种植体联合牙半切术单冠修复下颌磨牙的疗效观察

目的探讨应用种植体联合牙半切术单冠修复下颌磨牙的临床疗效。方法选择12例患牙,健康牙根完善根管治疗,微创拔除病变牙根。半切术后8～10周植入种植体,种植体植入后3～4个月进行种植二期手术,安装穿牙龈愈合基台。牙龈愈合4～6周后开始进行全冠修复,并随访2～4年。结果 11例种植体联合牙半切术单冠修复下颌磨牙均获成功,种植体稳固,种植体周骨组织未见明显吸收,修复体形态美观,功能恢复良好,患者满意度高。1例因病变的远中牙根与牙槽骨发生骨粘连,术中不得不使用骨凿损伤了近中牙根而一并拔除。结论种植体联合牙半切术单冠修复下颌磨牙是一种有效的修复方法。     

叶状牙种植体在上前牙种植中的临床研究

用国产CDIC叶状牙种植体及配套器械 ,瑞士产CH -9400型牙种植机 ,对身体健康 ,无全身系统性疾病的43名患者 ,按常规操作植入牙种植体。部分种植体在模板引导下定位 ,部分于唇侧骨倒凹区植入可降解的α -磷酸三钙。术后0～2周暂冠修复 ,3～6月永久修复。观察时间近3年 ,除一枚种植体松动而拔除外 ,其余牙种植体均稳固。其中5枚牙种植体在暂冠修复后有I°松动 ,经调后半年至一年稳固 ,39枚种植体上已永久修复者均能正常行使功能。说明叶状牙种植体在上前牙缺失种植修复中有其独特的优势     

上置法植骨技术与种植修复

目的：为了恢复缺牙后重度吸收牙槽嵴的三维骨量,继而行种植体植入,探讨上置法植骨技术及结果。方法：３３例重度吸收牙槽嵴患者接受了上置法槽骨术,平均３个月植入了４５颗种植体。术后６个月行种植体暴露术,暴露后６周行烤瓷冠修复。结果：所有病例修复后平均追踪１１个月,未见种植体脱落。结论：上置法植骨技术简单,效果可靠。     

40枚Frialit-2种植体的临床应用效果

目的 评价Frialit-2种植体用于修复牙列缺损的临床效果并总结牙种植治疗中的经验教训.方法 对20例牙列缺损的患者,用40枚Frialit-2种植体进行修复,于植入术后1周、 3个月、 6个月,上部修复后3个月、6个月复诊,记录周围软组织情况、种植体松动度、X线检查牙槽嵴边缘高度、神经感觉状况、患者满意度等指标.结果 40枚种植体中有1枚发生一期术后感染,有4枚种植体在二期术前松动脱落,有1枚种植体在二期术后松动脱落,患者满意度高.结论 Frialit-2种植体用于修复牙列缺损效果较好.     

桥基牙为种植牙与天然牙时的固定修复对种植体稳定性的影响探讨

目的:探讨种植牙与天然牙联合作为桥基牙的固定修复对种植体稳定性的影响。方法:对2001年到2007年就诊于口腔科的42例进行种植修复的患者,考虑到患者的口腔条件、缺牙数目的多少、经济条件、对义齿的要求等因素,调整种植体与天然牙的距离,然后进行种植牙与天然牙联合作为桥基牙的固定修复方式进行修复。结果:当种植体与天然牙相近时,易导致种植体的松动;当种植体与天然牙相远时,不会导致种植体的松动。结论:种植体远离天然牙设计固定修复是可行的。     

应用不翻瓣技术进行后牙区种植义齿修复的临床体会

目的：总结应用不翻瓣技术进行后牙种植义齿修复的临床体会。方法：后牙缺失需要进行种植义齿修复患者53例,男26例,女27例,平均年龄47.4±12.3岁,90颗缺牙。术前均进行CT扫描,三维重建分析缺牙区可用骨长度、宽度和高度,术中环形切除缺牙区黏骨膜进行不翻瓣种植体植入手术,必要时辅助手术导板引导种植体窝洞预备和种植体植入。记录手术耗时时间,术后即刻CT检查植入位置,观察有无并发症的发生,种植体骨结合后完成上部结构修复并定期随访。结果：53例患者应用不翻瓣种植手术成功植入90枚种植体,种植体植入位置良好,术中耗时平均（17.4±5.8）min,无上颌窦底黏膜穿孔、下颌神经损伤、骨壁侧穿等手术并发症,86枚种植体成功修复义齿并经3～10个月随访正常。结论：绝大多数后牙缺牙患者都适合进行不翻瓣种植手术,选择比种植体直径稍大的黏骨膜环切钻更有利于手术,种植体上方皮质骨需要修整后方能使愈合基台准确就位。     

