改良式GBR技术联合即刻种植术后即刻修复上前牙的疗效分析

目的:评估改良式GBR技术联合即刻种植术后即刻修复上前牙的疗效.方法:选择12例共12颗满足即刻种植术适应症的无法保存的上前牙,微创拔除后即刻植入种植体12枚,均于术后完成即刻临时冠修复,4～6个月后永久修复.种植永久修复后随访6 ～12个月,观察种植体周围软硬组织情况,骨结合情况,统计种植义齿成功率.结果:12例患者12枚种植体均无感染、松动,对邻牙支持组织无损害,种植体周围X线无透射区,骨结合良好,未见明显病理性骨吸收,无种植体周围炎症出现,软组织健康,种植体成功率100％,患者对修复效果均满意.结论:在严格掌握即刻种植即刻修复适应症的前提下,采用改良式GBR技术联合即刻种植术后即刻修复上前牙能获得理想的临床效果.     

DLD种植系统用于即刻种植修复临床探讨

目的应用BLB系统种植体行即刻种植，对种植效果进行，临床分析。方法对具有即刻种植适应证7例患者行9枚牙种植体植入，牙槽窝较宽者加用CERASORB人工骨植入或联合超薄生物膜覆盖，3个月-5个月后，行种植义齿修复。结果9个种植体植入后，伤口I期愈合，义齿修复后行使咀嚼功能3个月～12个月，未发现种植失败。结论BLB系统即刻种植应严格掌握适应证，避免牙槽骨损伤，保证充分的骨组织与种植体结合，软组织要充分松驰，伤口无张力缝合。     

即刻种植临床应用观察

目的 探讨分析即刻种植适应证的选择、操作要点及失败原因分析.方法 应用ITI种植体及CDIC种植体即刻种植42例患者,共植入种植体60枚,ITI种植体20枚,CDIC种植体40枚,术后三到四月种植体冠部修复.检查种植体松动度,X线检查种植体骨结合情况及牙龈外形,评价临床成功率及美学修复效果.结果 随访2～5年60枚种植体中,2枚术后2周内感染松动,拔除.1枚3个月复诊时未达到骨结合,拔除.其余57枚种植体无松动,达到骨结合,成功率达到95%.结论 即刻种植只要严格选择适应证,精细操作,同样与延期种植一样达满意的临床成功率及远期效果.     

军事训练致前牙损伤即刻种植义齿修复的临床应用

目的探讨即刻种植义齿修复在军事训练所致前牙损伤的临床应用。方法因军事训练损伤导致15例23颗上颌前牙缺失后行即刻种植,共植入种植体23颗,植入4~6个月后行二期手术,最终完成修复体制作。结果 22颗术后无明显并发症,l颗于完成修复半年因松动拔除。修复完成后观察2~3年,种植义齿行使功能良好,取得良好的功能及美学效果。结论即刻种植义齿修复为军事训练所致上颌前牙损伤的治疗提供了一种新途径。     

种植义齿连冠修复即刻负重的临床疗效分析

目的探讨种植义齿连冠修复即刻负重的临床治疗效果,为临床治疗提供依据。方法选取多颗牙齿缺失的患者88例,随机分为对照组和观察组,每组44例。对照组采用延期法治疗,观察组采用种植义齿连冠修复即刻负重治疗,进行疗效比较观察。结果对照组和观察组的各有3例患者在种植1个月之后都出现1颗种植义齿脱落的现象,但是没有影响到其余义齿的功能,种植体边缘的骨吸收<1 mm,并且患者对牙齿外形都很满意;对照组和观察组的种植成功率分别是96.8%和97.8%,P>0.05,两组比较经统计学处理没有显著性差异。结论在临床上应用即刻负重种植义齿修复具有手术过程更加简化和便于临床操作等优点,不仅避免了多次手术带给患者的疼痛与畏惧,而且在缓解患者对缺少牙齿的不适感的同时,也很大程度上减轻了患者的经济负担,最大限度地帮助患者及早恢复咀嚼功能和达到美化牙齿的效果,值得临床推广。     

