牙根留置技术在前牙区种植修复的临床效果研究

目的:评价牙根留置技术(root submergence technique, RST)应用于前牙区种植体支持式固定桥桥体位置的临床效果,并探讨其技术要点。方法:选择上颌前牙区拟行种植体支持式固定桥修复的患者,桥体位点采用牙根留置技术,延期以种植体支持的树脂临时固定桥成形牙龈形态,3个月后行最终修复,最终修复后1年复诊。最终修复当天和复诊时评估桥体位置红色美学指数(pink esthetic score, PES);复诊时评估桥体位置和对侧同名牙的改良菌斑指数(modified plaque index, mPI)和改良出血指数(modified sulcus bleeding index, mSBI);记录随访期内各种相关并发症。结果:本研究共有11个桥体位置留置牙根,随访期内未出现牙根留置的相关并发症;最终修复当天和1年后复诊时的PES平均值分别为8.91±0.94和9.18±0.87,差异无统计学意义(P>0.05);复诊时软组织健康状况良好,桥体位置mPI和mSBI平均值分别为0.82±0.60和0.45±0.52,对侧同名牙mPI和mSBI平均值分别为0.73±0.79...     

下颌前牙区种植修复的临床应用研究

【摘要】：目的 探讨下颌前牙区种植修复的临床应用效果。方法 选择2013年2月至2017年8月期间在本院进行下颌前牙区种植修复的60例患者作为研究对象,根据种植区的条件及适应症,设置对照组和实验组,各30例。实验组实施即刻种植,对照组采取择期种植,对比两组患者修复后牙周组织情况 [改良龈沟出血指数(mBI)、探诊深度(PD)和边缘骨吸收(MBL)],采用红色美学指数(PES)评估两组美学效果,并监测两组患者修复后1年种植体留存情况。结果 修复完成后1、6和12个月实验组和对照组mBI指数比较,均无显著差异p＞0.05,无统计学意义;修复后1、6和12个月实验组和对照组PD值比较,均无显著差异p＞0.05,无统计学意义;修复后1、6和12个月实验组MBL值（0.37±0.11 mm、0.52±0.13 mm、0.54±0.17 mm）均显著低于对照组（0.65±0.12、0.93±0.19、0.85±0.33mm）,差异具有统计学意义（p＜0.05）。修复后即刻、6个月和12个月实验组美学效果PES评分（9.19±1.32分、9.86±1.02分、10.04±1.14分）均显著高于对照组（7.27±1.63分、8.63±1.37分、8.02±1.25分）,差异具有统计学意义（p＜0.05）。实验组修复1年后种植体留存率（93.75%）与对照组（93.55%）比较,无显著差异p＞0.05,无统计学意义。结论 下颌前牙区种植修复中采取即刻种植方式,可有效减少边缘骨吸收,改善美学效果,且对牙周组织和种植体留存情况无明显影响,可作为下颌前牙区种植修复的首选方式。     

前牙种植体上部结构修复类型的选择

种植义齿是由种植体及与种植体连接的上部结构和义齿组成的一种修复体，其美观、舒适、咀爵功能恢复良好。随着社会的进步．人们对自己的美观要求越来越高，尤其是前牙缺失患者，用一般的方法修复缺牙，基牙的制备或有基托均不可避免。而种植牙对前牙既能达到美观要求，又无基托，不损伤邻牙。我院自1995年8月～1996年8月对19名前牙缺失患者，共植入23枚种植体，全部完成修复。现作一总结。材料与方法1研究对象前牙缺失患者19例。其中男8名，种植体11枚，占47．82％；女11名，种值体12枚，占52．17％。基台数共23枚，其中单牙基台14枚占60．…     

前牙区即刻种植并修复的临床研究

我们对前牙区病例采用拔牙后即刻种植修复，观察其临床效果。     

上颌前牙区即刻种植修复软组织改变的临床研究

目的：观察即刻种植修复在上颌前牙区牙龈组织萎缩高度及患者自主满意程度,探讨提高前牙美容效果的临床技巧。方法：15例前牙缺失患者在不翻瓣拔牙的条件下同期植入ITI种植体18枚,48小时内完成上部临时固定修复,种植体植入后3个月进行永久修复。测量术后1月,3月,6月,12月牙龈萎缩高度及永久修复后患者主观满意程度。结果：18枚种植体均形成良好的骨结合,无炎症发生。1月后牙龈平均萎缩高度为(0.31±0.28）mm,3月为(0.60±0.44)mm,6月为(0.28±0.32)mm,12月为(0.32±0.60)mm。患者主观满意程度达8.8分。结论：三维位置正确的种植体可获得良好的美学效果和长期稳定性,在严格把握适应症的前提下,上前牙即刻种植修复可获得理想的临床效果。     