52例牙半切术的临床疗效观察

目的:观察半切术治疗牙的疗效并进行评价。方法:选取52例牙半切术适应症患者,常规行根管治疗后施行牙齿半切除术,保留尚健康的牙根和部分牙冠,而后行全冠或固定桥修复,追踪2~5年观察疗效。结果:52例半切牙中成功成功47例;失败5例,成功率为90.38%。结论:牙半切除术可有效地保存部分患牙。     

单纯种植体与天然牙联合种植体的临床修复效果及影响因素分析

目的 ：分析单纯种植体与天然牙联合种植体的临床修复效果及影响因素。方法 ：选择2016年5月—2017年6月上饶市人民医院收治的采用天然牙联合种植体修复的牙列缺损患者34例（联合组）,单纯种植体修复的牙列缺损患者33例（单纯组）,随访3年,评价2组患者修复与骨吸收情况,收集患者一般资料,分析种植体失败影响因素。采用SPSS 20.0软件包对数据进行统计学分析。结果：联合组种植体修复成功率为93.65%,与单纯组的95.08%相比无显著差异（P>0.05）。联合组术后1年半,牙槽嵴吸收水平均高于单纯组（P<0.05）。种植体失败组,女性、上颌后牙区、牙体牙髓病、缺失骨密度Ⅳ级、糖尿病、吸烟、种植体直径>4.5 mm、长度>12 mm、牙周探针深度>3 mm、龈沟出血指数≥2均显著高于成功组（P<0.05）。缺牙骨密度、糖尿病、吸烟及天然牙龈沟出血指数≥2、探针深度>3 mm是种植体失败的危险因素（P<0.05）。结论：单纯种植体与天然牙联合种植体均具有较好的临床修复效果,短期随访结果显示,天然牙联合种植体修复是可行的。缺牙骨密度、糖尿病、吸...     

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.     

个别牙缺失的种植义龄修复

采用种植义齿修复缺失牙已成为一种较理想的修复方法应用于临床。本文对３６例个别牙缺失的病人用４２枚种植体入并修复，经过半年至两年半的观察，３９枚种植体至今仍稳固于牙槽骨中，取得较满意的疗效。     

Fixed restoration of sectioned mandibular molar teeth

A mandibular molar tooth may have its furcation area or one of its roots severely affected by periodontal disease or caries. Multiple factors must be favorable to restore health to such a compromised tooth. Adequate bone support for stabilization of the individual roots and coronal segments must be available after periodontal therapy. Root morphology and separation space must allow for ease of preparation and cleaning between the sectioned roots. Endodontic therapy should be uncomplicated and provide an excellent prognosis for long-term success. All caries must be removed and adequate tooth structure must remain after root and crown sectioning. Appropriate resistance and retention form must be achievable after tooth preparation of a sectioned mandibular molar. If these conditions can be met and the patient wants to keep the tooth, fixed restoration of a sectioned molar tooth is a viable treatment alternative to extraction and replacement with a removable partial denture or a dental implant. This article has described factors and procedures that should be considered for successful fixed prosthodontic treatment of sectioned multirooted mandibular molar teeth. The authors recommend an interdisciplinary diagnostic and treatment planning approach before performing endodontics, providing periodontal therapy, and restoring bicuspidized or hemisectioned multirooted teeth.     

影响上颌中切牙单个种植修复体龈乳头高度的因素分析

目的分析影响上颌中切牙单个种植修复体龈乳头高度的因素，探讨促进种植修复美学效果的相关因素。方法选择16例上颌中切牙单个种植修复患者（30个龈乳头），通过分析临床资料、口内照片、X线片和研究模型，得到龈乳头高度及相关因素数据，采用多重线性回归方法进行分析。结果16例患者中切牙种植修复体龈乳头高度为（4．01±1．85）mm，影响龈乳头高度的相关因素按作用由大到小的排列顺序为：种植修复体外冠接触点高度、邻近天然牙邻面牙槽嵴顶高度、邻近天然牙邻面牙槽嵴顶到外冠接触点的垂直距离、种植修复体外冠邻面凸度、种植体基台与邻牙牙根距离、冠根长度比例、种植修复体邻面牙槽嵴顶高度、种植修复体外冠唇面凸度、探诊深度。结论中切牙种植修复体龈乳头高度受多种因素影响。     

