口腔正畸联合骨水平种植体修复治疗牙列缺损的临床效果

目的 探讨口腔正畸联合骨水平种植体修复治疗牙列缺损的效果。方法 选取2020年10月-2023年 4月泰安市第四人民医院收治的牙列缺损患者80例,以随机数字表法分成对照组（n =40）和研究组 （n =40）。对照组采用骨水平种植体修复治疗,研究组采用口腔正畸联合骨水平种植体修复治疗,比 较两组种植成功率、牙周指标[龈沟出血指数（SBI）、探诊深度（PD）、菌斑指数（PLI）]、牙齿 功能、咀嚼功能、并发症发生情况。结果 研究组种植6个月后种植成功率为100.00%,高于对照组 的82.50%（P ＜0.05）;研究组种植后SBI、PD、PLI均低于对照组（P ＜0.05）;研究组种植后语言功能、 固定功能评分均高于对照组（P ＜0.05）;研究组种植后最大力咬合时颞肌表面肌电活动、双侧咬肌肌电 活动均高于对照组（P ＜0.05）;研究组并发症发生率为5.00%,与对照组的12.50%比较,差异无统计学 意义（P ＞0.05）。结论 采用口腔正畸联合骨水平种植体修复治疗能够提高牙列缺损患者种植成功率,改 善牙周指标,提高牙齿和咀嚼功能,安全性较高。     

种植牙修复联合骨肽注射液对粉碎性牙槽骨骨折患者种植体骨吸收量的影响

目的 探讨种植牙修复联合骨肽注射液对粉碎性牙槽骨骨折患者种植体骨吸收量的影响.方法 回顾性分析2017-12—2020-12于睢县中医院接受治疗的80例粉碎性牙槽骨骨折患者的临床资料.根据治疗方法分为种植牙修复联合骨肽注射液组(观察组)和单纯种植牙修复组(对照组),各40例.比较2组患者的基线资料.记录治疗后2个月和6...     

两种不同材料种植体修复牙列缺损的力学性能及美学效果观察

目的：观察钛合金种植体与纯钛种植体修复牙列缺损的力学性能及美学效果。方法：回顾性分析2020年1月-2022年9月笔者医院收治的160例牙列缺损患者的临床资料,按种植体不同修复方式分为观察组79例（108颗牙,采用钛合金种植体）和对照组81例（112颗牙,采用纯钛种植体）。比较两组的种植有效率、咀嚼效率、牙齿总咬合力、牙周健康指数、并发症发生率及美学评分差异。结果：两组种植总有效率比较,差异无统计学意义（P>0.05）,但观察组显效率显著高于对照组（P<0.05）;两组咀嚼效率治疗后均显著升高,且观察组咀嚼效率显著高于对照组（P<0.05）;两组牙齿总咬合力随时间延长逐渐升高,且观察组各时间段内总咬合力显著高于对照组（P<0.05）;两组菌斑指数、牙龈指数及龈沟出血指数均较术前降低,且观察组显著低于对照组（P<0.05）;观察组种植体周围炎发生率显著低于对照组（P<0.05）;观察组红白美学指数评分显著高于对照组（P<0.05）。结论：相比于纯钛种植体,钛合金种植体用于修复牙列缺损患者具有更强力学性能,可改善患者咀嚼和咬合能力,降低种植体周围炎...     

口腔种植体周围炎龈下菌群分布及危险因素分析

目的 分析口腔种植体周围炎龈下菌群分布及危险因素。 方法 选取2021年5月-2022年5月于我院行口腔种植术的100例患者,跟踪随访1年内发生种植体周围炎者28例（炎症组）,其余未发生种植体周围炎者72例（非炎症组）,检测龈下微生物,同时对引发种植体周围炎的影响因素进行单因素、二元Logistic回归分析。 结果 经测定,炎症组28例（34颗种植体）共检出细菌45株,前3位分别为厌氧菌（66.67%）、口腔链球菌（46.67%）、需氧菌（24.44%）。经二元Logistic回归分析可知,有糖尿病、饮酒、吸烟、慢性牙周炎病史,种植体周围牙槽骨不良为种植体周围细菌感染的独立危险因素（OR＞1, P＜0.05）;粘结剂残留、口腔卫生习惯属于种植体周围细菌感染的保护因素（OR＜1, P＜0.05）。 结论 口腔种植体周围炎龈下菌群以厌氧菌、口腔链球菌为主,且影响因素多为客观原因,于口腔种植术后对患者进行有效的健康指导,利于降低种植体炎发生率。     

帐篷技术在牙槽骨垂直骨增量中的应用

在牙槽骨骨增量手术中,垂直骨增量往往具有挑战性。其难点在于受植区的周围缺少骨壁支撑,难以保持血凝块和骨替代物的稳定性,从而影响了垂直骨增量效果。近年来,帐篷技术的提出及在实践中的不断完善,逐渐发展出三类理念相同却各有特点的具体术式,以应对大部分需要垂直骨增量的情况。本文将对帐篷技术的具体内容和该技术在垂直骨增量中的应用进展作一综述。     

