」｜caveat: 100 例＋100 对照之就诊人群研究，非社区普查。本条摘述自 KM-DENTAL-34（該卡为此題 canonical），本卡不重写其完整分析
  • F25｜confidence: verified｜basis: peer_reviewed（PMID 22211303，系统性回顾）｜period: 2012 刊出，纳入 20 篇｜geo: universal｜span: 「horizontal dimensional reduction (3.79 ± 0.23 mm) was more than vertical reduction (1.24 ± 0.11 mm on buccal, 0.84 ± 0.62 mm on mesial and 0.80 ± 0.71 mm on distal sites) at 6 months」｜caveat: 限未经处置之自然癒合拔牙窩。同錨 KM-DENTAL-34 之 F24 与 KM-DENTAL-28
  • F26｜confidence: verified｜basis: peer_reviewed（PMID 42021242，质性研究）｜period: 2026-04-23 刊出；試验註册 ISRCTN26302774｜geo: universal｜span: 「a purposive sample of 15 older partially dentate patients」「Each patient received resin-bonded bridgework (RBB) to restore them to a functional dentition of 10 occluding pairs」「the patients indicated concern that the SDA treatment provided in the clinical study would not be available to them in a primary care setting」｜caveat: 质性訪談、n=15、人群限先前參加該試验的年長者，且研究地点在爱爾蘭与北爱爾蘭；受訪者对可近性的担憂为当地情境，本卡不外推到台湾
  • F27｜confidence: verified（2026-08-06 以 ego-browser 实载，逐字对得上）｜basis: law｜period: 现行条文（法规整编资料截止日：民国 115 年 07 月 31 日）｜geo: TW｜span: 《全民健康保险法》第 51 条「下列項目不列入本保險給付範圍：……十一、義齒、義眼、眼鏡、助聽器、輪椅、拐杖及其他非具積極治療性之裝具。」｜caveat: 个别给付以健保署现行公告为准，本卡不作给付判定。同錨 VERIFIED-FACTS
  • F28｜confidence: verified（2026-08-06 以 ego-browser 实载，逐字对得上）｜basis: law｜period: 现行条文｜geo: TW｜span: 《医疗法》第 81 条「醫療機構診治病人時，應向病人或其法定代理人、配偶、親屬或關係人告知其病情、治療方針、處置、用藥、預後情形及可能之不良反應。」｜caveat: 条文引述，非法律意见
  • F29｜confidence: verified（2026-08-06 以 ego-browser 实载，逐字对得上）｜basis: law｜period: 现行条文｜geo: TW｜span: 《医疗法》第 87 条「医学新知或研究报告之发表、病人卫生教育、学术性刊物，未涉及招徠医疗业务者，不視为医疗广告。」｜caveat: 条文引述，非法律意见
