临时固定修复体用于前牙美容修复体会

美给人以愉悦的感受,容貌美是人类追求和向往的,美的容貌给人以强烈的自信。笔者对94例前牙因变色、排列不整齐、缺失(损)及因牙周病致的前牙松动行美容固定修复,运用临时固定修复体对基牙预备后等待永久性修复体和拔牙后待伤口愈合的患者修复,取得比较好的效果。     

美学区域即刻种植即刻修复的临床研究

目的:探讨美学区域即刻种植即刻修复的临床应用及疗效.方法:14例患者美学区域新鲜拔牙创即刻植入22颗种植体并行即刻临时修复,3-6个月后制作终义齿,临床观察8-22个月.结果:2颗失败后拔出,20颗无松动3～6月行永久修复,X-线追踪观察永久修复后6～12月种植体颈部边缘骨吸收均小于1.5Mm,获得临床成功.结论:严格掌握适应证,保证种植体良好的初期稳定性,行无功能的临时修复,美学区域行即刻种植即刻修复能够获得良好的临床效果.     

前牙即刻固定义齿的临床应用

我科采用拔牙后即刻固定义齿修复减少拔牙创愈合过程中缺牙对患者美观和语言功能的影响收到良好的效果本文就5年来处理的3550例患者作如下报道临床资料门诊就诊要求拔除前牙适于并愿意在拔牙后3～6月行金属烤瓷桥修复的患者3550例其中男性1420例女性2130例最大年龄50岁最?..     

临时固定桥早期应用的临床研究

目的 研究拔牙后早期应用临时固定桥进行即刻修复的临床效果。方法 选择12例患者，上切牙拔除3～5天后即牙体预备（龈上边缘）、临时固定桥修复，拔牙术后2～3个月重新牙体预备（龈下边缘）、永久修复，并且重新制作临时固定桥。所有基牙均为上颌切牙，对戴用两次临时固定桥前后基牙的牙周状况进行检查。结果 早期应用采用龈上边缘的临时固定桥对基牙的牙周状况没有明显影响；常规应用的采用龈下边缘的临时固定桥对基牙的牙周状况有一定不利影响，表现为龈沟出血指数明显增加。结论 拔牙后早期应用临时固定桥（采用龈上边缘设计）进行即刻修复不会对基牙牙周组织产生不利影响，在临床是可行的。     

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.     

美学区域即刻种植修复22颗的临床研究

目的探讨美学区域即刻种植修复的临床应用及疗效。方法14例患者美学区域新鲜拔牙创即刻植入22颗种植体并行即刻临时修复,3-6个月后制作终义齿,临床观察8-22个月。结果22颗种植体永久修复后6-12个月,X线观察种植体颈部边缘骨吸收均小于1.5 mm,种植体无松动脱落。结论严格掌握适应证,保证种植体良好的初期稳定性,行无功能的临时修复,美学区域行即刻种植修复能够获得良好的临床效果。     

数字化技术辅助下全牙弓种植固定修复一例

本病例中一位慢性牙周炎导致下颌余留牙待拔除的患者借助口腔数字化技术，在下颌余留牙全部拔除后即刻行下颌全牙弓种植固定修复。该患者拔牙后在种植导板引导下于下颌即刻植入6颗种植体，术后即刻行临时修复体修复。术后5个月联合使用口内扫描、口外扫描、电子面弓进行个性化设计，交付患者形态、功能更加理想的永久修复体。全程数字化技术辅助下，种植导板、数字化扫描、电子面弓的联合使用，使得全牙弓种植修复更加精准、高效、便捷。     

全牙弓即刻种植即刻修复的临床疗效观察

目的:初步评价全牙弓即刻种植即刻修复的临床疗效.方法:回顾性分析2016年1月至2019年12月拔牙后全牙弓即刻种植即刻修复患者17例(上颌4例,下颌7例,全口6例)的临床疗效,平均随访时间24个月(12～36个月).结果:所有患者均顺利完成整个治疗程序,17例患者共计植入128颗种植体,观察期内无一例发生种植体骨结合失败,2例在术后发生种植体周围黏膜炎,4例临时修复体发生机械并发症,3例永久修复体发生机械并发症,均为冠崩瓷/崩塑;所有患者对咀嚼和美观效果满意.结论:在严格把握适应证、保证种植体植入扭矩的条件下,全牙弓即刻种植即刻修复可以取得理想的临床效果.     