即刻种植修复对慢性牙周炎患者的应用效果

目的 探讨慢性牙周炎患者即刻种植修复的方法及临床效果.方法 回顾性分析2013年3月至2015年1月我院经拔牙后即刻种植修复的19例慢性牙周炎患者的临床资料.结果 19例患者共植入33枚种植体,上颌14枚,下颌19枚,术后伤口一期愈合,X线片显示种植体与根尖部周围骨组织无明显间隙,术后6个月种植体与周围骨质完全结合,无明显透射影及骨吸收.上颌2枚种植体于术后6个月松动并去除,余下31枚种植体稳固,无种植体周围炎症发生,临时修复体美观,功能及牙龈形态良好.冠修复后31颗种植体颈部边缘垂直骨吸收均＜ 0.612 mm,种植成功率93.9％.结论 在术前完善牙周治疗,选择合适种植体以及合理应用骨引导技术基础上,慢性牙周炎患者即刻种植修复安全、可行,临床效果满意.     

瓷睿刻在种植却刻修复中的应用

目的探讨种植体植入后瓷睿刻即刻修复的临床可行性。方法对11例骨密度较好,骨量充足的前牙缺失患者,MG种植体植入后CAD／CAM玻璃陶瓷临时冠即刻修复,6个月后永久修复,于术后1．3、6个月观察颈部骨吸收情况。结果X线片显示种植体与骨结合紧密。修复体美观,功能状况及软组织形态良好,患者满意。结论利用瓷睿刻进行种植即刻修复,是一种比较好的修复方法。     

前牙外伤患者即刻种植美学影响因素的临床观察

目的 评价前牙外伤后即刻种植的临床美学效果。方法 选取2013—2014年就诊于种植中心的前牙外伤患者31例,共植入种植体48枚。拔除外伤患牙后,即刻种植,部分患者同期引导性骨组织再生,3个月后行最终修复。随访1年,统计种植体成功率,观察种植体周围软硬组织改变情况,评价龈乳头指数与红白美学指数、测量边缘骨水平。结果 观察期内,种植体成功率均为100 %。软组织恢复较好,无牙龈乳头退缩,红色美学得分随植入时间增加,差异有统计学意义,白色美学总分为(7.23±1.17)分。早期骨丧失与骨增量无明显差距,随着骨改建趋于稳定,骨丧失量明显减少,牙槽骨恢复良好。结论 前牙外伤患者的即刻种植能缩短手术疗程,减缓种植体周围软硬组织吸收,达到较高的美学满意度。     

拔牙创即刻植入牙种植体＋HA颗粒36例临床疗效观察

目的：观察验证拔牙创即刻植入牙种植体和羟基磷灰石（ＨＡ）颗粒的临床疗效。方法：在拔除牙齿同时修整拔牙窝，植入牙种植体及ＨＡ颗粒。结果：对３６例４１颗牙种植体经３年临床观察，成功率为９７．５％，与３２颗延期牙种植体比较无显著差别。结论：拔牙后即刻植入牙种植体的同时植入ＨＡ颗粒，有助于牙种植体的稳固和骨愈合，同时可以达到与 同样效果。     

膜引导技术在即刻种植牙中的应用

目的探讨牙拔除术后结合膜引导技术即刻植入种植体修复牙缺失的可行性。方法对52例76颗牙拔除术后患者,即刻植入种植体使用医用钛膜完全封闭骨缺损区。6个月～1年行冠修复,根据临床X线检查和患者主诉评价修复效果。结果76例即刻种植体12周后骨缺损修复形成,冠修复后承载了3年无松动。5年随访,除1例有进行性骨吸收外,其余种植体周围骨吸收高度平均1.27mm。结论运用膜引导技术进行即刻种植,可获得良好的骨修复,缩短种植修复疗程,很好地承担修复体传导的牙牙合力,与延期种植无明显差异。     

前牙即刻种植即刻修复临床应用研究

目的探讨即刻种植与即刻修复技术的临床应用效果。方法34例患者共52个牙位在拔牙后植入种植体,其中28例36个牙位于前牙区种植后,在种植体上部完成临时冠修复,另6例患者进行常规种植手术,3个月后于种植体上烤瓷冠修复,所有患者均于术后10天、3、6、12个月复查一次。结果除2例3枚种植体松动外,其余种植体均获得良好的临床效果,X线示种植体周无低密度透光区,4年累计存留率为94.23%。结论严格掌握适应证,即刻种植与即刻修复可应用于临床,并获得较满意的临床效果。     

