吸烟对慢性牙周炎患者龈沟液及牙龈组织中β防御素2、3的影响

目的 探讨吸烟对慢性牙周炎患者龈沟液（gingival crevicular fluid,GCF）及牙龈组织中β防御素(human beta def-ensin,hBD)2、3表达的影响。方法 将研究对象分为吸烟慢性牙周炎组和非吸烟慢性牙周炎组。采用酶联免疫吸附法（Elisa）检测hBD2、3的浓度;反转录多聚合酶链反应(RT-PCR)检测hBD2、3mRNA的表达,并做半定量分析。相关数据采用SPSS 17．0软件包进行统计学分析。结果 在GCF中,hBD2、3在吸烟组的水平表达均低于非吸烟组;hBD2、3在2组牙龈组织样本中均有mRNA表达,其中吸烟组较非吸烟组mRNA表达水平减弱。结论 吸烟可使GCF及牙龈组织中hBD2、3的表达发生改变,提示吸烟可对牙周宿主免疫防御系统产生消极影响。     

A novel organotypic dento-epithelial culture model: effect of Fusobacterium nucleatum biofilm on B-defensin-2, -3, and LL-37 expression

Background: In the present study, the expression and localization of three epithelial peptides (human β‐defensin [hBD]‐2 and ‐3, and cathelicidin [LL‐37]) are studied in an organotypic dento‐epithelial (OD‐E) model exposed to Fusobacterium nucleatum (Fn) biofilm. Methods: Biofilm of Fn ATCC 25586 or AHN 9508 were produced by culturing each strain on semipermeable membranes. The OD‐E model was constructed by seeding keratinocytes on fibroblast‐containing collagen gels and by placing dentin pieces on the top. A 3‐day‐old biofilm was placed on the top of the OD‐E and the coculture was incubated for 5 hours or 24 hours. Production of epithelial antimicrobial peptides was determined immunohistochemically. Results: After 5 hours of incubation, the biofilm of each Fn strain stimulated expression of hBD‐2 and ‐3. hBD‐2 was localized on superficial layers and hBD‐3 on basal cell layers of the epithelium and dento‐epithelial junctions, whereas LL‐37 was only weakly expressed. After 24 hours, hBD‐2 expression was extended toward basal cell layers of the epithelium. In contrast, hBD‐3 expression extended toward superficial layers of the epithelium. In the case of Fn AHN 9508 biofilm, LL‐37 was localized in the cell layers of the dento‐epithelial junction. Conclusion: In our OD‐E model, epithelial antimicrobial peptide responses to Fn biofilms have distinct regulation and localization characteristics, resembling those known to occur in the gingival epithelium in vivo.     

种植体黏膜与种植体乳头水平及周围软组织稳定性的关系探讨

目的: 探讨种植体黏膜（dental implant mucosa,DIM）与种植体乳头（dental implant papilla,DIP）水平及周围软组织稳定性的关系。方法: 选择2015年1月—2019年1月于青岛市海慈医院接受口腔种植体修复的患者86例,从治疗起随访至2020年12月,分别于植入物放置即刻（T0）、4周（T1）、2年（T2）和随访结束（T3）时检测边缘骨吸收水平（MBLs）、中颊黏膜水平（MBMLs）、DIP、改良龈沟出血指数（mSBI）、改良出血指数（mBI）植入物稳定性系数（ISQ）水平及之间的相关性。采用SPSS 23.0软件包对数据进行统计学分析。结果: 随访1.0~5.2年,平均（4.79±0.34）年,脱落2例,最终纳入患者84例（95颗种植体）。与T0时相比,T1、T2、T3时mSBI、mPLI、mBI、邻牙接触点的远端骨水平、中骨水平依次显著降低（P<0.05）,DIP高度显著升高;T0、T1、T2、T3时,PD、MBLs、MBMLs水平相比差异无统计学意义（P>0.05）。邻牙接触点的远端骨水平、中骨水平可影响DIP高度（P<0.05）。DIP增加49例,丧失46例;T0时,DIP增加、丧失组的ISQ水平均较高;T1时较T0时DIP增加、丧失组的ISQ水平降低（P<0.05）;T2、T3时,DIP增加组ISQ值显著大于丧失组（P<0.05）。结论: DIM、DIP水平之间存在依赖性,种植体周围软组织的稳定性取决于角化组织高度和DIP高度。     