牵张成骨术修复火器伤性颌面部缺损的研究进展

颌面部属暴露部位,平战时遭受火器伤机会较多,枪弹等高速投射物击中质地硬而脆的颌面骨后,易于使之破碎,往往遗留骨性缺损,同时还会伴有软组织及牙列缺损,患者面容及咀嚼、发音等生理功能受损,如不作修复,会遗留严重面部畸形和功能、心理障碍,严重影响患者的身心健康和生存质量。牵张成骨术修复颌面部火器伤具有创伤小,效果可靠等优点,近年来受到关注。现将颌面部火器伤及牵张成骨术修复火器伤性颌面部缺损的研究进展综述如下。     

骨引导再生术在牙槽骨缺损牙种植中的临床应用效果

目的 探讨骨引导再生术在牙槽骨缺损牙种植中的临床应用效果。方法 选取2019年1月至2022年1月医院收治的行牙槽骨缺损牙种植的患者62例作为研究对象,依据随机数字表法将患者分为观察组（n=31）与对照组（n=31）。对照组患者给予单纯植骨术治疗,观察组给予引导再生术治疗,对两组患者术前、术后6个月牙槽骨密度、骨缺损高度,术区牙周探诊深度（PD）、附着丧失（CAL）、龈退缩（GR）进行统计比较,对两组种植效果、并发症情况进行统计比较。结果 术前,观察组与对照组牙槽骨密度（656.47±93.67）HU、（655.23±92.47）HU,骨缺损高度（4.01±1.23）mm、（4.03±1.13）mm,植骨厚度（1.54±0.35）mm、（1.58±0.34）mm,成骨厚度（1.55±0.13）mm、（1.56±0.12）mm比较差异均无显著性（P>0.05）,术后6个月,观察组患者牙槽骨密度（713.23±68.63）HU,植骨厚度（2.75±0.38）mm,成骨厚度（3.29±0.33）mm均较对照组显著提高,骨缺损高度显著降低（P<0.05）;术前,两组PD(5.61±...     

个性化钛网联合引导骨再生术修复牙槽骨缺损的作用及美学效果观察

目的:探讨基于锥形束CT三维重建的个性化钛网联合引导骨再生技术(GBR)修复牙槽骨缺损的效果及对种植美学指标的影响.方法:选取笔者医院拟接受钛网联合GBR进行修复牙槽骨缺损的86例患者为研究对象,随机分为两组.三维组:43例,接受基于锥形束CT三维重建的个性化钛网联合GBR进行牙槽骨修复;传统组:43例,患者采用传统钛...     

牙槽骨扩展增加骨量后的植牙术

目的观察运用致密羟基磷灰石(HA)微粒,在颌骨萎缩患者牙槽嵴上行牙槽骨扩展术后行人工种植牙的临床效果。方法使用HA颗粒采用牙槽骨扩展术和粘骨膜下隧道法,对26例颌骨萎缩患者增加牙槽骨骨量后行人工种植牙。结果牙槽骨扩展术后置入HA颗粒不移位不弥散,与基骨牢固相接,人工种植牙时间为术后3.2个月,26例全部成功;粘骨膜下隧道术6例置入HA颗粒都有不同程度移位、弥散,与基骨大多为纤维性包裹及部分新骨长入,人工种植牙时间为术后4.8个月,1例失败。结论运用牙槽骨扩展术大大地扩大了人工种植牙的适应证、缩短疗程和提高成功率。     

Comparative study of axial and femoral bone mineral density and parameters of mandibular bone quality in patients receiving dental implants

Introduction In view of the increase in the life expectancy of humans and in edentulism of the population above 50 years of age, in which the prevalence of osteoporosis is also higher, it is fundamental to better understand the effects of systemic bone mass loss on the healing process of dental implants and to determine the quality of the bone that surrounds them. The objective of the present study was to compare systemic osteoporosis (axial and femoral) and parameters of mandibular bone quality, and to evaluate osseointegration in postmenopausal women receiving dental implants. Methods The sample consisted of 39 women aged 48–70 years, 19 with a densitometric diagnosis of osteoporosis in the lumbar spine and femoral neck and 20 controls with a normal densitometric diagnosis. Bone mineral density was measured in the patients and controls by dual-energy X-ray absorptiometry. Eighty-two osseointegrated dental implants were placed in the mandible, 39 of them in the osteoporosis group and 43 in the control group. Mandibular bone quality was evaluated by classifying mandibular inferior cortical and trabecular bone on panoramic radiographs and by histomorphometric analysis of a mandibular bone biopsy. Osseointegration was analyzed after 9 months. Results No significant difference was observed between patients with osteoporosis and controls when comparing individuals with a normal cortex and those with a severely or moderately eroded cortex determined on panoramic radiographs. Histomorphometric analysis also revealed no difference in the parameters of bone formation or resorption between the two groups. Implant failure was observed in only one case. Conclusion We conclude that there is no association between systemic osteoporosis (axial and femur) and parameters of poor mandibular bone quality. The loss of one implant (1.2%) is compatible with the literature and cannot be attributed to systemic osteoporosis. An erratum to this article can be found at     