  • F30｜confidence: verified（2026-08-06 以 ego-browser 实载，页面标題与 4 筆档案清单逐字读取）｜basis: official_statement｜period: 页面所列生效日 115.07.01、更新日 115.06.24｜geo: TW｜span: 卫生福利部中央健康保险署「全民健康保险医疗服务给付项目及支付标准」公告页，列有支付标准压缩档等 4 筆资料｜caveat: 本卡未下载档案逐项比对，仅将其定位为查证管道，不代为判定任何项目是否给付
  • F31｜confidence: verified（2026-08-06 以 ego-browser 实载，逐字读取）｜basis: official_statement｜period: 诠释资料更新時间 2026-07-13｜geo: TW｜span: 政府资料开放平台资料集「臺北市醫療收費標準」，提供机关为台北市政府卫生局，更新频率为不定期更新｜caveat: 單一县市例证；其他县市页面放量前逐一补验
  • F32｜confidence: verified（2026-08-06 以 ego-browser 实载并逐字读取；页面标示资料更新 115-05-29）｜basis: official_statement｜period: 页面现况｜geo: TW｜span: 台北市政府社会局「中低收入老人假牙补助」：补助态样含活动假牙、固定假牙、活动假牙維修三类；服务对象为列册該市之低收入户、中低收入户、领有中低收入老人生活津貼、收容安置补助、身心障碍者生活补助费等身分别，并分别訂有年滿五十五岁或六十五岁以上之年龄门檻；备註载明「后牙区連续缺牙超過三颗（含）仅核予活动假牙」「活动及固定假牙装置补助，同一牙位五年内（以装置完成日起算）不得重复申请」；应备文件由該局每年公告｜caveat①：本站不转载該办法之任何补助金额。caveat②：仅台北市一县市例证，其他县市规定不同，本卡未逐一查证。caveat③：「后牙区連续缺牙超過三颗仅核予活动假牙」为补助核定之行政规則，非临床适应症判准。caveat④：中央層级同性质计划名称本卡未实测验证，故不引用。同錨 KM-DENTAL-13
  • F33｜confidence: verified｜basis: internal_dataset｜period: 2025-03 至 2026-08 GSC｜geo: TW｜span: backlog #35「缺牙没钱补」「拔牙后一定要种植牙吗」「缺牙一定要种植牙吗」「没有牙根一定要种植牙吗」「牙齿掉了一定要种植牙吗」「一定要种植牙吗」等 6 词项合计曝光 103,429，跨 2 站｜caveat: 曝光为资产级数字，非去重流量；掛载名單依佇列页 #35 栏，禁增刪。本条为内部数据，发布转档時不輸出可见層
  • F34｜confidence: 结构性整理（编辑框架，非外部事实宣称）｜basis: editorial_framework｜period: 2026-08-06｜geo: universal｜span: 「兩个问題的拆解」与「六个条件清单」为本站依 F1 至 F26 文献整理的溝通用架构｜caveat: 非临床判准、非诊断工具，不取代医師评估
  • F35｜confidence: verified（2026-08-05 OP 以 ego-browser 親验，兩轨页面全文无「牙」字）｜basis: official_statement｜period: 入口现况｜geo: TW｜span: 健保署「醫材比價網」兩轨查询类别（自付差額医材比价 12 类、医材收费比价 8 类）皆不含牙科品项｜caveat: 引自本站跨卡已验事实档（VERIFIED-FACTS.md），本卡未重测；用途为避免读者白跑，不作为牙科费用查证管道