微型种植体支抗和XIVE种植体在牙列缺损修复中的临床应用

目的：探讨用微型种植体作为正畸支抗压低伸长磨牙,同时用XIVE种植体修复对（牙合）缺失牙的可行性.方法：选择7例下颌第一磨牙缺失,对颌牙伸长＞2.5mm种植修复的患者.在对颌伸长的第一磨牙的近中腭侧和远中颊侧各植入1枚微型种植体.用橡皮链挂在颊、腭侧的种植体上,以压低伸长的对颌牙齿,定期更换并进行临床检查.同时缺牙区植入XIVE种植体,常规种植治疗.结果：7例患者中,1枚微型种植钉松动脱落,余6例患者伸长牙平均压低3mm,平均压低时间为5个月,经种植修复后均获得满意的临床效果.结论：针对下颌第一磨牙缺失对颌牙伸长较多的病例,微型种植体支抗和种植体的联合应用,能达到良好的修复效果.     

Organization of the connective tissue barrier around long-term loaded implant abutments in man

The study aimed to investigate the connective tissue seal and the spatial organization of collagen fibers around long-term loaded implants in man. Block specimens containing smooth titanium implant abutments and the surrounding supracrestal connective tissue were obtained from patients rehabilitated for at least 1 year with implant-retained overdentures or implant-supported fixed prostheses and were histologically investigated. The histological features of the connective tissue around long-term loaded titanium abutments were specific: the tissue was rich in collagen fibers, organized in bundles, presenting a constant spatial arrangement, similar to that reported in animal studies. Circular fibers, the most numerous, were located externally, and longitudinal fibers internally. Radial fibers inserted on the abutment surface, similar to those of the periodontal system, were not observed in any case. No histological differences were found between tissue sampled around implants supporting a fixed restoration and those anchoring an overdenture.     

Psychological stress has no association with salivary levels of β‐defensin 2 and β‐defensin 3

J Oral Pathol Med (2010) 39 : 765–769 Background: Recent studies suggest that stress can predispose an individual to the development of periodontal disease, but the exact biological mechanism is unknown. Considering that psychological stress can down‐regulate the production of β‐defensins (antimicrobial peptides produced in the oral cavity), the aim of the present study was to evaluate the association between stress and salivary levels of β‐defensin 2 (HBD‐2) and β‐defensin 3 (HBD‐3). Methods: For this purpose, seventy five volunteers, classified as periodontally healthy, were submitted to a psychological evaluation using a validated questionnaire (Questionnaire of Lipp‐ISS). Following analysis of the questionnaires, the subjects were divided in two groups (Group A: Absence of stress and Group B: Presence of stress). Unstimulated saliva samples were collected and the concentration of total protein was determined using the BCA method, and the concentrations of HBD‐2 and HBD‐3 were determined by ELISA. Results: The levels of total protein did not show a statistically significant difference between the groups. Analyses of HBD‐2 and HBD‐3 concentrations indicate that the stress condition was not associated with the levels of either peptide in saliva (P = 0.3664 for HBD‐2 and P = 0.3608 for HBD‐3). Conclusion: In periodontally healthy subjects, HBD‐2 and HBD‐3 levels are not influenced by stress.     