Comparative study of axial and femoral bone mineral density and parameters of mandibular bone quality in patients receiving dental implants

INTRODUCTION: In view of the increase in the life expectancy of humans and in edentulism of the population above 50 years of age, in which the prevalence of osteoporosis is also higher, it is fundamental to better understand the effects of systemic bone mass loss on the healing process of dental implants and to determine the quality of the bone that surrounds them. The objective of the present study was to compare systemic osteoporosis (axial and femoral) and parameters of mandibular bone quality, and to evaluate osseointegration in postmenopausal women receiving dental implants. METHODS: The sample consisted of 39 women aged 48-70 years, 19 with a densitometric diagnosis of osteoporosis in the lumbar spine and femoral neck and 20 controls with a normal densitometric diagnosis. Bone mineral density was measured in the patients and controls by dual-energy X-ray absorptiometry. Eighty-two osseointegrated dental implants were placed in the mandible, 39 of them in the osteoporosis group and 43 in the control group. Mandibular bone quality was evaluated by classifying mandibular inferior cortical and trabecular bone on panoramic radiographs and by histomorphometric analysis of a mandibular bone biopsy. Osseointegration was analyzed after 9 months. RESULTS: No significant difference was observed between patients with osteoporosis and controls when comparing individuals with a normal cortex and those with a severely or moderately eroded cortex determined on panoramic radiographs, although patients with MEC/SEC had lower femoral neck BMD than those with NC (0.688 +/- 0.17 vs. 0.814+/- 0.144 g/cm2, P<0.012). Histomorphometric analysis also revealed no difference in the parameters of bone formation or resorption between the two groups. Implant failure was observed in only one case. CONCLUSION: We conclude that there is an association between low femoral neck BMD and poor mandibular bone quality as assessed by panoramic radiography. The loss of one implant (1.2%) is compatible with the literature and cannot be attributed to systemic osteoporosis.     

组织工程骨修复牙槽嵴裂的实验研究

目的探讨骨髓来源的种子细胞复合胶原蛋白海绵构建组织工程骨修复牙槽嵴裂的可行性。方法12条实验犬被分成4组。于双侧上颌第3切牙处去除长15mm牙槽骨形成牙槽嵴裂动物模型;经股骨骨髓穿刺,分离骨髓基质干细胞,培养、传代扩增诱导后,与蛋白胶原海绵混合培养48h,植入骨缺损处。饲养12周后处死动物,通过三维CT及组织学检查评价骨缺损修复的效果。结果实验组牙槽骨断端间形成完整的骨连接,切片可见髓腔通畅,新形成的牙槽嵴宽度与松质骨组相似(P>0.05),但高度不足(P<0.05)。结论组织工程骨可以较好地修复牙槽嵴裂,有望成为修复牙槽嵴裂的治疗方法。     

种植牙对200例牙列缺损患者的修复美容效果观察

目的 探究口腔种植修复治疗牙列缺损的应用效果。方法 选取2022年10月-2023年10月本院收 治的200例牙列缺损患者作为研究对象,依据抽签法将其分为对照组与观察组,各100例。对照组进 行常规修复治疗,观察组进行口腔种植修复治疗,比较两组临床疗效、口腔相关指标、并发症发生情 况。结果 观察组治疗总有效率为98.00%,高于对照组的83.00%（P ＜0.05）;观察组治疗后语言能力、 咀嚼能力、舒适度、美观度、固位功能评分均优于对照组（P ＜0.05）;观察组并发症发生率低于对照组 （P ＜0.05）。结论 口腔种植修复技术和传统的修复方法相比较,不仅能够有效弥补牙齿缺失,提高修 复效果,还可以改善患者的语言能力、咀嚼能力、舒适度、美观度、固位功能,减少并发症发生率,值 得应用。     

多种抗骨质疏松症药物对牙种植体的影响及研究

在种植体和骨组织之间建立和保持骨整合界面是确保种植义齿长期稳定地存留于颌骨中发挥支持固位功能的关键。骨质疏松症对牙种植体的骨整合有很大的影响。本文就骨质疏松症状态下的种植手术及药物干预等几个方面对种植牙骨结合的影响的研究进展进行探讨。     