来源清单

取用日期均为 2026-08-06。PubMed 条目以 E-utilities efetch 取得摘要原文逐字对照，并以 esummary 逐笔检视 pubtype（除第 3 条外均无撤回标记）；台湾官方与法规页面以 ego-browser 实载并读取 innerText 逐字比对。

  1. McLister C, et al. Effectiveness of prosthodontic interventions and survival of remaining teeth in adult patients with shortened dental arches — A systematic review. J Dent. 2018. PMID 29476794
  2. Herrera D, et al. Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. J Clin Periodontol. 2022. PMID 35688447
  3. WITHDRAWN: Interventions for replacing missing teeth: partially absent dentition. Cochrane Database Syst Rev. 2019. PMID 31425605（**已撤回，本卡标为非证据**）
  4. Jung RE, et al. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants. Clin Oral Implants Res. 2012. PMID 23062124
  5. Giok KC, et al. Risk factors for Peri-implantitis: An umbrella review of meta-analyses of observational studies and assessment of biases. J Dent. 2024. PMID 38762079
  6. Tarce M, Quirynen M. Peri-implantitis Risk Assessment (PiRA) Part 1: Umbrella Review. Int J Oral Maxillofac Implants. 2025. PMID 40512526
  7. Herrera D, et al. Prevention and treatment of peri-implant diseases — The EFP S3 level clinical practice guideline. J Clin Periodontol. 2023. PMID 37271498
  8. Pjetursson BE, et al. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses? Part II: Multiple-unit FDPs. Dent Mater. 2015. PMID 25935732
  9. Scheuber S, et al. Implants versus short-span fixed bridges: survival, complications, patients' benefits. A systematic review on economic aspects. Clin Oral Implants Res. 2012. PMID 23062127
  10. Gotfredsen K, et al. Efficacy and risks of removable partial prosthesis in periodontitis patients: A systematic review. J Clin Periodontol. 2022. PMID 34761421
  11. Liang S, et al. Effects of removable dental prostheses on masticatory performance of subjects with shortened dental arches: A systematic review. J Dent. 2015. PMID 26066662
  12. Kanno T, Carlsson GE. A review of the shortened dental arch concept focusing on the work by the Käyser/Nijmegen group. J Oral Rehabil. 2006. PMID 17002745
  13. Walter MH, et al. The Randomized Shortened Dental Arch Study: Tooth Loss Over 10 Years. Int J Prosthodont. 2018. PMID 29316570
  14. Funke N, et al. Impact of shortened dental arch therapy on nutritional status and treatment costs in older adults: A systematic review. J Dent. 2023. PMID 37001792
  15. Borda MF, et al. Comparative outcomes of endodontically treated teeth versus dental implant-supported prostheses: a systematic review. Acta Odontol Scand. 2025. PMID 40552466
  16. Sinsareekul C, et al. Survival, complications, and patient-reported outcomes of endodontically treated teeth versus dental implant-supported prostheses: A systematic review. J Prosthet Dent. 2025. PMID 38443242
  17. Sanz M, et al. Treatment of stage I-III periodontitis — The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020. PMID 32383274
  18. Broers DLM, et al. Reasons for Tooth Removal in Adults: A Systematic Review. Int Dent J. 2022. PMID 33648772
  19. Fee PA, et al. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev. 2020, CD004346.pub5. PMID 33053198
  20. Leite FRM, et al. Tooth Loss and Edentulism Are Associated With Poorer Quality of Life: A Systematic Review and Meta-Analyses. J Periodontal Res. 2026. PMID 42131949
  21. Zelig R, et al. Tooth Loss and Nutritional Status in Older Adults: A Systematic Review and Meta-analysis. JDR Clin Trans Res. 2022. PMID 33345687
  22. Moynihan P, Varghese R. Impact of Wearing Dentures on Dietary Intake, Nutritional Status, and Eating: A Systematic Review. JDR Clin Trans Res. 2022. PMID 34210202
  23. Brígido JA, et al. The effect of prosthetic rehabilitation with or without dietary advice on nutritional status in elderly patients: a systematic review. Aging Clin Exp Res. 2023. PMID 37837498
  24. Craddock HL, Youngson CC. Occlusal changes following posterior tooth loss in adults. Part 1. J Prosthodont. 2007. PMID 17559530
  25. Tan WL, et al. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res. 2012. PMID 22211303
  26. Meaney S, et al. Patient perceptions of prosthodontic management options for partially dentate older adults: a qualitative study. BMC Oral Health. 2026. PMID 42021242
  27. 全民健康保险法 第 51 条（全国法规资料庫）
  28. 医疗法 第 81 条（全国法规资料庫）
  29. 医疗法 第 87 条（全国法规资料庫）
  30. 卫生福利部中央健康保险署「全民健康保险医疗服务给付项目及支付标准」公告页
  31. 政府资料开放平台：臺北市醫療收費標準（提供机关：台北市政府卫生局）
  32. 台北市政府社会局「中低收入老人假牙补助」
  33. 内部数据：`analysis/reports/km-dental-backlog.md` #35 附录（词×站×曝光逐笔可对账）
  34. 编辑框架：本站「两个问题」拆解与「六个条件」清单（无外部来源，标示为结构性整理）
  35. 跨卡已验事实：`km-compliance/VERIFIED-FACTS.md`「醫材比價網不含牙科」（2026-08-05 实测）

