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种植义齿的生理特殊性决定了种植义齿应有特殊的学。种植体骨界面是由力产生的微创伤和修复动态平衡来维持的。在种植义齿受到与种植体长轴方向一致的正常力时,对种植体基本没有危害。种植修复的基本建原则是:采用合理的咬合设计,使力沿种植体长轴传导,最大程度减少种植体承受的侧向力和应力。磨牙症患者可以种植,只是此类患者的种植义齿修复,要有加强固位的设计。     

Dental occlusion: modern concepts and their application in implant prosthodontics

The aim of this article was to review the literature on various aspects of occlusion related to implant prosthodontics, using PubMed and the Cochrane library. Even if the number of studies on implants and prosthodontics is very large, no randomized controlled trials or Cochrane reviews were found on the possible influence of occlusal design or characteristics of occlusion on treatment outcome. Therefore, studies and articles of a lower evidence level were accepted as the main part of the review. The widely spread opinion that implants are superior to natural teeth was refuted by two recent consensus conferences, which concluded that the long-term outcome of implant restorations is not better than that of natural teeth. No controlled studies on the optimal features of a harmonious natural and/or restored occlusion, including implant prostheses, were found. Nor was there any evidence that more sophisticated methods in jaw registration, e.g., using face-bows and adjustable articulators, compared with simpler methods, will yield better clinical prosthodontic results. This article discusses, among other things, concepts of occlusion of implant-supported restorations, occlusal material, cantilevers, and occlusal risk factors. Within the limitations of the review, it was concluded that many factors can influence implant failure and peri-implant bone loss but that little is known of the relative importance of such factors. Most probably, however, occlusal factors and details of occlusion are in general of minor importance for the outcome of implant restorations. Occlusion can be managed successfully by using simple methods for jaw registration and different occlusal concepts. This article is based on a lecture presented at the Asian Academy of Osseointegration, Hiroshima, Japan, July 18, 2008     

数字化印模在口腔种植修复中的研究进展

数字化印模是指使用口内扫描仪在患者口内无需直接接触即获取组织图像,并合成三维牙列影像的印模技术。数字化印模于口腔种植修复中的应用近年来开始受到关注,但其印模精度尚不明确,尤其是多颗种植体的数字化印模精度。本文详细介绍数字化印模的原理、在种植修复不同类型牙列缺损或缺失情况下的精度以及影响精度的相关因素,以期为数字化印模在种植修复中的临床应用提供参考依据。     

Fixed reconstructions in partially edentulous patients using two‐part ITI implants (Bonefit®) as abutments. Treatment planning, indications and prosthetic aspects.

Fixed reconstructions on implant abutments may be a welcome modality in the treatment of partially edentulous patients following the principles of a prophylactically oriented comprehensive care. The option to create artificial tissue integrated abutments widens the range of indications for fixed reconstructions. Risky long-span bridges as well as the preparation of intact teeth for bridge abutments may frequently be avoided. Never should the contours of the prosthesis interfere with the patient's performance of optimal plaque control. Furthermore, supportive periodontal therapy with regular maintenance visits must be provided to optimize a long-term prognosis of the dention as well as the tissue-integrated artificial abutments.     

Eleven-year report on a predoctoral implant dentistry program.

PURPOSE: An elective program on implant dentistry was started in the summer of 1994 at the University of Detroit Mercy School of Dentistry (UDM). The program provides comprehensive didactic and clinical training in implant dentistry to a select group of senior dental students. This study describes the program and clinical results of the first 11 years of the elective program in implant dentistry at UDM. MATERIALS AND METHODS: The program is 1 year long and is offered to a group of 10 senior students out of a class of 72. In addition to a one-semester lecture course offered to all dental students, students in the elective program participate in a one-semester seminar which includes literature review and "hands-on" surgical and prosthodontic components. Patients are assigned during the summer term to students who work in pairs. Students actively participate in diagnosis and treatment planning, assist in surgery, and accomplish the prosthodontic procedures. Prosthodontic services include single-tooth restorations, multiple-unit fixed restorations, overdentures, and full-arch fixed prostheses. A retrospective analysis of the patients treated in the first 11 years of the program was conducted. RESULTS: During the first 11 years of the program, 159 implants were placed in 70 patients. There were a total of 10 failed implants in seven patients (failure rate 6.3%): eight implants prior to loading and two following loading. Minor complications included gold screw loosening, gold screw fracture, porcelain fracture, and soft tissue inflammation, which occurred in less than 5% of the patients. CONCLUSIONS: The rates of implant failure and complications in the first 11 years of the elective implant program at UDM appear to be within an acceptable range when compared to other educational programs and studies reported in the dental literature.     

Subjective need for implant dentistry in a Swedish population aged 45–69 years

The present paper is part of a comprehensive study of dental conditions and attitudes in a Swedish county population aged 45-69 years. A questionnaire was mailed to 3000 randomly-sampled individuals. The response rate was 79.4%. Part of the questionnaire contained questions about subjective need for implant treatment. The subjects were informed of the clinical procedures as well as of the fees for implant treatment in the Swedish insurance system. The subjects wearing removable dentures were asked if, instead of their removable denture(s), they wanted dental implants if such treatment was possible. Of those wearing removable partial dentures, 23% answered "yes". The corresponding figure for subjects totally edentulous in one jaw was 17%; for subjects totally edentulous in both jaws 8%. The individuals who had reported missing teeth not replaced were asked if they wanted their missing teeth replaced by dental implants if such treatment were possible. The % answering "yes" was 21%. The subjects with all teeth remaining were hypothetically asked what kind of treatment they wanted if they would lose 1 or 2 of their teeth. The answer "dental implant" was given by 51%. Thus, subjective need for dental implants tended to decrease with poorer dental conditions. The major reason for not wanting dental implants was satisfaction with present dental conditions. Cost for treatment had some importance, while environmental and psychological factors showed only very limited influence.     