BLB种植系统在前牙修复中的美学评价

目的：探讨BLB种植系统在前牙缺失修复中的美学效果。方法：对86例前牙缺失的病人共植入BLB种植体169枚,术后4个月修复,并分别于修复后0,6,12个月由患者与随访医生对修复体的外形、颜色、牙龈形态、色泽、丰满度、龈缘曲线、牙间乳头高度、修复体与邻牙的协调性八个方面进行评价。结果：86例患者,修复后0,6,12个月满意度分别为92．6％、94．9％和95％。结论：BLB种植系统操作简单,基台可调磨,应用于前牙区修复可以获得较好的美学效果。     

BLB种植系统在前牙修复中的美学评价

目的:探讨BLB种植系统在前牙缺失修复中的美学效果.方法:对86例前牙缺失的病人共植入BLB种植体169枚.术后4个月修复,并分别于修复后0,6,12个月由患者与随访医生对修复体的外形、颜色、牙龈形态、色泽、丰满度、龈缘曲线、牙间乳头高度、修复体与邻牙的协调性八个方面进行评价.结果:86例患者,修复后0,6,12个月满意度分别为92.6%、94.9%和95%.结论:BLB种植系统操作简单,基台可调磨,应用于前牙区修复可以获得较好的美学效果.     

上颌前牙即刻种植即刻修复的临床应用研究

目的:评估上颌前牙区即刻种植即刻修复的临床应用效果,特别是美学效果,并探讨其临床应用技巧及美学影响因素。方法:选择16例共18颗无法保存的上前牙,微创拔除后即刻植入Xi ve或Repl ace种植体共18枚,均于48小时内完成临时固定修复,4～6个月后完成最终修复。种植永久修复后追踪观察12～36个月,观察种植体周围软硬组织情况,统计种植义齿存留率、牙龈乳头充盈指数以及修复体与相邻天然牙唇侧牙龈的协调性、患者主观满意度。结果:在观察期内18枚种植体均获得了良好的骨结合,种植体无松动,种植体周围未见病理性骨吸收,存留率为100%;18枚种植修复体周围共34个牙龈乳头充盈指数均为2到3度,其中24个(70.6%)为3度;15枚种植修复体唇侧龈缘位置与相邻天然牙协调无差异,3枚轻度差异;16枚种植修复体与相邻天然牙牙龈颜色质地协调无差异,2枚轻度差异。患者主观满意度VAS值平均达91.5。结论:在严格掌握适应证的前提下,应用正确的手术技巧对无法保存的上前牙进行微创拔除后即刻种植即刻修复能获得理想的临床效果,特别是美学效果。     

前牙种植即刻修复技术的临床应用

目的：探讨前牙种植即刻修复的临床可行性并观察其近期效果方法：从2004年8月至2005年6月共为17位患者行23枚种植体植入后即刻修复。均于1周内在种植体上部完成烤瓷冠修复。所有患者均于术后1、3、6月复查．结果：本组17例患者23枚种植体即刻修复，所有患者均对即刻修复效果满意。16例22枚种植体经2-10个月观察．稳定性良好，未发生种植体脱落．牙龈色泽正常．X线片显示骨组织无异常吸收。一例患者种植体即刻稳定性好，3个月后因外伤至种植体拆除。结论：严格掌握适应证和特殊设计的种植系统，应用改良的种植外科和修复技术对一些前牙缺失患者行种植即刻修复近期开效满意．     

上颌单颗前牙不翻瓣即刻种植修复的临床效果观察

目的 评价即刻种植即刻修复联合不翻瓣技术在上颌单颗前牙位点的临床应用效果,并探讨其技术要点.方法 选择上颌单颗中切牙无法保留的患者17例,采用不翻瓣技术,拔除患牙后即刻植入种植体,并即刻行种植体支持临时冠修复,术后2个月复诊调整临时冠外形,术后3个月行最终修复.最终修复后1、3、6、12、24个月复诊.最终修复即刻、1...     

后牙区螺丝固位与黏结固位种植义齿修复效果的比较研究

目的探讨后牙区螺丝同位与黏结固位种植固定义齿临床修复效果的差异。方法选择上下颌后牙区牙列缺损患者42例共70枚种植体．其中24枚采用螺丝固位修复体．46枚采用黏结周位修复体。分别于修复后1年复诊．检测种植体周围边缘骨吸收量、改良菌斑指数（mPLI）、改良出血指数（mSBI）等临床指标以及患者对种植义齿的美观满意度。结果螺丝固位组及黏结固位组平均种植体周围边缘骨吸收量分别为0．78mm和0．68mm：螺丝组与黏结组mPLI平均水P50均为1，mSBI平均水平P50亦均为1：两组美观满意度平均得分P50为1。统计结果显示螺丝固位组与黏结固位组间种植体周围边缘骨吸收量、mPLI、mSBI以及患者满意度的差异均无统计学意义（P〉0．05）。结论后牙区螺丝固位与黏结固位种植义齿短期临床修复效果差异无统计学意义。     

Strain of implants depending on occlusion types in mandibular implant-supported fixed prostheses

PURPOSE

This study investigated the strain of implants using a chewing simulator with strain gauges in mandibular implant-supported fixed prostheses under various dynamic loads.