种植体和微型种植体支抗在正畸与修复中的联合应用

目的：探讨种植体和微型种植体支抗在正畸与修复中的联合应用的可行性,并观察临床效果。方法：选择24例下颌磨牙缺失时冶牙伸长需要做种植的患者。缺牙区植入ITI种植体,常规种植治疗。同时在对猞伸长的磨牙的近中腭侧和远中颊侧各植入一枚微型种植体,用橡皮链挂在颊、腭侧的种植体上,以压低伸长的对日冶牙齿,定期更换并进行,陆床检查。结果：24例患者中,1枚微型种植钉松动脱落,余23例患者伸长牙平均压低2．4mm,平均压低时间为5．6个月,经种植修复后均获得满意的临床效果。结论：针对下颌磨牙缺失对骀牙伸长的病例,种植体和微型种植体支抗的联合应用,能达到最佳的修复效果。     

Histological and histomorphometric evaluation of immediate implant placement on a dog model with a new implant surface treatment

Purpose: The aim of this study was to evaluate crestal bone resorption and bone apposition resulting from immediate post‐extraction implants in the canine mandible, comparing a conditioned sandblasted acid‐etched implant surface with a non‐conditioned standard sandblasted implant surface. Material and methods: In this experimental study, third and fourth premolars and distal roots of first molars were extracted bilaterally from six Beagle dog mandibles. Each side of the mandible received three assigned dental implants, with the conditioned surface (CS) on the right side and the non‐conditioned surface (NCS) on the left. The dogs were sacrificed at 2 (n=2), 4 (n=2) and 12 weeks (n=2) after implant placement. Results: The microscopic healing patterns at 2, 4 and 12 weeks for both implant types (CS and NCS) yielded similar qualitative bone findings. The mean crestal bone resorption was found to be greater for all implants with NCS (2.28±1.9 mm) than CS (1.21±1.05 mm) at 12 weeks. The mean percentage of newly formed bone in contact with implants was greater in implants CS (44.67±0.19%) than with the NCS (36,6±0.11%). There was less bone resorption with the CS than the NCS. Conclusion: The data show significantly more bone apposition (8% more) and less crestal bone resorption (1.07 mm) with the CS than with the NCS after 12 weeks of healing. This CS can reduce the healing period and increase bone apposition in immediate implant placements. To cite this article:
Calvo‐Guirado JL, Ortiz‐Ruiz AJ, Negri B, López‐Marí L, Rodriguez‐Barba C, Schlottig F. Histological and histomorphometric evaluation of immediate implant placement on a dog model with a new implant surface treatment.
Clin. Oral Impl. Res. 21 , 2010; 308–315.
doi: 10.1111/j.1600‐0501.2009.01841.x     

种植体数目与分布对下颌种植覆盖义齿骨组织应力变化的影响

目的：建立下颌种植覆盖义齿三维有限元模型,研究咬合力作用下种植体数目与位置分布对牙槽骨组织应力分布的影响因素。方法：临床采集患者下颌骨及其原有义齿CT数据,使用逆向工程软件建立种植体数目与位置不同的下颌种植覆盖义齿实体模型。通过Abaqus有限元软件分析咬合力作用下种植体数目与位置分布对种植体周围以及下颌后端牙槽骨应力变化的影响。结果：在咬合力作用下,下颌骨Mises应力主要分布在种植体周围骨组织,种植体远中颈部呈现应力集中,下颌后端区域应力较小且分布均匀。随着种植体数目的增加,后端种植体周围骨应力上升,远端牙槽骨应力降低。当牙弓前、后端种植体距离增加时,种植体周围骨应力增大,远端牙槽骨应力降低。结论：采用2植体支持的下颌种植覆盖义齿种植体周围骨吸收风险较小,但远端牙槽嵴骨吸收风险增大。4植体义齿所承受的咬合力主要由植体承担,修复时应注意前后植体的距离和咬合力在义齿上的合理分布。     