内部引用链

  • 缺牙不补会发生什么、短牙弓的完整討论（本題 canonical，本卡不重写）：臼齿拔掉可以不补吗？会怎样？（KM-DENTAL-34）
  • 活动假牙的费用组成、維护与地方补助細節：活动假牙要多少钱？（KM-DENTAL-13）
  • 固定假牙（牙桥、牙冠）的费用组成与报价單读法：做一颗固定假牙要多少钱？（KM-DENTAL-03）
  • 种植牙费用的组成与变因：种植牙一颗到底多少钱？（KM-DENTAL-09）
  • 修磨较少的黏着式牙桥是什么、适合谁：黏着式（馬里蘭）牙桥是什么？适合谁？（KM-DENTAL-22）
  • 多颗缺牙、整口重建的费用怎么问：全口重建要多少钱？（KM-DENTAL-32）
发布闸门提醒：本卡为 draft。四语（zh-Hans／en／ja）未产前不得进 km_entries；F3 为撤回文献，任何情况下不得被改写成临床证据；F32 之补助金额一律不得补回可见层；F35 沿用跨卡已验结论，若 VERIFIED-FACTS 更新须同步。

FAQ

缺一颗牙，一定要种植牙吗？
**不一定。** 一份以短牙弓／牙列缩减成年病人为对象的系统性回顾结论写明，目前证据不足以推荐任一种补牙策略优于其他策略 [F1]；而涵盖更广「部分缺牙」人群的那份 Cochrane 回顾已撤回，没有现行有效结论 [F3]。种植牙的植体 5 年存活率在统合分析中为 97.2% [F4]，但同一份回顾也记录技术性、生物性与美观并发症频繁出现 [F4]；牙周炎与吸烟是高度提示的植体周炎风险因子 [F5]，且植体负重后需要结构化的支持性照护 [F7]。牙桥、活动假牙、以及在特定条件下不补回后段大臼齿，都是文献中讨论过的处理方式 [F8][F10][F12]。哪一种适合你，须由牙医师评估。
1 本欠損したら、必ずインプラントが必要ですか？ — **必ずしもそうではありません。** 短縮歯列・歯列縮減の成人を扱った系統的レビューは、どの補綴戦略をほかより推奨するにも現時点のエビデンスが不十分としています [F1]。より広い部分欠損歯の集団を扱う Cochrane レビューは撤回され、現在有効な結論はありません [F3]。メタ解析はインプラントの 5 年生存率を 97.2% と報告しましたが [F4]、同レビューは技術的、生物学的、審美的合併症も頻繁と記録しました [F4]。歯周炎と喫煙はインプラント周囲炎の高度に示唆的なリスク因子で [F5]、荷重後には構造化された支持的ケアが必要です [F7]。ブリッジ、可撤式義歯、そして一定の条件では後方大臼歯を補わないことも、文献で扱われる方法です [F8][F10][F12]。どれが合うかは歯科医師の評価が必要です。
If I am missing one tooth, do I definitely need an implant? — **Not necessarily.** A systematic review of adults with shortened dental arches/reduced dentitions says current evidence is insufficient to recommend any replacement strategy over another [F1]. The Cochrane review covering the broader population with partial tooth loss has been withdrawn, leaving no current valid conclusion [F3]. Meta-analysis reported 5-year implant survival of 97.2% [F4], but the same review recorded frequent technical, biological, and aesthetic complications [F4]. Periodontitis and smoking are highly suggestive peri-implantitis risk factors [F5], and structured supportive care is needed after loading [F7]. Bridges, removable dentures, and—in specified circumstances—not replacing posterior molars are all approaches discussed in the literature [F8][F10][F12]. A dentist must assess which suits you.
我真的没有钱，是不是只能先放着？
**「先放着」和「有计划地暂缓」是两回事。** 文献上，拔牙指征中龋齿占 36.0% 至 55.3%、牙周炎占 24.8% 至 38.1% [F18]——会让你再多缺一颗的，通常是这两件事，所以在有限的预算下，先控制它们的顺序高于补回已缺的位置。牙周治疗本身就是阶梯式的疗程结构 [F17]，而牙周炎造成的功能后果，指引也把重建排在完成主动牙周治疗之后 [F2]。此外，一份针对年长者的系统性回顾在临床意义段写的是：短牙弓治疗「可被考虑」为年长者的可行治疗概念，特别是在病况复杂与财力有限者身上 [F14]——这是保留语气的研究层级建议，人群限年长者，且该回顾仅纳入 4 篇报告；适不适用你，仍须由牙医师依你的口内条件判断。
本当に費用がありません。当面は放っておくしかないですか？ — **「放っておく」と「計画して延期する」は異なります。** 文献では、抜歯適応のうち、う蝕は 36.0% 〜 55.3%、歯周炎は 24.8% 〜 38.1% を占めます [F18]。これらは次の歯を失う原因になり得るため、予算が限られるなら欠損部を補う前にコントロールします。歯周治療自体に段階構造があり [F17]、指針は活動性歯周治療の完了後に機能的な結果の再建を置いています [F2]。高齢者の系統的レビューは、短縮歯列治療が、複雑な医学的状態や限られた経済的余裕がある人で実行可能な概念として「考慮され得る」と慎重に記しています [F14]。これは慎重な研究レベルの表現で、対象は高齢者、組み入れ報告は 4 件だけです。口腔内の条件に当てはまるかは歯科医師が判断します。