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。     

对105名实施即刻种植伴即刻跨弓长桥修复患者的回顾性队列研究

目的：1评价即刻种植伴即刻跨弓长桥修复患者牙列缺失的治疗疗效;2．比较愈合拔牙位点和新鲜拔牙窝种植体植入成功率的差异性。材料和方法：共有105名患者的下颔经拔牙变成无牙骀（平均每名患者拔除61颗牙）,在每名患者的下颌种植4～6颗种植体（共植入448颗种植体）,这些种植体被植入在愈合（共266颗种植体．占59％）或新鲜（共182颗种植体．占41％）的拔牙窝内。制作即刻临时义齿并即刻负载．所有患者术后随访4个月。治疗成功的标准包括：修复是否成功;单颗种植体的稳定性及术后并发症的评估。结果：没有患者中途退出。105名患者在治疗4个月后均接受了永久固定义齿修复。术后4个月．种植体的植入成功率为98.2％。8名患者的8颗种植体出现治疗失败（8％）。失败的8颗种植体中．有4颗位于新鲜的拔牙窝内（2．2％）,4颗位于愈合的拔牙位点内（1．5％）。在新鲜的拔牙窝和愈合拔牙位点植入的种植体成功率差异无显著性（P=0．4990）。所有患者均无并发症出现。结论：即刻种植和即刻负载均获得了较高的成功率。愈合拔牙位点和新鲜拔牙窝对种植体的植入成功率并无影响。     

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.     

Comparison of uniaxial resistance forces of cements used with implant-supported crowns

PURPOSE: Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations. While the functional life spans of these cements are unpredictable, the relative retentiveness of various permanent and provisional cements between dental alloys and titanium abutments is not well documented. The aim of this study was to compare the uniaxial resistance forces of permanent and provisional luting cements used for implant-supported crowns. MATERIALS AND METHODS: Seven samples on 4 different abutments (a total of 28 crowns) were cast using a gold-platinum-palladium alloy. The crowns were cemented with 3 different provisional, polycarboxylate, and glass-ionomer cements and 1 zinc phosphate cement. After storage of samples in artificial saliva for 24 hours, tensile tests were performed. RESULTS: While the highest uniaxial resistance forces were recorded for polycarboxylate cements, provisional cements exhibited significantly lower failure strengths (P < .05). The uniaxial resistance force of cements on different abutments exhibited notably different trends; however, more force was required to remove crowns cemented to long abutments (P < .05). DISCUSSION: Glass-ionomer and zinc phosphate cements may be used to increase the maintenance of implant-supported crowns. Temporary cementation of such restorations may necessitate frequent recementation, particularly for restorations on short abutments. CONCLUSIONS: Temporary cementation may be more suitable for restorations supported by multiple implants.     

临时冠对美学区单颗种植修复体美学效果的影响

目的：观察在单颗上前牙的种植修复病例中使用临时冠与否对最终美学效果的影响。方法：收集70例上前牙种植修复病例,A组在二期术后使用临时冠（30例）,B组在二期术后使用愈合基台（40例）。采集所有病例戴入永久修复体后的口内临床数码照片,由一位种植科医生用红白美学指数对其评分。对评分结果进行非参数统计分析,比较2组病例的得分有无差异。结果：A组红色美学指数评分结果（均值8.03±1.38）高于B组（均值6.80±1.73）,差异有统计学意义。其中,A组近远中龈乳头2个参数得分高于B组,差异有统计学意义。结论：在美学区的种植修复病例中,使用临时冠有助于改善最终戴牙后的软组织美学效果,特别是对龈乳头的恢复非常有帮助。     

