XIVE种植系统在上颌前牙缺失修复中的疗效观察

目的:评价Xive种植体在上颌前牙缺失美学修复的临床效果。方法:临床选择30例上颌前牙缺失的患者,从美观效果进行考虑选取恰当的外科手术和修复方法,共植入Xive种植体48枚,种植后嘱患者按期复查,评价应用效果。结果:种植牙修复后咀嚼功能恢复良好,种植体周围软组织健康美观。修复体单冠和修复基台的接缝位于龈下,种植牙给人以从龈下长出来的视觉效果。28名患者对修复体及其临床应用效果和美观效果都评价为满意,1枚种植体发生周围炎,1颗烤瓷冠崩瓷。满意度为93.33%。结论:Xive种植体修复上颌前牙缺失能够获得满意的临床效果。但要注意种植中软、硬组织和修复体的美学处理。     

前牙种植修复体美观效果的影响因素和评价方法

牙科种植体己广泛应用于临床,其留存率和成功率越来越高,很多患者开始选择种植体支持式义齿来修复口内缺失牙.随着人们对美的追求不断上升,前牙区种植修复体的美观问题也日益受到患者和口腔医生的关注.但是,有哪些因素能够影响到前牙区种植修复体的美观效果,以及如何对已完成的种植体进行比较全面的美学评价,目前学术界尚未达成共识.为此,本文就影响前牙区种植修复体美观效果的相关因素和一些正在临床使用的评价方法进行综述.     

用Replace种植修复体修复上颌前牙缺失

目的：本文报告单独用Replace种植体、或联合邻牙支持和固位的、用粘固剂固定的金属陶瓷单冠修复上颌前牙缺失患者的基本情况、临床修复程序,评价了种植修复体的临床应用效果.方法：用Replace种植体支持的种植单冠为25例患者缺失的31颗上颌前牙进行了修复治疗.22位患者（26枚种植牙）按期复查,其中,10位患者在种植体植入的同期接受了自体组织移植或人工骨植入手术.根据对种植体周围软组织健康情况、附丽高度、外形和色泽的临床观察,结合医、患双方对种植修复体的美观效果、功能状况满意度评价来确定修复效果.结果：种植牙修复后咀嚼功能恢复良好,面容和语音功能有显著改观,种植体周围软组织健康.种植单冠和修复基台的接缝位于龈下,种植牙给人以从龈下长出来的视觉效果,美观.20例按期复查的患者和修复医生对修复体、及其临床应用效果都评价为满意.2例患者对3个种植牙评价为可接受.结论：用Replace种植体支持的、暂时性粘固剂固定的种植上颌前牙能够获得医、患双方都满意或可接受的临床应用效果.     

即刻种植修复上前牙的临床美学疗效观察

目的:评价上颌前牙即刻种植即刻修复的临床关学效果.方法:临床选择26例上前牙残根患者,在拔牙后即刻植入 Xive种植体26枚,同时接入基台行复合树脂临时冠/桥修复,6个月后,行永久性修复.种植后嘱患者按期复查,评价应用效果.结果:种植牙修复后咀嚼功能恢复良好,种植体周围软组织健康美观.修复体单冠和修复基台的接缝位于龈下.种植牙给人以从龈下长出来的视觉效果.24名患者对修复体及其临床应用效果和美观效果都评价为满意,1枚种植体发生周围炎,1颗烤瓷冠崩瓷.满意度为92.31%.结论:Xive种植体在上颌前牙缺失即刻种植即刻修复中能够获得满意的临床效果.但要注意种植中软、硬组织和修复体的美学处理.     

即刻种植修复上前牙的临床美学疗效观察

目的：评价上颌前牙即刻种植即刻修复的临床美学效果。方法：临床选择26例上前牙残根患者,在拔牙后即刻植入Xive种植体26枚,同时接入基台行复合树脂临时冠/桥修复,6个月后,行永久性修复。种植后嘱患者按期复查,评价应用效果。结果：种植牙修复后咀嚼功能恢复良好,种植体周围软组织健康美观。修复体单冠和修复基台的接缝位于龈下,种植牙给人以从龈下长出来的视觉效果。24名患者对修复体及其临床应用效果和美观效果都评价为满意,1枚种植体发生周围炎,1颗烤瓷冠崩瓷。满意度为92.31%。结论：Xive种植体在上颌前牙缺失即刻种植即刻修复中能够获得满意的临床效果。但要注意种植中软、硬组织和修复体的美学处理。     

