下颌牙周病渐进缺牙致无牙颌的种植方案设计

目的：牙周病致牙列缺失的义齿修复是非常困难的,尤其是下颌骨低平条件较差的下颌牙列缺失修复。患者常抱怨义齿的压疼、固位稳定及咀嚼效率差。虽然牙种植体应用较好地解决了上述问题,但在临床中患者由于下颌后牙区骨高度不足且距下颌神经管较近,医疗风险及手术难度加大,使得种植覆盖义齿修复效果不如预期。本文目的是用种植体最佳分布结果指导临床牙周病渐进性拔牙病例设计种植修复方案。方法：通过分析牙周病致无缺牙行种植覆盖义齿修复的临床效果并对下颌无种植覆盖义齿三维有限元分析。结果：牙周病致无缺牙行种植覆盖义齿常规在两侧颏孔区之间种植2-4枚种植体,由于后牙区没有种植体支撑,从义齿修复受力原则及防止磨牙区及种植体周骨质吸收来讲不是最佳方案,最佳应在后牙区种植种植体。结论：牙周病治疗过程中在下颌缺牙的磨牙区植入1-2枚种植体,即便最后下颌自然牙全部缺失,可以常规在两侧颏孔区之间种植2-4枚种植体,结合前期植入的种植体共有6-8枚,可以考虑种植固定或者套桶冠固位进行下颌牙列缺失的种植修复,使种植修复效果达到最佳。     

种植义齿修复牙列缺失后嚼肌肌电活动变化及意义

目的：评价种植义齿修复牙列缺失后咀嚼功能的改善程度。方法：应用种植覆盖义齿及固定义齿修复牙列缺失，定量分析嚼肌肌电图，并对照天然牙列及常规全口义齿修复。结果：在ICP位最大紧咬时，种植覆盖义齿的AMP值明显大于常规义齿，对应嚼肌较高肌力水平，在承受50％MVC时，其MPF值与对照组无显著差异，但150s出现明显下降变化。结论：种植覆盖义齿修复较常规全口义齿明显提高咀嚼功能，种植固定义齿的修复优势未能体现是因为患者担心咬合力过大造成种植体及上部结构破坏。     

CDIC种植体联合磁性附着体在种植覆盖义齿修复中的临床应用

目的：探讨CDIC种植体联合磁性附着体制作种植覆盖义齿修复牙列缺失的临床效果。方法：选取12例牙槽嵴萎缩或全口义齿固位不良的牙列缺失患者,在CDIC组合式骨内结合种植体支持的基础上,行磁性附着体覆盖义齿修复,对义齿的固位、咀嚼功能和使用情况进行2年的随访观察。结果：31枚种植体修复前均达到骨结合,平均愈合周期5个月;磁性附着体覆盖义齿修复后,义齿稳定,咀嚼功能、容貌改善明显,达到患者对美观和功能的要求。结论：CDIC种植体联合磁性附着体制作的种植覆盖义齿是修复牙列缺失的一种行之有效的方法,其性价比高,更宜临床推广应用。     

ERA全口覆盖义齿修复保留残根的半口牙列缺失患者的临床评估

目的：研究ERA附着体全口覆盖义齿的临床修复效果。方法：35例保留残根的半口牙列缺失患者，采用ERA全口覆盖义齿修复。结果：经过6个月至1年3个月时间随访，患者表示对该义齿的固位性能、咀嚼效能、舒适程度，以及装卸的方便程度感到满意。有1例出现ERA阳性部件老化，进行了即刻更换，其余无失败病例。结论：采用ERA全口覆盖义齿修复保留残根的半口牙列缺失病例，临床观察患者较满意，提示该方法是一种方便、可靠的修复方式。但ERA附着体的阳性部件需要根据老化情况，随时进行更换。     