MATERIALS AND METHODS

Three implant-supported 5-unit fixed prostheses were fabricated with three different occlusion types (Group I: Canine protected occlusion, Group II: Unilaterally balanced occlusion, Group III: Bilaterally balanced occlusion). Two strain gauges were attached to each implant abutment. The programmed dynamic loads (0 - 300 N) were applied using a chewing simulator (MTS 858 Mini Bionix II systems, MTS systems corp., Minn, USA) and the strains were monitored. The statistical analyses were performed using the paired t-test and the ANOVA.

RESULTS

The mean strain values (MSV) for the working sides were 151.83 µε, 176.23 µε, and 131.07 µε for Group I, Group II, and Group III, respectively. There was a significant difference between Group II and Group III (P < .05). Also, the MSV for non-working side were 58.29 µε, 72.64 µε, and 98.93 µε for Group I, Group II, and Group III, respectively. One was significantly different from the others with a 95% confidence interval (P < .05).

CONCLUSION

The MSV for the working side of Groups I and II were significantly different from that for the non-working side (Group I: t = 7.58, Group II: t = 6.25). The MSV for the working side of Group II showed significantly larger than that of Group III (P < .01). Lastly, the MSV for the non-working side of Group III showed significantly larger than those of Group I or Group II (P < .01).     

Complication rates for various retention types in anterior implant-supported prostheses: A retrospective clinical study

Statement of problemImplant-supported prostheses have typically been retained by cement or screws, each of which has advantages and disadvantages. Two new types of prosthesis with complementary advantages and disadvantages have been proposed: the screw- and cement-retained prosthesis, which combines cement and screw retention, and the antiloosening inner-post screw (ALIPS) type, which uses lateral screws. Both esthetic and functional factors should be considered for anterior prostheses; however, clinical studies of the complication rates of these designs are lacking.PurposeThe purpose of this retrospective clinical study was to evaluate the complications of dental implant-supported restorations with various prosthetic types in the anterior region and to analyze other factors that affect complications.Material and methodsThis study included 51 patients who had 83 implants placed in the anterior region by a single clinician between August 2009 and December 2016. Surgical and prosthetic features were recorded, and implant complications were analyzed.ResultsThere were 45 (55.4%) cement-retained implants, 5 (6.0%) screw- and cement-retained prosthesis implants, and 32 (38.6%) ALIPS-retained implants. Peri-implant mucositis was observed most frequently in the ALIPS type (21.9%), but the biological complications did not differ significantly with the prosthetic type. The most common mechanical complication was loss of retention in the cement type of prosthesis (30.4%) and screw loosening in the ALIPS type (43.8%). Implant complications varied with position (maxilla or mandible) and implantation timing (period from tooth extraction to implant placement).ConclusionsThe complications of implants placed in the anterior region were affected by different factors but did not differ significantly with the type of the retention.     

A clinical evaluation of 76 implant-supported superstructures in the composite grafted maxilla

The aim of the study was to evaluate the material behaviour and nature of implant-supported superstructures in function. A total of 37 overdentures, 26 fixed partial and 13 fixed full dentures with a mean lifetime of 40 months were clinically evaluated in relation to damage, occlusion and articulation, parafunction, retentive devices, hygiene and speech problems. In general 70% of all superstructures were damaged. Fixed partial dentures were significantly less damaged than overdentures and fixed full dentures (P<0.001). A significant high percentage of newly gained parafunction was found (P<0.05).     

上颌前牙区根盾术即刻种植与常规即刻种植的临床效果评价

目的 比较上颌前牙美学区根盾术即刻种植与常规即刻种植唇侧骨量的厚度变化及临床效果,探讨根盾术的临床操作要点。方法 收集2017年9月—2019年3月行上颌前牙美学区即刻种植患者48例,随访18~36个月,其中26例为常规即刻种植组（RI组）,22例为保留唇侧牙根片的根盾术即刻种植组（SS组）,比较2组患者种植体成功率,距种植体肩台0 mm（I0）、3 mm（I3）、6 mm（I6）的唇侧骨量厚度变化,术后18个月时粉色美学指数（PES）、改良龈沟出血指数（mSBI）以及临床满意度。采用SPSS 25.0软件包对数据进行统计学分析。结果 2组种植体成功率均为100%。术后6个月及18个月,SS组唇侧骨量厚度变化量低于RI组,在I0、I3处有统计学差异（P小小小0.05）; SS组PES评分高于RI组,但无统计学差异;改良龈沟出血指数无统计学差异,2组均获得较高的患者满意度。结论 相对于常规即刻种植,根盾术即刻种植在短时间内可以较好地维持种植体颈部唇侧骨量及软组织轮廓,对成功率无明显影响,建议将牙根片制备至平齐骨面,厚度约1 mm,种植体唇侧保留约1~2 mm“跳跃间隙”,植入低替代率骨移植材料,但临床操作要求较高。     