Functional and esthetic considerations for single-tooth Ankylos implant-crowns: 8 years of clinical performance

PROBLEM: Following the loss of an anterior natural tooth, the mucogingival complex begins to collapse. The early placement of endosseous dental implants can prevent or reduce the extent of this collapse. If there is a long interval between the loss of the natural tooth and the placement of the implant prosthetic replacement, this collapse tends to increase significantly. PURPOSE: This paper will report on the clinical success of this implant product in the fabrication of esthetic, functional, and harmonious replacements for missing single, natural teeth for a period of 8 years. METHOD: A total of 275 single Ankylos implant tooth restorations in the anterior and posterior jaw regions were placed and monitored for 8 years. Of these, 264 implants were restored using the titanium Balance abutments, and only 11 were restored using ceramic abutments. The final restorations were either metal-ceramic or full-ceramic crowns and were cemented with glass ionomer cement. RESULTS: The survival rate was 98.2%, with only 5 implants being lost during the healing phase. There were no other implant losses in the postloading period that averaged 3.2 years. To date, there have been no mechanical complications associated with the prosthetic components (ie, screw loosening, screw breaking, or crown breaking) for either the titanium or the ceramic abutments. CONCLUSIONS: Experience with the Ankylos system with single-tooth replacement indications may be considered positive with regard to the esthetic and functional results of the treatment. The lack of mechanical complications and problems with the hard and soft tissue in the loading phase of the implants suggests the functional safety of the tapered connection between implant and abutment.     

Immediate loading of two single tooth implants in the maxilla: preliminary results after one year

This clinical report describes the traumatic avulsion of the left maxillary central and lateral incisors with minimal tissue trauma, followed by placement of provisional restorations of two root-form implants in a 14-year old female patient. Ten days following the avulsion, implant therapy was performed with Summers osteotomes and flapless technique using a root-form 3i osseotite NT. Angulated abutments and acrylic provisional crowns were placed. No occlusal contact was detected. An impression was made 30 days after implant insertion and ceramic restorations were placed 3 months later. No significant soft tissue contraction was observed during the provisional period. The patient exhibited no clinical or radiologic complications for 8 months after loading. In carefully selected under-aged patients implant therapy and immediate loading in the anterior maxilla for traumatic tooth avulsion may prove to be valuable to avoid soft tissue contraction, alveolar bone resorption, and positive esthetic/psychological response.     

Transition from failing dentition to a fixed implant-supported restoration: a staged approach

This article describes a staged approach to provide a fixed restoration to patients with a hopeless dentition without a removable provisional phase. The rehabilitation protocol, which includes initial conservative periodontal care, starts with strategic extraction of some of the remaining teeth. The aim of the first step is to permit implant placement and to strategically keep residual teeth as abutments for a provisional fixed denture during the implant healing period. After the implants have osseointegrated, abutment connection is performed, residual teeth are extracted and, simultaneously, a second group of implants is placed. A second fixed provisional restoration is delivered to the patient. After the second group of implants has healed, the patient is ready to undergo normal prosthetic treatment. Advantages of the technique include no removable provisional prosthesis, soft tissue management, preserved function and enhanced esthetics during treatment, and prosthetically driven implant placement. The main drawbacks are extended treatment time, adjustments of the provisional restorations, and no less than two surgical steps.     

Customized abutments to shape and transfer peri-implant soft-tissue contours

With the functional successes of implant therapy being realized, the emphasis is shifting to the creation of tooth-like esthetics with implant therapy. Dental implants are placed after careful planning and site preparation, which may include bone and soft tissue grafting. The final soft tissue appearance is enhanced through the early use of provisional restorations. A combination technique is described to fabricate provisional healing abutments for cement-on prostheses and to transfer the individualized peri-implant soft-tissue contours to the dental laboratory. This technique will allow the practitioner to deliver highly customized implant care with familiar techniques and readily available materials.     