杆卡和球帽附着体下颌种植覆盖义齿放射学对比研究

目的：了解杆卡和球帽附着体下颌种植覆盖义齿修复后种植体周齿槽骨的变化。方法：同顾性分析42例全颌牙缺失病例在下颌区各植入2颗种植体,行种植体支持覆盖义齿修复的病例,其中杆卡下颌种植覆盖总义齿19例,球帽式下颌覆盖总义齿23例。对其定期进行随访及放射学检查获得的数据进行总结。结果：杆卡和球帽附着体下颌种植覆盖义齿修复后2年,种植基牙周齿槽骨吸收情况经统计学处理没有差别。结论：杆卡和球帽附着体下颌种植覆盖义齿修复后,短期对种植体基牙周齿槽骨影响没有明显差别。     

老年下颌牙列缺失患者种植覆盖义齿治疗的临床评估

无牙颌是一常见的口腔疾病,全球社会人口老化的发展趋势导致牙列缺失患者的人数相继增加。近年来,随着种植技术越发成熟,以种植义齿为导向的修复方式在提高患者的生活质量和改善心理素质方面均获得良好反响。下颌无牙颌种植覆盖义齿主要具有两大优势：相较于传统单颌全口义齿,具有更优良的固位和咀嚼效能;相较于种植固定义齿,所需的植入位点更少,且能恢复更多缺损的软组织,从而有助于恢复美观和发音,价格也更为患者所接受。因此,本文通过系统性的整理、分析和探讨下颌种植覆盖义齿针对老年牙列缺失患者的临床疗效,结合现有相关研究中对于下颌种植覆盖义齿操作过程中种植体数目、植入位点及上部修复体的选择要点,进一步阐释其在下颌无牙颌修复中的优势。     

老年下颌牙列缺失患者种植覆盖义齿治疗的临床评估

无牙颌是一常见的口腔疾病,全球社会人口老化的发展趋势导致牙列缺失患者的人数相继增加。近年来,随着种植技术越发成熟,以种植义齿为导向的修复方式在提高患者的生活质量和改善心理素质方面均获得良好反响。下颌无牙颌种植覆盖义齿主要具有两大优势：相较于传统单颌全口义齿,具有更优良的固位和咀嚼效能;相较于种植固定义齿,所需的植入位点更少,且能恢复更多缺损的软组织,从而有助于恢复美观和发音,价格也更为患者所接受。因此,本文通过系统性的整理、分析和探讨下颌种植覆盖义齿针对老年牙列缺失患者的临床疗效,结合现有相关研究中对于下颌种植覆盖义齿操作过程中种植体数目、植入位点及上部修复体的选择要点,进一步阐释其在下颌无牙颌修复中的优势。     

变异套筒冠全口覆盖义齿修复的临床观察

覆盖义齿是指义齿的基托覆盖并支持在牙根或牙冠上的一种全口义齿或可摘局部义齿。它常用于牙列缺损和缺失患者的修复治疗。变异套筒冠全口覆盖义齿就是基牙上只制作金属内冠,在其上制作的一种全口义齿。牙列缺损或牙列缺失后,患者的咀嚼功能降低,影响全身健康。传统总义齿修复     

ITI种植体支持修复的临床研究

目的：评价非埋藏式ITI种植体修复牙例缺失的临床效果。方法：68例牙列缺失的患者，种植144颗ITI种植体。上颌种植牙于植牙后4～6个月行上部结构修复，下颌种植体于植牙后2～3个月行上部结构修复，种植后及义齿修复后的临床观察期为1～3年。结果：种植成功率为99．3％，义齿修复后行使功能的成功率为100％，有2例患者出现套冠脱落，未出现上部结构松动和折断现象。结论：非埋藏式种植体(ITI)修复牙例缺失有很高的成功率和良好的修复效果。     

