Abstract: The treatment of tooth with large defect often involves many subjects，which is a common problem in clinic. The continuous development of dental prosthodontics，periodontal crown lengthening surgery and root canal therapy provide technical support for the treatment and restoration of tooth with large defect，which makes more natural teeth retained. Although scholars at home and abroad have gradually recognized that the condition of residual tooth tissue affects the choice of restoration scheme，there is still a lack of systematic elaboration on the clinical selection of restoration methods for tooth with large defect. The author，as a specialist in prosthodontics，through discussing with experts in periodontology and endodontics，puts forward a specific principle of choosing the prosthodontic method based on the residual dentin wall condition，and shows 1 clinical case treated according to this principle，in order to provide guidance for the diagnosis and treatment of tooth with large defect.

Key words: tooth defect, ferrule, post-core crown, periodontal surgery, root canal therapy

摘要： 大面积牙体缺损患牙的治疗往往涉及多个学科，是临床上常见的难题。口腔修复技术、牙周冠延长术和根管治疗技术的不断发展为大面积牙体缺损患牙的治疗和修复提供了技术支持，使得更多的天然牙得以保留。尽管国内外学者逐渐认可剩余牙体组织状况影响修复方案这一理念，但大面积牙体缺损修复方式的临床选择仍缺乏系统的阐述。笔者作为口腔修复专科医生，通过与牙周科和牙体牙髓科专家共同探讨，提出一种以剩余牙本质壁状况为依据来选择修复方式的具体原则，并展示1例应用此原则完成治疗的临床病例，以期为临床上大面积牙体缺损患牙的诊治提供指导。

关键词: 牙体缺损, 牙本质肩领, 桩核冠, 牙周手术, 根管治疗