Early osseointegration to hydrophilic and hydrophobic implant surfaces in humans

Objective: To evaluate the rate and degree of osseointegration at chemically modified moderately rough, hydrophilic (SLActive) and moderately rough, hydrophobic (SLA) implant surfaces during early phases of healing in a human model. Material and methods: The devices used for this study of early healing were 4 mm long and 2.8 mm in diameter and had either an SLActive chemically modified or a moderately rough SLA surface configuration. These devices were surgically installed into the retro‐molar area of 49 human volunteers and retrieved after 7, 14, 28 and 42 days of submerged healing. A 5.2‐mm‐long specially designed trephine with a 4.9 mm inside diameter, allowing the circumferential sampling of 1 mm tissue together with the device was applied. Histologic ground sections were prepared and histometric analyses of the tissue components (i.e. old bone, new bone, bone debris and soft tissue) in contact with the device surfaces were performed. Results: All device sites healed uneventfully. All device surfaces were partially coated with bone debris. A significant fraction of this bone matrix coating became increasingly covered with newly formed bone. The process of new bone formation started already during the first week in the trabecular regions and increased gradually up to 42 days. The percentage of direct contact between newly formed bone and the device (bone‐to‐implant contact) after 2 and 4 weeks was more pronounced adjacent to the SLActive than to the SLA surface (14.8% vs. 12.2% and 48.3% vs. 32.4%, respectively), but after 42 days, these differences were no longer evident (61.6% vs. 61.5%). Conclusion: While healing showed similar characteristics with bone resorptive and appositional events for both SLActive and SLA surfaces between 7 and 42 days, the degree of osseointegration after 2 and 4 weeks was superior for the SLActive compared with the SLA surface. To cite this article :
Lang NP, Salvi GE, Huynh‐Ba G, Ivanovski S, Donos N, Bosshardt DD. Early osseointegration to hydrophilic and hydrophobic implant surfaces in humans.
Clin. Oral Impl. Res. 22 , 2011; 349–356. doi: 10.1111/j.1600‐0501.2011.02172.x     

临时种植体即刻负载在半颌即刻种植中的应用

目的：评价临时种植体即刻负载在半颌即刻种植中的应用效果。方法：20例半颌即刻种植患者行136枚即刻种植体植入,采用95枚临时种植体即刻负载恢复患者牙列。3-6月后行固定修复。结果：即刻负载临时种植体和即刻种植体成功率达100%。结论：临时种植体即刻负载半颌即刻种植是很好的临床方法。     

Diagnosis of implant stability and its impact on implant survival: a prospective case series study

Objectives: To assess the predictability of implant stability assessment either clinically or by resonance frequency analysis (RFA). Material and methods: This prospective case series study evaluated 4114 consecutive SLA Straumann^® implants in two private clinics. Primary stability was classified in four categories, depending on the degree of implant rotation when tightening the healing cap: A (no rotation at all), B (light rotation with a feeling of resistance), C (rotation without resistance) and D (rotation and lateral oscillation). In one clinic (n=542 implants), RFA method was also used the day of the surgery (Osstell 1) and at restoration placement (Osstell 2). Survival rates were stratified according to the clinical classification categories using life table analysis. The association between Osstell 1 and 2 and the clinical classification was tested with ANOVA. Results: 3899 implants were classified as stable (A) and 213 as unstable (B–D). Their survival rates were 99.1% and 97.2%, respectively. The unstable implants were further classified in B (158), C (51) and D (4), with survivals of 98.1%, 94.1% and 100%, respectively, being these differences statistically significant (P<0.009). Using Osstell^®, implants were stratified in two groups according to a predefined threshold of implant stability quotient (≥60). At the Osstell 1 measurement there was no significant association between primary stability and implant survival (P<0.753). In Osstell 2, however, the association was significant (P<0.001). Conclusions: Only secondary stability RFA values were able to significantly predict implant outcomes, but not primary stability values. There was a good correlation between RFA and the proposed clinical classification of primary stability. To cite this article:
Rodrigo D, Aracil L, Martin C, Sanz M. Diagnosis of implant stability and its impact on implant survival: a prospective case series study.
Clin. Oral Impl. Res. 21 , 2010; 255–261.
doi: 10.1111/j.1600‐0501.2009.01820.x     

Influence of implant length and bicortical anchorage on implant stress distribution