Impact of osteoporosis in dental implants: A systematic review

AIM: To assess the failure and bone-to-implant contact rate of dental implants placed on osteoporotic subjects.METHODS: Extensive examination strategies were created to classify studies for this systematic review. MEDLINE (via PubMed) and EMBASE database were examined for studies in English up to and including May 2014. The examination presented a combination of the MeSH words described as follow: “osteoporosis” or “osteopenia” or “estrogen deficiency” AND “implant” or “dental implant” or “osseointegration”. Assessment of clinical and/or histological peri-implant conditions in osteoporosis subjects treated with titanium dental implants. The examination included a combination of the MeSH terms described as follow: “osteoporosis” or “osteopenia” or “estrogen deficiency” AND “implant” or “dental implant” or “osseointegration”.RESULTS: Of 943 potentially eligible articles, 12 were included in the study. A total of 133 subjects with osteoporosis, 73 subjects diagnosed with osteopenia and 708 healthy subjects were assessed in this systematic review. In these subjects were installed 367, 205, 2981 dental implants in osteoporotic, osteopenic and healthy subjects, respectively. The failure rate of dental implant was 10.9% in osteoporotic subjects, 8.29% in osteopenic and 11.43% in healthy ones. Bone-to-implant contact obtained from retrieved implants ranged between 49.96% to 47.84%, for osteoporosis and non-osteoporotic subjects.CONCLUSION: Osteoporotic subjects presented higher rates of implant loss, however, there is a lower evidence to strengthen or refute the hypothesis that osteoporosis may have detrimental effects on bone healing. Consequently, final conclusions regarding the effect of osteoporosis in dental implant therapy cannot be made at this time. There are no randomized clinical trial accessible for evaluation and the retrospective nature of the evaluated studies shall be taken in account when interpreting this study.     

种植牙修复牙列缺损30例临床效果观察

目的：观察ITI Straumann等常用牙种植系统在常见牙列缺损修复中的I临床效果。方法：牙列缺损患者30例,植入ITI Straumann等常用牙种植体60枚,其中3例行上颌窦内提升术。2～6个月后行上部结构修复,定期随访,检查种植体骨结合状况、种植体周围软组织与修复体情况。结果：本组病例经修复后1～3年的l临床观察,种植成功率100％,仅一例患者上部修复体在修复后1年出现基台松动,其余患者各项评价指标良好。结论：牙种植技术在常见牙列缺损修复方面具有美观舒适、不损伤余留牙、咀嚼效果好等优点,是一种良好的修复方法。     

Effect of zoledronate acid treatment on osseointegration and fixation of implants in autologous iliac bone grafts in ovariectomized rabbits

One main problem associated with alveolar bone augmentation in implant dentistry is resorption of grafted bone, which may be further compromised by systemic skeletal disorders such as osteoporosis. Zoledronate acid (ZOL) is the most potent bisphosphonate to treat osteoporosis and therefore it is hypothesized to be able to invert the negative effect of osteoporosis on osseointegration and fixation of dental implants in autologous bone grafts. In this study, 56 rabbits received bilateral ovariectomy (OVX) (40 rabbits) or sham operation (16 rabbits). Three months later, 8 animals from each group were sacrificed for bone mineral density (BMD) examination. Then the remaining animals underwent bilateral autologous iliac bone grafting with simultaneous implantation of titanium implants in tibiae and were divided into 5 groups (n = 8): Sham, OVX, Loc-ZOL (local treatment), Sys-ZOL (systemic treatment) and Loc + Sys-ZOL (local plus systemic) group. At 3 months after implantation, all animals were sacrificed and specimens were harvested for examinations. Both BMD and histological examinations of femurs showed osteoporotic changes after ovariectomy, while systemic treatment with ZOL restored mineralized bone. Micro-CT examination demonstrated that OVX group showed significant decrease of mineralized bone and implant-bone contact when compared with sham control, whereas both systemic and local treatments of ZOL significantly increased mineralized bone and implant-bone contact in ovariectomized animals. However, the best effects were observed in Loc + Sys-ZOL group (combined use of ZOL) and most of bone indices were similar to (IBCR, p > 0.05) or higher than (BV/TV, Conn.D and Tb.N) (p < 0.01) those of the sham group, except Tb.Th, which was still significantly lower (p < 0.01), and Tb.Sp, which was further decreased (p < 0.01). The aforementioned effects were also confirmed by histomorphometric analysis of bone indices on implant-bone contact and mineralized bone. In addition, biomechanical testing further supported the beneficial effect of ZOL treatment and maximal removal torque of titanium implants was observed in Loc + Sys-ZOL group. In conclusion, our study suggests that both systemic and local treatments with ZOL can invert negative effect of osteoporosis and promote osseointegration and fixation of dental implants in autologous bone grafts under osteoporotic condition. Combined systemic and local use of ZOL exerts best effects when compared to their single use.