无牙颌种植义齿的咬合设计

随着种植义齿的不断普及,种植义齿的咬合设计也引起了大家的关注。本文就无牙颌种植义齿咬合设计的一些相关方面,如应力改变与颌骨的关系,咬合设计与种植并发症,髁突的水平关系确定,尖牙引导牙合的设计,种植体与天然牙对牙合力反应的异同等进行探讨和分析。     

Prosthodontic considerations designed to optimize outcomes for single-tooth implants. A review of the literature

Background: The aim of this study was to review the literature on the restoration of single‐tooth implants, and to develop evidence‐based conclusions to optimize aesthetic, biologic and patient‐related outcomes. Methods: An electronic and hand search was conducted using the search terms ‘dental implants, single‐tooth; dental restoration, temporary; dental impression materials; dental impression technique; dental prosthesis, implant‐supported; dental prosthesis design; dental abutments; dental occlusion; maintenance; survival; and survival analysis’. Resultant titles were screened, and full text was obtained where relevant. The authors selected the most appropriate articles, giving preference to systematic reviews and long‐term, patient‐based outcome data. Results: Thirty‐nine articles were selected and critiqued by the authors. Conclusions: There was strong suggestion by several authors that peri‐implant soft tissue aesthetics can be sculpted through provisional restoration contour, but there are no clinical outcome studies to define or support this claim. Laboratory studies demonstrate that pick‐up type impression copings in conjunction with elastomeric impressions are the most accurate means for transferring implant position to a dental cast. Laboratory and finite‐element analysis studies suggest implants with an internal‐type connection show improved stress distribution, but supportive clinical data are lacking. The authors of this review favour a screw‐retained prosthesis for retrievability. Clinical and histological studies show that gold, titanium and zirconia ceramic abutment materials exhibit excellent biological responses, although there is insufficient data on the clinical service provided by zirconia as an implant‐substructure material. The literature does not associate any particular occlusal scheme with superior clinical outcomes. Implant‐borne single crowns offer comparable clinical service to tooth‐borne fixed dental prostheses. However, single‐tooth implant restorations are associated with an increased incidence of biological and technical complications.     

Plasma in dentistry: A review of basic concepts and applications in dentistry

Objective. Plasma-related technologies are essential in modern industries. Recently, plasma has attracted increased attention in the biomedical field. This paper provides a basic knowledge of plasma and a narrative review of plasma applications in dentistry. Materials and methods. To review plasma applications in dentistry, an electronic search in PubMed, SCOPUS and Google scholar up to December 2012 was done. This was followed by extensive hand searching using reference lists from relevant articles. Conclusion. There have been attempts to apply plasma technology in various fields of dentistry including surface modifications of dental implants, adhesion, caries treatment, endodontic treatment and tooth bleaching. Although many studies were in early stages, the potential value of plasma for dental applications has been demonstrated. To enlarge the scope of plasma applications and put relevant research to practical use, interdisciplinary research with participation of dental professionals is required.     

University postgraduate training in implant dentistry for the general dental practitioner

AIMS OF THIS PAPER: This paper aims to: (1) Describe the educational requirements of general practitioners who want to safely and effectively introduce implant dentistry procedures to their practice. (2) Define the necessary competencies and level of complexity that would need to be attained in a postgraduate implant dentistry programme for general dental practitioners. (3) Discuss the programme structures which universities can utilize in order to provide quality education in implant dentistry for general practitioners. (4) Provide guidelines for the resources, content, course format and instructional methods which could be well suited to the educational requirements of such programmes. The authors intend to produce a headline reference guide to outline the necessary educational structures for postgraduate pathways aimed at facilitating the continuous professional development of general practitioners within implant dentistry. This paper does not address issues concerning specialist training or higher research degrees.     

Preservation of esthetics with implant dentistry: a clinical report

Background: The replacement of single teeth with implants in the anterior maxilla poses a significant challenge to the clinician because of its esthetic implications. Purpose: The purpose of this article is to report a protocol in which single teeth are replaced by implants and temporarily restored without load, immediately after extraction. Materials and Methods: Between June 2001 and July 2002, 16 cases were followed up in which this protocol was used. Briefly, the teeth are extracted with a Periotome (Friadent, Mannheim, Germany), using a napless technique, the sockets are evaluated and débrided, an osteotomy is performed following the direction of the socket, and a tapered implant is placed using the alveolar crest as the landmark. A temporary abutment is immediately custom made, and a temporary crown is placed without loading. The 16 cases are summarized, and 4 of them are presented to illustrate this approach. Results: All four cases have provided excellent esthetic results maintaining an ideal implant‐to‐supporting‐tissue relationship. Furthermore, the overall time needed to restore the cases was considerably reduced when compared with time needed for the conventional approach. Conclusion: The four cases presented support the use of the described protocol in the placement of single implants in areas of the maxillary anterior region where esthetics is a high priority.