Background: Short implants present superior failure rates for everybody. Purpose: The aim of this theoretic study was to assess to what extent implant length and bicortical anchorage affect the way stress is transferred to implant components, the implant proper, and the surrounding bone. Materials and Methods: Stress analysis was performed using finite element analysis. A three‐dimensional linear elastic model was generated. All implants modeled were of the same diameter (3.75 mm) but varied in length, at 6, 7, 8, 9, 10, 11, and 12 mm (Branemark System®, Nobel Biocare AB, Gothenburg, Sweden). Each implant was modeled with a titanium abutment screw and abutment, a gold cylinder and prosthetic screw, and a ceramic crown. The implants were seated in a supporting bone structure consisting of cortical and cancellous bone. An occlusal load of 100 N was applied at a 30° angle to the buccolingual plane. Results: With the selected model and bone properties, the coronal cortical anchorage was dominating, and the bone stress concentrated to that area. Conclusions: The maximum bone stress was virtually constant, independent of implant length and bicortical anchorage. The maximum implant stress, however, increased somewhat with implant length and bicortical anchorage.     

前牙种植体即刻种植修复牙龈软组织指标观察

目的　评价种植体即刻种植修复临床效果及美学意义。方法　 18例患者 18枚Camlog种植体在前牙区即刻种植即刻临时冠修复 ,对种植体成功率及周围牙龈附着水平进行观察 ,6个月后永久冠修复。结果　 12个月时所有种植体都发生了骨结合现象 ,牙龈变化平均为 0 .75mm ,在允许范围内。患者对种植即刻修复效果满意。结论　在严格掌握适应证前提下 ,前牙美学区单牙种植体即刻修复与延期修复相比在种植成功率、种植体周围软组织组织学变化上差异无显著性     

Histological evaluation of the peri‐implant tissues of three human‐retrieved Straumann implants

The most frequently‐used histological parameters to define dental implant osseointegration include bone‐to‐implant contact and quantitative and qualitative assessments of the surrounding tissue (rate of mineralized/non‐mineralized tissue and proportion of lamellar and woven bone compared to soft tissue or bone marrow). The aim of this paper was to present the histological features of the bone tissue surrounding three well‐functioning Straumann SLA and SLActive implants placed in two patients after 12 and 60 months of loading. The percentage of osseointegration ranged from 66.4% and 71.9% for SLA surfaces, to 88.3% for the SLActive implant. Such results confirm that osseointegration occurs with high rates of bone‐to‐implant contact in humans, and that implants can be similarly clinically successful, although they show different bone‐to‐implant contact values.     

In vitro evaluation of the implant abutment connection sealing capability of different implant systems

This study sought to evaluate the sealing capability of the implant abutment connection of different dental implant systems. Five Nobel Replace select, Straumann and Intra-lock implants of approximately 4.5 mm diameter with their respective abutments were provided by the manufacturers. A calibration curve was determined by placing toluidine blue (TB) increments of 0.1 microL into 1.5 mL of distilled water and recording its absorbance in a spectrophotometer until reaching 0.7 microL. Then, 0.7 microL of TB was placed in the deepest portion of each implant's internal screw, the abutments were adapted to the implant according to the manufacturer's instructions and the specimens were placed in vials with 1.5 mL of distilled water. Spectrophotometric analysis was performed at 1, 3, 6, 24, 48, 72, 96 and 144 h. Statistical analysis was performed by One-way anova at 95% level of significance. The calibration curve was linear with respect to the TB amount in 1.5 microL distilled water (R(2) = 0.9961). All implant abutment systems presented an increase in absorbance as a function of time. As time elapsed in vitro, significantly higher amounts of TB was released from the Straumann and Nobel Replace Select connection systems (P < 0.0001). Leakage was significant between the groups. Despite controlled torquing, the seal between the implant body and the abutment could not be maintained in all three of the systems tested.     