纤维增强树脂粘接桥修复老年缺失前牙的临床观察

目的:探讨纤维增强树脂粘接桥修复老年缺失前牙的临床效果。方法:选取48例前牙缺失的老年患者,行纤维增强树脂粘接桥修复缺失前牙,对义齿的固位、功能和使用情况进行30个月的随访临床观察。结果:1例修复体折裂,2例修复体脱粘接,其余45修复体均获得成功,患者咀嚼、容貌改善明显,达到预期对义齿功能和美观的要求。结论:纤维增强树脂粘接桥修复老年缺失前牙是一种大道至简的修复方案,适宜临床推广应用。     

上颌前牙区人工种植牙即刻修复的临床研究

目的 探讨即刻负重在上颌前牙区种植义齿修复中的临床应用.方法 43例前牙缺失患者植入55枚Frialit-2阶梯螺旋状种植体,手术当日即以聚丙烯酸树脂冠完成修复,消除正中、前伸和侧方(牙合)早接触点并以(牙合)夹板固定,术后6个月完成全瓷冠修复体.结果 植入上颌前牙区的55枚种植体直径分别为4.5 mm(28枚)、5.5 mm(27枚),长度为13 mm(30枚)和15 mm(25枚),种植体植入时的转矩介于32Ncm和45Ncm.植入后随访1～4年.种植体周围牙槽骨的吸收程度平均分别为0.35 mm和0.55 mm.植入后12个月未见种植体松动脱落,所有种植体均稳定地行使功能,除2例外,患者均获得满意的美观修复效果.结论 上颌前牙区种植体即刻负重修复可缩短种植修复疗程,及时恢复患者美观、发音等功能,有良好的临床应用前景.     

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.     

成年人个别前牙缺失伴反畸形的修复前正畸

目的探讨成年人个别前牙缺失伴前牙反(牙合)患者修复前正畸的相关问题和疗效.方法对11例成年人个别前牙缺失伴前牙反(牙合)的患者,采用方丝弓矫治技术进行修复前正畸治疗.结果11例成年人个别前牙缺失伴前牙反(牙合)的患者经修复前正畸治疗后,再进行牙列缺损修复治疗,获得了令患者更为满意的治疗效果和外貌.结论通过正畸和修复等这种多学科相结合的口腔综合治疗,可以有效地使修复体达到更加完善的口腔功能及美观的要求.     

种植牙-天然牙混合支持早期修复前牙缺失

目的 :评价种植牙 -天然牙混合式支持固定义齿早期修复前牙缺失的临床效果。方法 :5 7例前牙缺失患者 ,74个种植体种植手术后即刻进行临时冠配戴 ,1周内完成修复。结果 :随访 0 .5 -2年 ,临床成功率 96% ,修复体各项指标正常 ,牙槽嵴吸收 <1mm /第一年 ,GI为 0 -1。结论 :在无牙合创伤的条件下 ,人工种植牙 -天然牙混合支持早期修复前牙缺失能增加种植体初期稳定性 ,缩短修复周期 ,及时满足患者的美观要求     

Esthetic potential of single-implant provisional restorations: selection criteria of available alternatives

Provisional implant restorations are essential tools used to optimize the esthetic outcomes for single-tooth implant restorations. This article describes three groups of available alternatives and the specific options within each group including removable prostheses (interim removable partial denture, vacuum-formed appliance), tooth-supported prostheses (bonded extracted or denture teeth, cast metal or fiber-reinforced resin-bonded fixed partial denture [FPD], wire-retained resin-bonded FPD, acrylic resin provisional FPD), and implant-supported fixed prostheses (implant-retained provisional restoration). Advantages and disadvantages as well as fabrication guidelines for each option are provided. The author proposes that the restorative dentist consider eight criteria in selecting the most appropriate type of provisional prosthesis for a specific patient situation including the esthetic potential, patient comfort, treatment time, laboratory cost, occlusal clearance, ease of removal, durability, and ease of modification. The patient's esthetic expectations are critical in determining the most suitable type of provisional restoration. Esthetically pleasing provisional restorations are part of the evolving implant continuum, making implant dentistry more appealing to practicing dentists and potential patients. CLINICAL SIGNIFICANCE: Provisional restorations for single implants have evolved from temporary expedients during osseous and soft tissue integration to critical therapeutic tools used to assess patient expectations, communicate with the laboratory, and optimize definitive implant treatment. The selection of the type of provisional restoration may significantly influence esthetics during the period of implant integration and soft tissue healing. However, it is unlikely that there is a direct correlation between the type of provisional restoration used and the esthetic outcome of the definitive prosthesis.     