种植体支持球帽附着体固位下颌覆盖总义齿的临床应用

目的：探讨球帽附着体固位的下颌种植覆盖总义齿的临床效果。方法：随机选择18例下颌牙列缺失的患者,植入2颗种植体,利用球帽附着体固位制作的覆盖义齿,随访6个月—4年,从患者主观感受和X射线检查两方面观察修复效果。结果：覆盖义齿的美观、舒适、固位稳定性好,咀嚼效率高。结论：种植体支持球帽附着体固位的下颌覆盖义齿修复下颌牙列缺失患者临床效果好。     

Masticatory function and patient satisfaction with implant-supported mandibular overdentures: a prospective 5-year study

PURPOSE: The aim of this study was to assess the outcome of treatment with implant-supported mandibular overdentures in terms of biting and chewing, in entirely satisfied and not fully satisfied patients. MATERIALS AND METHODS: Twelve edentulous patients who had worn dentures for at least 5 years participated. They were in good health but had retention problems with their mandibular dentures. First, all patients received new dentures. After 3 months, two Astra Tech implants were placed in the anterior part of the mandible, and 6 months later the abutments were connected. Patient assessment (questionnaire) and functional recordings (chewing ability, bite force, electromyographic activity) were performed with the new dentures, and again 3 months, 1 year, and 5 years after overdenture treatment. RESULTS: After treatment, all patients were able to comminute hard and tough food, the maximum bite force and the chewing activity increased in parallel, and the duration of the chewing cycle was reduced. Every patient felt improved function and reduction of chewing pain. However, the seven patients not fully satisfied with the function of the implant-supported mandibular overdentures were characterized by lower muscle activity, even before implant placement, than the entirely satisfied patients. CONCLUSION: Implant-supported mandibular overdenture treatment permits better biting and chewing function than conventional complete dentures.     

Evaluation of transitional implant stabilized overdentures: a case series report

Transitional implants (TI) can immediately improve the stability and retention of existing unstable mandibular complete dentures. This study evaluated the improvement of mandibular complete denture stability and retention with the use of TI. Three TIs were placed in the intraforaminal region of the edentulous mandible of seven patients (three men, four women; mean age 69.7 years). The patients' existing mandibular complete dentures were immediately modified to TI-stabilized overdentures. Their masticatory movements (mandibular movements during mastication) were measured using a commercially available tracking device (BioPACK, Bioresearch, Japan), both before TI placement and about 1 month after delivery of the TI-stabilized overdentures. The mean time of each chewing phase (opening, closing, and occluding) and coefficients of variation were calculated. The patients also completed a questionnaire about the foods they could chew and indicated on a 100 mm Visual Analog Scale (VAS) their personal levels of comfort, ease of chewing, speech, and stability. For masticatory movements, there were no significant differences (P > 0.05) between the TI-stabilized overdentures and existing complete dentures. However, the number of foods that could be chewed increased, and the stability and comfort were reported as improved with the TI-stabilized overdentures. Using TIs, the stability and comfort of the existing mandibular complete dentures studied in this report could be immediately improved.     

种植体支持球帽附着体固位下颌覆盖全口义齿的临床应用

目的:评价种植体支持球帽附着体固位的下颌覆盖全口义齿临床应用效果.方法:随机选择15例下颌无牙颌患者,每例植入2枚种植体,共植入30枚,随访观察1-12个月,从患者满意度、临床检查及种植体X线片观察修复效果.结果:种植体支持覆盖全口义齿修复下颌无牙颌,义齿固位和咀嚼功能满意率分别为100％和93.3％,义齿稳固,咀嚼功...     

Oral health impact on daily performance in patients with implant-stabilized overdentures and patients with conventional complete dentures.

This cohort study (n = 83) investigated whether patients with implant-stabilized overdentures would demonstrate less impact on daily life, would have less difficulty in the mastication of different types of food, and would generally be more satisfied than patients with conventional complete dentures. The groups were comparable for gender, age of dentures, and duration of edentulism. The patients were interviewed using a questionnaire, which included the Oral Impacts on Daily Performances (OIDP) sociodental indicator. Patients with implant-stabilized overdentures were more satisfied with the comfort of their dentures, could eat a wide range of food items with less difficulty, and experienced less impact on daily life than patients with conventional complete dentures. The findings of this study support the need to consider implant-stabilized overdentures in the treatment of edentulous patients.     