Professional and patient-based evaluation of oral rehabilitation in patients with tooth agenesis

Objectives: The outcome of oral rehabilitation is usually monitored with clinical tests rather than by patient's perception of change. The aim of this study was to describe the objective measure and subjective perception of oral rehabilitation in patients with tooth agenesis. Material and methods: The study included 129 patients with tooth agenesis rehabilitated with implant‐ or tooth‐supported reconstructions, and a control group of 58 patients. Professional assessments included biological, technical and aesthetic variables. An aesthetic index score included mucosal discoloration, crown morphology, crown color match, occlusal harmony, and papilla level. The Oral Health Impact Profile (OHIP) questionnaire was used to evaluate the patient‐based outcomes. Six OHIP questions were subtracted to evaluate the patient‐based aesthetic outcomes. Results: Severe root resorption was observed in 36% of the patients in whom orthodontic treatment had been performed. Twelve percent of patients had implants with 5–7 mm peri‐implant bone defects. Mucosal discoloration was recorded in 57% of the patients. Twelve percent of the patients had metal visible on the buccal side. The median scores for all five aesthetic variables were acceptable in 92% of the implant reconstructions and for 83% of the tooth‐supported fixed dental prostheses (FDPs). The total OHIP score was inferior in rehabilitated patients with tooth agenesis to that of the control group without tooth agenesis. The total OHIP score after rehabilitation was <50 for 95% of the patients with tooth agenesis. The six OHIP questions concerning aesthetics demonstrated patient‐based aesthetic problems in 41% of patients treated with implant‐supported reconstructions and 47% of patients treated with tooth‐supported FDPs. Ninety‐eight percent of the group treated with implant‐supported reconstructions and 84% of the patients in the tooth‐supported FDP group were very satisfied or satisfied with the treatment outcome. Conclusions: Patients with tooth agenesis had a high risk of severe root resorption after orthodontic treatment. A better aesthetic outcome was obtained with implant‐supported reconstructions than with tooth‐supported reconstructions. A positive but not significant correlation was observed between the professional and patient‐based evaluations of aesthetic outcomes.     

A 22‐year follow‐up of an endodontic implant

Root fractures in the middle and apical thirds of the root are treated by repositioning and for approximately 6 weeks of immobilization while those in the cervical third are immobilized for 3 months. Even though the results are good, some root‐fractured teeth are lost and replaced by dental implants or fixed partial dentures. One historic but effective treatment option for those root fractures with unfavorable crown to root ratios is an endodontic implant in middle and apical third root fractures. This method offers immediate stable fixation of a crown and its coronal root segment to the underlying alveolar bone. This report documents the long‐term survival of a tooth treated with an endodontic implant. A 25‐year‐old male patient presented following a bicycle accident with a dislocated unfavorable root fracture in the middle third. The crown with the coronal root segment was secured to the bone using a commercially available endodontic implant. The apical part of the root was removed. Although the clinical and radiological follow‐up results of the endodontic implant demonstrated a good clinical function and little bone loss, the implant ultimately had to be removed after 22 years of service due to pain and increasing mobility.     

种植体初期稳定性与即刻CERECⅢ-3D全瓷冠修复的临床研究

目的:研究单颗前牙早期种植后使用西诺德CEREC-3D椅旁型即刻制作全瓷修复冠的临床应用和疗效。方法:1名前牙根折患者,使用奥齿泰GS3种植体1枚即刻微创非翻瓣种植术,术后同期使用CEREC-3D系统(椅旁型)行全瓷冠修复,术后12个月复查。结果:种植体愈合良好,牙龈美学效果良好,保存率100%,X线复查骨吸收小于0.5mm,软组织无明显退缩,获得满意的临床效果。结论:在严格把握临床适应症和种植体初期稳定性的前提下,使用CEREC-3D系统(椅旁型)可以在单颗前牙即刻种植后即刻修复取得很好的临床效果。     

Immediate implant placement: treatment planning and surgical steps for successful outcomes

Diagnosis and treatment planning are key factors in achieving successful outcomes after placing and restoring implants placed immediately after tooth extraction. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. Some or all of the following suggestions, depending on individual circumstances, should be considered when evaluating a patient for dental implants: thorough medical and dental histories, clinical photographs, study casts, periapical and panogram radiographs as well as a linear tomography or computerised tomography of the proposed implant sites. Reasons for tooth extraction include but are not limited to: insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts, root resorption, teeth with deep furcation invasions being considered as abutments for fixed partial dentures and questionable teeth in need of endodontic retreatment.     