Immediate provisional restorations to aid in gingival healing and optimal contours for implant patients

A procedure for making an impression at stage I implant surgery is described, and the sequential laboratory procedures for fabricating a custom provisional restoration are presented. The provisional restoration is delivered at the uncovering of the implant, providing a template for the tissue healing with desired contours. This procedure facilitates the fabrication of implant restorations with optimal gingival contours and esthetics.     

Implant Digital Impression in the Esthetic Area

The aim of this report is to describe two standardized protocols for digital impression when implant support rehabilitation is used in the esthetic area. The two techniques were used to transfer all provisional crown parameters to definitive restorations in different clinical scenarios. In the direct technique, an impression (STL1) is made of the provisional restorations attached to the implants, with surrounding gingival tissue. The second scan (STL2) captures the sulcular aspect of the peri‐implant soft tissue immediately after removal of the provisional restoration. The last impression (STL3) of the complete arch is made with a standardized scanbody attached to the implant to capture the 3D location of the implant. The direct technique is indicated when the peri‐implant soft tissues are stable upon removal of the provisional restoration. The indirect technique is used when the gingival tissue collapses rapidly after the removal of the provisional crown. The impressions of the provisional restoration and the position of the implant are similar to those obtained with the direct technique, and the shape of the peri‐implant tissue is extrapolated from the negative shape obtained from making the digital impression when the provisional restoration is taken out of the mouth. Finally, in both techniques the 3 scans are superimposed to obtain a file, which contains the details of the peri‐implant soft tissue. The direct and indirect digital techniques allowed realization of a predictable definitive restoration in the esthetic zone in different clinical scenarios, reducing the duration of clinical procedures.     

Clinical performance of provisional screw‐retained metal‐free acrylic restorations in an immediate loading implant protocol: a 242 consecutive patients' report

Objective: To evaluate the clinical performance of provisional screw‐retained metal‐free acrylic restorations in an immediate loading implant protocol. Material and methods: Two hundred and forty‐two consecutive patients were selected retrospectively, who received 1011 implants and 311 immediate provisional screw‐retained implant restorations (2–4 h after implant surgery). The patients were monitored for a period of 2–3 months, until they were referred for a final restoration. The primary variables recorded include the survival time and the appearance of fractures in the provisional restoration, and the independent variables included age, sex, dental arch, type of restoration, type of attachment and components used, as well as cantilevers and opposing dentition. A survival analysis (Kaplan–Meier) and a Cox regression analysis were performed. Results: Twenty‐three restorations in 20 patients (8.26%, 95% CI 4.8–11.7) showed at least one fracture (7.39%). More than half of the new fractures (52%, 12 cases) occurred in the first 4 weeks. The cumulative survival probability observed was greater in mandible (P=0.05) and non‐cantilever restorations (P=0.001), and in those opposed by full restorations or natural teeth (P=0.001). With an opposing implant‐supported prosthesis, the risk of fracture was multiplied by 4.7, and the use of cantilevers as well as the location of the restoration in the maxilla multiply the risk by 3.4–3.5. Conclusions: Immediate provisional screw‐retained metal‐free implant‐supported restorations can be considered a reliable restoration (92.6% remain intact) for the healing period of 3 months. To cite this article:
Suarez‐Feito JM, Sicilia A, Angulo J, Banerji S, Cuesta I, Millar B. Clinical performance of provisional screw‐retained metal‐free acrylic restorations in an immediate loading implant protocol: a 242 consecutive patients' report.
Clin. Oral Impl. Res. 21 , 2010; 1360–1369.
doi: 10.1111/j.1600‐0501.2010.01956.x     

An accurate chairside technique for fabricating a temporary restoration for ITI single-tooth implant

Current implant restoration techniques depend upon a well-fitting, anatomic provisional restoration--especially at the restoration margin--to promote healthy soft tissue contours, which are necessary for successful final restorations. The ITI implant system presents a particular challenge in this regard because of the configuration of the implant head and shoulder, especially when these are placed subgingivally. A chairside method for obtaining an accurate marginal fit and customized contours in the single-tooth provisional restoration is described and illustrated.     

Selecting treatment options and sequencing treatment in the replacement of 2 maxillary central incisors with implants: a case report

This article describes treatment provided to replace 2 maxillary central incisors with implant-supported restorations. The site of a missing maxillary central incisor was treated utilizing a bone expansion technique to augment the labial hard and soft-tissue profiles at the time of implant placement. The adjacent central incisor tooth, although destined to be extracted, was retained to serve as an abutment for a fixed provisional restoration until the first implant was deemed to have successfully integrated. At the appointment to uncover this implant, the fractured tooth was extracted and an implant was immediately placed into the socket. The first implant was then used to support the provisional restoration during the healing phase of the second implant. The techniques utilized resulted in optimum soft-tissue contours, allowed the patient to have a comfortable and esthetic provisional restoration, and minimized the number of surgical procedures.     