I truly have no money. Is my only option to leave it alone for now? — **“Leave it alone” and “defer it with a plan” are different.** In the literature, caries account for 36.0% to 55.3% of extraction indications and periodontitis for 24.8% to 38.1% [F18]. These are commonly what can lead to another missing tooth, so with a limited budget, controlling them comes before replacing the missing site. Periodontal treatment itself has a stepwise structure [F17], and guidelines place reconstruction for functional consequences after active periodontal treatment is completed [F2]. A systematic review in older adults says, cautiously, that shortened dental arch treatment “may be considered” as a feasible concept, especially for people with complex medical status and limited finances [F14]. This is a guarded, study-level statement; the population is older adults and the review included only 4 reports. A dentist must decide whether it applies to your oral condition.
没有牙根了，是不是只剩种植牙一条路？
**要先分清楚你的状况是哪一种。** 如果牙根还在、只是严重损坏，那要先讨论的是「治疗后保留」与「拔除后重建」的取舍：一份 2025 年的系统性回顾记录两者失败率介于 0.7% 至 12.0%、无显着差异，而植体与较高频率的术后处置与并发症相关，并写明决策应考量临床因素、病人偏好、费用与可近性 [F15]；另一份同年的系统性回顾则写明哪一种在存活结果上较好并不明确 [F16]。如果牙根确实已经没有了，那么种植牙、牙桥、活动假牙都是文献中的选项 [F4][F8][F10]，并非只剩一条路。
歯根がなければ、残る道はインプラントだけですか？ — **まず、どの状況かを分けてください。** 歯根が残り歯が大きく損なわれているなら、まず治療後の保存と抜歯後の再建の負担を相談してください。 2025 年の系統的レビューは、失敗率 0.7% 〜 12.0%、有意差なし、インプラントでより頻繁な術後介入・合併症、臨床因子・選好・費用・利用可能性を考える必要を報告しました [F15]。別の 2025 年の系統的レビューは、生存でどちらがよいかは不明確としました [F16]。歯根が本当にない場合も、インプラント、ブリッジ、可撤式義歯はいずれも文献で扱われる選択肢であり [F4][F8][F10]、残る道が一つだけということではありません。
If there is no root, is an implant the only path left? — **First distinguish which situation you have.** If the root remains and the tooth is severely damaged, first discuss the trade-off between retention after treatment and reconstruction after extraction. A 2025 systematic review reported failure rates of 0.7% to 12.0%, no significant difference, more frequent postoperative interventions and complications with implants, and the need to consider clinical factors, preferences, cost, and accessibility [F15]. Another 2025 systematic review said which gives better survival remains unclear [F16]. If the root truly is absent, implants, bridges, and removable dentures are all literature-discussed options [F4][F8][F10], not a single remaining path.

来源锚定

引用本文

km 編輯部・《缺牙一定要种植牙吗？没钱补怎么办？｜證據鏈》・IDAEO 知識庫・2026-08-13・https://km.idaeo.ai/reports/dental-missing-tooth-options-evidence

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更新 2026-08-13T14:17:27.371Z · server-rendered · four-language · IDAEO 知識庫