Immediate provisional for single-tooth implant replacement with Brånemark system: preliminary report

Background: The success of osseointegrated implants ad modum Brånemark for single‐tooth restorations is documented. Future developments should aim at improving the benefits to patients by decreasing treatment time, minimizing surgical stages, and maximizing esthetic outcomes. Using knowledge from studies of immediate implant placement, one‐stage, immediate loading protocols, the authors developed the immediate provisional. Purpose: The purpose of this study was to develop a protocol to provide an immediate solution for restoring a single missing tooth in the esthetic zone. The protocol should be simple, predictable, cost effective, and allow the use of other techniques to improve esthetic outcome. Materials and Method: This prospective clinical study included 24 patients treated from August 1999 to October 2000. Single‐tooth implant replacement was done according to immediate provisional protocol. Thirteen of the 24 patients had immediate implant placement after tooth extraction. All implants were placed in the esthetic zone. During surgery, emphasis was placed on obtaining primary stability by achieving bicortical anchorage and maximum insertion torque of at least 40 Ncm. CeraOne (Nobel Biocare) abutments were used, and provisional crowns were fabricated immediately before wound closure. The occlusion was protected by adjacent teeth. Results: Within the follow‐up period of between 1 month and 15 months, all fixtures in the 24 patients were stable. Crestal bone loss greater than one thread‐width was not detected. The esthetic result was considered satisfactory by all patients. Conclusions: The implant placement and restoration protocol used in this study showed promising initial results for both the immediate implant and healed extraction site groups. The desirable goals of patient satisfaction, excellent esthetic outcomes, and no increase in treatment cost were achieved in this protocol. Further studies to elucidate the potential of the immediate provisional protocol are justified.     

Immediate functional loading of immediate implants in edentulous arches: two-year results.

The purpose of this study was to evaluate the clinical success of immediate functional loading of immediate implants in edentulous arches. Five maxillary and five mandibular jaws were treated, and a total of 91 implants were placed; 66 of these implants were placed immediately after tooth extraction, and 25 were placed in healed sites. No bone substitutes or barrier membranes were used. Within 24 hours, fixed temporary restorations were inserted in all cases. During the entire 6-month healing time, all fixed temporary restorations were in normal function, after which the final fixed implant-supported restorations were inserted. After 24 months, the overall success rate of the implants was 92.31% (87.50% for the maxillary implants and 97.26% for the mandibular implants). The bone level measured mesially and distally was in 93.40% of all cases between the implant shoulder and the first thread. The present study shows that the immediate functional loading of immediate implants without the use of any bone substitutes or barrier membranes for fixed complete-arch reconstructions can be successful over a 2-year period.     

Effect of provisional restorations on the final bond strengths of porcelain laminate veneers

The purpose of this in vitro study was to evaluate the effect of the different provisional restorations cementation techniques on the final bond strengths of porcelain laminate veneers (PLVs). Thirty-six extracted human central incisors were sectioned 2 mm below the cemento-enamel junction, and crown parts were embedded into self-cure acrylic resin. Standardized PLV preparations were carried out on labial surfaces of the teeth. Then the teeth were randomly divided into three groups of 12 each. In group 1, provisional restorations were cemented with eugenol-free cement. In group 2, prepared teeth surfaces were first coated with a desensitizing agent then provisional restorations were cemented with resin cement. In group 3, provisional restorations were not fabricated to serve as control. After specimens were stored in distilled water for 2 weeks, provisional restorations were removed and final IPS Empress 2 ceramic veneers were bonded with a dual-curing resin. Two microtensile samples from each tooth measuring 1.2 x 1.2 x 5 mm were prepared. These sections were subjected to microtensile testing and failure values were recorded. The data were analysed by one-way anova and Tukey HSD tests. The PLVs, placed on the tooth surface that had received a dentine desensitizer and provisional restorations luted with resin cement (group 2), showed the lowest bond strength in all test groups. But no statistically significant differences were found between the bond strength of PLVs in control group (no provisional restorations) and group 1 (provisional restorations cemented with eugenol-free cement before final cementations). Scanning electron microscopic (SEM) examination of this study also showed that the bonding to enamel surface was better in control group and group 1 than group 2.