Technique for fabricating a cement-retained single-unit implant-supported provisional restoration in the esthetic zone

The fabrication of provisional restorations is an important stage in implant treatment. In the esthetic zone, the potential for error without the use of provisional restorations in the selection of the abutments, framework design, appropriate vertical dimension of occlusion, occlusal profile, and the esthetic interpretation may be significant. Provisional restorations are indicated in esthetic zones, for the contouring of the gingiva, to achieve an acceptable emergence profile, to have custom-guided tissue healing, and to induce appropriate soft-tissue topography. This article describes the fabrication of a provisional restoration for a single-unit implant-supported crown.     

Digital Custom Impression Technique to Record Emergence Profile and Fabrication of an Esthetic Implant Supported Restoration

One of the challenges in esthetic implant supported restorations is to replicate the emergence profile of soft tissue contours created by provisional restorations. Various analog techniques have been used to achieve the most esthetic and natural emergence profile in final restorations. The evolution of digital dentistry has made dentistry easier and efficient albeit with a learning curve. The technique described here uses digital technology to describe a complete digital workflow from the provisional stage to the final restoration.     

Syncrystallization: a technique for temporization of immediately loaded implants with metal-reinforced acrylic resin restorations

Background Rigid temporization has been recognized to have a significant impact on the peri‐implant tissue response in immediate implant loading since it reduces the mechanical stress exerted on each implant. Purpose A successful protocol for immediate loading of multiple implants depends on an adequate fixation and immobility of the implants to prevent the risk of micromovements in relation to the surrounding bone. The objective of this article was to evaluate a prosthetic concept for an accelerated rigid splinting of multiple implants for same‐day immediate loading with metal‐reinforced provisional restorations using a technique of welding temporary implant abutments with a prefabricated titanium bar directly in the oral cavity (syncrystallization). Materials and Methods Between June 2004 and January 2005, immediate loading of threaded implants with a metal‐ reinforced acrylic resin provisional restoration at stage 1 surgery was evaluated in 40 consecutive patients. A total of 192 implants were placed in selected edentulous or partially edentulous patients using the syncrystallization technique. Once the titanium bar was welded intraorally to the abutments, opaque was applied and the provisional restoration was relined and screw‐retained the same day. In addition, a comparison of deformations and stress distributions in implant‐supported, metal‐reinforced and nonmetal‐reinforced resin provisional restorations was analyzed in the edentulous mandible by a three‐dimensional finite element model (FEM). Results All of the 192 rigidly temporized immediately loaded implants osseointegrated. An implant success rate of 100% was achieved over a period of 6 months postplacement. No fracture or luting cement failure of the provisional restoration occurred during the observation time. Compared to mere acrylic superstructures, a significant reduction of deformation and strain within metal‐reinforced provisional restorations was detected by FEM analysis. Conclusion The results of this study indicate that the syncrystallization technique allows an expedite and adequate rigid splinting of multiple immediately loaded implants. The advantages of the technique are: (1) reduction of treatment time for immediate temporization at stage 1 surgery; (2) predictable fixation and immobility of implants in the early stages of bone healing; and (3) less time for repairing provisional restorations as a result of no or rare fracture.     

Human mineralized bone in extraction sites before implant placement: preliminary results

BACKGROUND: Bone loss after tooth extraction may prevent dental implant placement. Human mineralized bone grafts can be used to restore bone volume and allow for tooth replacement with dental implants. METHODS: The authors grafted 22 sites in 18 patients with human mineralized bone after tooth extraction. They allowed molar sites 16 weeks for graft healing, placed the implants and restored them with a final crown after a four-month integration period. Single-rooted maxillary sites received implants and immediate placement of provisional crowns or underwent a delayed two-stage restoration approach. The authors used radiographs and clinical examinations to evaluate the results. RESULTS: All of the sites were restored successfully with a single-tooth implant restoration. Periapical radiographs indicated that the crestal bone levels were limited to the first thread of the implants or slightly coronal to the first thread of the implant. Clinical evaluation indicated excellent gingival health around the provisional and final restorations, without obvious gingival migration. CONCLUSIONS: The use of human mineralized bone may have significant potential to reconstruct missing bone resulting from tooth extraction and to preserve bone after tooth extraction. In addition, healed bone graft sites seem to be able to support immediate placement of a provisional crown and implant restorations. CLINICAL IMPLICATIONS: Patients who are having teeth extracted may become candidates for implant restorations when the sites are appropriately grafted to preserve and reconstruct bone volume, thus allowing for more options for reconstructing the missing tooth site.