Surgical factors influencing mesiodistal implant angulation

OBJECTIVES: The aim of this experimental study was to identify relevant surgical parameters influencing the mesiodistal angular deviation of dental implants. MATERIAL AND METHODS: Pilot drillings of 2 mm diameter were performed in bovine ribs with a parallelometer. The subsequent preparation of the implant socket was performed freehand. Utilizing six different implant systems, at least 80 drillings per system of different diameters were performed. The pilot drillings were marked with 2 mm steel pins and cephalometric radiographs were taken. The mesiodistal angle between the longitudinal implant axis and the marked pilot drillings was measured and evaluated by a blinded investigator. To evaluate the influence of the surgeons' experience, their drillings were compared with those of a group of unexperienced surgeons. Additionally, the influence of drilling speed and size of bur steps on drilling accuracy were evaluated. RESULTS: The difference between the lowest value of 0.91 degrees of mesiodistal angular deviation found for 3i implants and the highest of 1.36 degrees for Ankylos implants was of low statistical significance (P=0.065). Drillings of experienced surgeons showed less deviation compared with those of a beginners group (P<0.0001). Higher deviations were measured when a bur size was skipped. Drillings performed at high speed showed significantly higher deviations than those with fewer rewinds per minute. CONCLUSION: In order to achieve precise implant angulation, all bur diameters available should be used. Utilizing low drilling speeds results in less mesiodistal deviation. The surgeon's experience seems to be the most relevant factor in precise implant placement.     

Attachment systems for implant overdenture: influence of implant inclination on retentive and lateral forces

Objective: To evaluate the retentive force and lateral force of an implant with various types of attachments for overdentures in relation to implant inclination. Material and methods: An implant (3.75 × 13 mm) was embedded into an acrylic resin block, simulating the edentulous ridge. Four different attachment systems were used, including: (1) Locator black and blue, (2) a ball attachment, (3) a flat‐type magnetic attachment and (4) a self‐adjusting magnetic attachment, which has vertical and rotational movement. All of the attachments were under a constant dislodging force with an angle of the implant at 0°, 15°, 30° and 45°, and the experiments were repeated 10 times using a universal testing machine to measure the retentive force. The lateral force to the implant was measured by strain gauges attached on the implant surface. Statistical analysis was performed by multiple comparisons with Bonferroni's correction. P<0.05 was considered statistically significant. Results: At 0°, the significantly highest retentive force was observed in the Locator blue, followed by the Locator black, ball, flat‐type and self‐adjusting magnetic attachments. The Locator blue and ball attachment maintained the retentive force until a 30° inclination; however, the lateral force increased significantly, especially with the ball attachment. The retentive force of the magnetic attachment was significantly lower at 0°, as well as the lateral force in the self‐adjusting magnetic attachment. Conclusion: Within the limitations of this study, we conclude that the retentive force decreases with an increase in implant inclination, whereas the lateral force increases, except for in magnetic attachments. To cite this article:
Yang T‐C, Maeda Y, Gonda T, Kotecha S. Attachment systems for implant overdenture: influence of implant inclination on retentive and lateral forces.
Clin. Oral Impl. Res. 22 , 2011; 1315–1319.
doi: 10.1111/j.1600‐0501.2010.02137.x     

上颌前牙即刻种植与即刻修复的临床体会

目的：探讨上颌前牙即刻种植与即刻修复的临床运用原则,并初步评价临床疗效。方法：25例患者共28个上颌前牙在拔牙同时植入了种植体,同期行即刻修复。平均4个月后进行最终修复。修复后平均追踪观察时间38个月。结果：所有种植体骨结合良好,2例出现不同程度的牙龈萎缩,对美观有一定程度的影响;其余26例修复完成至最后一次复查,临床效果良好,5年累积存活率达到100％。结论：在严格把握适应症的情况下,即刻种植与即刻修复,可获得很高的存活率。尽管即刻种植并不能阻断种植体周围牙槽嵴的吸收,但对维持牙龈形态,获得美学效果有积极影响。