A multiple post-core technique

An indirect technique to prepare a multirooted pulpless tooth to receive a crown is presented. The crown also may be made on the newly completed core and its die. The procedure promotes the use of a commercial dental laboratory. The system, which uses divergent roots, results in a cast core having maximum retention.     

The efficacy of subgingival calculus removal with endoscopy-aided scaling and root planing: a study on multirooted teeth

BACKGROUND: The dental endoscope was developed to facilitate visualization of the subgingival environment as an aid in diagnosis and non-surgical root debridement. The purpose of this study was to determine whether endoscopy-aided scaling and root planing (SRP) resulted in a greater reduction of residual calculus compared to SRP alone in multirooted teeth. METHODS: Twenty-four patients were enrolled and contributed 35 tooth pairs (70 teeth in total). Each tooth per pair was randomly assigned to receive endoscopy-aided SRP (test) or SRP alone (control). Both teeth were extracted immediately after treatment, washed with water, and stained with methylene blue. The percentage of residual calculus was determined via stereomicroscopy and digital image software by a single masked examiner. RESULTS: Overall, there was 1.16% (P = 0.097) less residual calculus at test versus control sites. At interproximal surfaces, test roots had 2.63% less residual calculus than control roots (P = 0.003), whereas test roots had slightly more residual calculus than controls at buccal/lingual surfaces (0.36%; P = 0.652). There were no statistically significant differences in residual calculus between groups at deeper probing depths or at sites with deep furcation invasions. Only at shallower interproximal sites with probing depths < or =6 mm was significantly less residual calculus seen in roots treated with endoscopy (P = 0.020). Treatment time decreased significantly as operator experience increased; however, no significant improvement in residual calculus levels was noted with greater experience. CONCLUSION: Within the confines of this study, the use of the endoscope as an adjunct to traditional SRP provided no significant improvement in calculus removal in multirooted molar teeth.     

双根单冠种植修复的临床研究

目的:研究双根单冠种植修复的临床应用效果。方法:对56例宽间隙单个牙缺失患者采用CDIC系统双种植体种植技术,并以单冠修复。观察1—5年,以种植成功率及患者满意率来评价其修复效果。结果:在愈合期有3例双种植体之中的远中种植体因松动而拔除,成功率为95%,永久修复后1—5年成功率为100%,患者满意率达到98%。结论:双根单冠种植修复宽间隙单个牙缺失是可行的。     

Incidence of inter-proximal papilla between a tooth and an adjacent immediate implant placed into a fresh extraction socket: 1-year prospective study

Background: Implant single‐tooth replacement with a natural appearance is a challenging and demanding procedure. The aim of this prospective study was to identify the factors affecting the presence of an inter‐proximal papilla between a tooth and an implant. Methods: Forty‐six patients with a total of 46 teeth scheduled for tooth extraction and immediate implant placement into fresh sockets were included in the study. Immediate implants were positioned after teeth removal. After 4 months of healing, the implants were restored with single crown fixed prostheses. The following parameters were assessed: (1) presence/absence of the inter‐proximal papilla, (2) gingival index, (3) inter‐implant–tooth distance (ITD) and (4) distance from the base of the contact point to the inter‐dental bone (CPB). A computerized analysis was performed to determine ITD and CPB values after converting perioapical radiographs to digitalized images. Statistical analyses were performed to determine the effect of ITD and CPB on the presence or absence of the inter‐proximal papilla. Results: All the implants were restored, so that a 100% of implant survival rate was observed after 12 months of function. Mean values were recorded for ITD and CPB parameters, respectively. When ITD was 3–4 mm, and CPB was 3–5 mm, the inter‐proximal papilla was significantly present (P<0.05). Conclusions: The recommended inter‐proximal space dimensions are 3–4 mm between an implant and the adjacent tooth, and 3–5 mm between the base of the CPB. The interaction between the surgical and prosthetic plans represents the key factor to optimize the edentulous site for predictable anterior single‐implant esthetics.