Implants in conjunction with removable partial dentures: a literature review

Although the benefits of implant-borne removable prostheses are readily apparent for the fully edentulous patient and have been well documented, there is a paucity of studies concerning the combination of implants with removable partial dentures in partially edentulous patients. The aim of this article is to review the literature regarding implants with removable partial dentures and evaluate the evidence for this clinical approach. A MEDLINE/PubMed search from 1990 to 2006, focusing on the use of implants with removable partial dentures and related features, was supplemented with a hand search to identify relevant peer-reviewed English articles published in dental journals and textbooks on removable partial dentures.     

Two-implant mandibular overdentures: simple to fabricate and easy to wear

Success rates for titanium dental implants in the anterior mandible are very high. Because of these success rates, as well as lower costs, it is common to treat edentulous patients with just 2 implants and ball anchors for retention of the overdenture, instead of 4 implants and a bar. In this paper the fabrication of 2-implant overdentures is described. In a controlled clinical trial (to be reported elsewhere), 30 subjects received a 2-implant overdenture for the mandible and a conventional prosthesis for the maxilla. The 30 control patients received conventional complete dentures for both jaws. The stability of the overdentures was excellent, and the lingual dimensions of the denture could be reduced to the level of the mylohyoid line to provide more space for the tongue. In patients with tense labial musculature or a limited amount of attached gingiva, it was important to elevate the shoulder of the implant and ball abutment above the gingival level to avoid peri-implant problems. Significantly fewer visits for adjustment related to post-placement pressure spots were required for mandibular overdentures than for conventional mandibular prostheses.     

全下颌种植固定义齿三维各向异性有限元模型的建立

种植义齿的远期成功率与其生物力学相容性关系密切。本文采用CT扫描数字探测法和图形图像处理分析系统，在微机上完成全下颌种植固定义齿三维空间坐标数据测量，在Var-6510计算机上采用ANSYS有限元分析程序的布尔运算和单元自动划分功能建立全下颌种植固定义齿的三维各向异性有限元模型；并在咀嚼肌附着区和颞颌关节区模拟口腔咀嚼状况时加约束反力，建立生理状况下的下颌有限元模型。     

The root-supported overdenture using the Locator overdenture attachment

This article reviews the rationale for the use of overdentures in the partially edentulous and fully edentulous maxilla and mandible. Treatment options, prosthetic designs, indications, and fundamental principles for the successful applications of overdentures are discussed. A detailed step-by-step procedure and technique for the construction of overdentures is provided.     

Comparison of stress distribution between complete denture and implant-retained overdenture-2D FEA

The aim of this study was to compare the stress distribution induced by posterior functional loads on conventional complete dentures and implant-retained overdentures with different attachment systems using a two-dimentional Finite Element Analysis (FEA-2D). Three models representative of edentulous mandible were constructed on AutoCAD software; Group A (control), a model of edentulous mandible supporting a complete denture; Group B, a model of edentulous mandible supporting an overdenture over two splinted implants connected with the bar-clip system; Group C, a model of edentulous mandible supporting an overdenture over two unsplinted implants with the O-ring system. Evaluation was conducted on Ansys software, with a vertical force of 100 N applied on the mandibular left first molar. When the stress was evaluated in supporting tissues, groups B (51.0 MPa) and C (52.6 MPa) demonstrated higher stress values than group A (10.1 MPa). Within the limits of this study, it may be concluded that the use of an attachment system increased stress values; furthermore, the use of splinted implants associated with the bar-clip attachment system favoured a lower stress distribution over the supporting tissue than the unsplinted implants with an O-ring abutment to retain the mandibular overdenture.