种植覆盖义齿临床疗效的回顾性研究

目的:回顾性分析评价无牙颌患者采用种植覆盖义齿修复后的临床疗效.方法:对行种植覆盖义齿修复的57 名无牙颌患者进行临床复诊,检查种植体周围菌斑指数、探诊深度、探诊出血、牙龈增生、种植体边缘骨吸收以及义齿修复后并发症的发生情况;采用VAS视觉模拟评分方法测量患者对种植覆盖义齿修复的满意度,并对相关影响因素进行分析,综合评价种植覆盖义齿的临床疗效.结果:经过(48±11.3) 个月的随访观察,4 枚种植体在愈合期内失败,存留率为98.1%;种植体的边缘骨吸收为(1.38±0.74) mm,不同类型附着体(杆卡、球帽、磁性)修复后种植体边缘骨吸收差异无统计学意义(P>0.05);杆卡组的菌斑指数、探针深度均高于磁性和球帽组(P<0.05);探针出血无明显差异(P>0.05);牙龈增生多见于杆卡组.并发症主要包括:上部基台折裂、义齿折裂、螺丝松动等等.患者对种植覆盖义齿的总体满意度较高,仅在"清洁方便程度"一项,磁性和球帽组患者的满意度高于杆卡组(P<0.05),其他各项均无明显差异(P>0.05).结论:种植覆盖义齿有较高的种植体存留率及患者满意度,但修复后需对义齿及种植体进行定期清理维护以减少后期并发症的发生,尤其是杆卡式种植覆盖义齿.     

Cortical and cancellous bone thickness on the anterior region of alveolar bone in Korean: a study of dentate human cadavers

PURPOSE

The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible.

MATERIALS AND METHODS

Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level.

RESULTS

The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root.

CONCLUSION

For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.     

磨牙缺失颌间距离不足种植体支持的螺丝固位一体冠修复临床分析

目的:观察磨牙缺失颌间距离不足种植体支持的螺丝固位一体冠修复体的临床效果.方法:选取376例磨牙缺失、颌间距离不足,不能满足常规种植修复5～7 mm的修复空间的患者,共计507颗种植体,采用常规种植一期手术,并运用种植体支持的螺丝固位一体冠修复.随访6个月～2 a,记录螺丝固位的一体冠修复体的临床效果,采用SPSS17.0软件包对数据进行方差分析和x2检验.结果:经过6个月～2 a的随访观察,种植体存留率为99.61％,37例患者发生崩瓷,主要发生在3～4 mm组.在各组别中,烤瓷修复比金属(牙合)面烤瓷更容易发生崩瓷(P＜0.05);颌间距离越小,越容易发生崩瓷(P＜0.05).13件修复体发生螺丝松动,13例患者出现牙龈红肿,探诊出血.经牙周治疗及口腔卫生宣教后恢复良好.患者满意度较高.结论:种植体支持的螺丝固位一体冠修复设计可以解决磨牙区颌间距离不足的缺牙患者的修复难题,治疗效果良好.     

Importance of a distal proximal contact on load transfer by implant-supported single adjacent crowns in posterior region of the mandible: a photoelastic study

Objective

This study aimed to evaluate the importance of a distal proximal contact on the load transfer to the posterior region of the mandible by non-splinted adjacent implant-supported crowns using photoelastic stress analysis.

Material and Methods

A rectangular model (68x30x15 mm) was made of polymethylmethacrylate resin to simulate half of the mandibular arch. One model was completed with resin replicas representing the first premolar and second molar and with two 3.75 mm dia.x11 mm internal hexagon threaded implants replacing the second premolar and first molar. The other model was manufactured in the same way but without the second molar. Both models were duplicated using photoelastic resin. The roots of the teeth replicas were covered with a layer of polyether impression material to simulate the periodontal ligament. Two different vertical loads were applied to the crowns as follows: 1 - single static point load alternately applied to the crowns replacing the second premolar and first molar (50 N); 2 - simultaneous static point loads applied to both of the crowns replacing the second premolar and first molar (100 N). The resulting isochromatic fringe pattern in the photoelastic model was monitored and photographed.

Results

All loading conditions studied showed that the presence of the second molar has changed the load transmission and the pattern of stresses.

Conclusion

Results showed that the presence of a second molar proximal contact can help minimize the stresses around the implants.