骨水平种植体与软组织水平种植体应用于后牙区的临床效果比较

目的 评价Straumann种植系统的软组织水平种植体和骨水平种植体应用于后牙缺失区的临床效果.方法 选取接受后牙区单颗种植修复的108例患者,分别植入58颗Straumann软组织水平种植体和50颗骨水平种植体.随访2年,统计两组种植成功率、种植体周围骨吸收高度、牙周探诊软组织情况和患者的满意程度.结果 术后2年内软组织水平种植体周围骨呈递减式吸收,骨水平种植体周围骨缓慢均匀吸收,骨水平种植体骨高度优于软组织水平种植体.牙周探诊检查两组牙周软组织健康相当,患者反馈满意度差异无统计学意义.种植体成功率均为100％.结论 在后牙区,骨水平种植体周围骨吸收优于软组织水平种植体.     

上颌前牙即刻种植的临床美学观察

目的：了解上颌前牙拔除后即刻种植的近期疗效及美学效果。方法对39例41颗无法保存的上前牙微创拔除后,即刻种植,即刻临时冠修复。6个月后行永久烤瓷冠修复。随访1-7年,观察种植体周围软硬组织情况及相邻天然牙唇侧牙龈的协调性。通过主观评价和临床检查进行综合评价分析。结果43枚种植体均获得良好的骨性结合。种植体无松动,种植体周围软组织外形正常。其中28枚种植修复体唇侧牙龈缘位置与邻近天然牙唇侧龈位置及颜色协调一致,15枚种植修复体唇侧牙龈外形轻度异常。患者对即刻种植修复的美学效果满意。结论即刻种植修复只要严格掌握适应证,应用正确的手术技巧,严格操作规程,可以获得理想的临床疗效和美学效果。     

Enhancement of Bone Growth by Sustained Delivery of Recombinant Human Bone Morphogenetic Protein-2 in a Polymeric Matrix

Purpose. The purpose of this study was to develop a polymeric sustained delivery system for recombinant human bone morphogenetic protein-2 (BMP-2) and to evaluate local bone growth induced by the sustained release of BMP-2 in an animal model. Methods. BMP-2 was incorporated in biodegradable poly(D,L-lactide-co-glycolide) (PLGA) microspheres to obtain different release rates. Two sustained and an immediate release implants were produced by suspending the BMP-2 loaded PLGA microspheres in aqueous sodium carboxymethylcellulose (CMC), lyophilizing, and cutting the dried materials to the size of the animal bone defects. The local in vivo release at the implantation site in rat calvarial defects was determined by gamma scintigraphy using radiolabeled BMP-2. The local bone induction in the critical size of rabbit calvarial defects was evaluated six weeks post implantation. Results. The immediate release implant showed about 65% initial drug release within 24 h and the remaining BMP-2 quickly exhausted from the implantation site within 7 days. The sustained release implants, showing 45-55% initial release followed by a prolonged release for 21 days, released a greater amount of BMP-2 at the implantation site and maintained higher serum BMP-2 for the longer period of time compared to the immediate release implant. Significant bone growth was observed in all BMP-2 treated defects while the defects without treatment or with BMP-2-free implant showed minimal bone healing. 75-79% of rabbit calvarial defect area was healed with newly induced bone matrix by the sustained release implants in 6 weeks as compared to 45% recovery from the immediate release implant. Conclusion. The sustained delivery of BMP-2 based on the biodegradable PLGA microsphere system resulted in faster and more complete bone healing in the animal model.     

人工牙种植中牙槽骨骨量不足和颌骨缺损的处理

目的 探讨人工牙种植中牙槽骨骨量不足和颌骨缺损的处理。方法 总结32例多种原因、多种类型牙槽骨骨量不足和颌骨缺损，应用植骨、植入Bio-Oss、骨引导膜等方法，创造条件进行人工牙种植。结果 32例病例、48个牙位，除1例植骨行即刻种植2枚种植体失败外，其余均取得满意的种植效果。结论 传统意义上认为不适合种植的牙槽骨骨量不足和颌骨缺损病例，通过创造条件能够取得良好的种植效果。     

种植体骨界面对非血管化下颌骨植骨后即刻种植的骨结合实验研究

目的:评价种植体骨界面对非血管化下颌骨植骨后即刻种植的骨结合效果。方法:选择12～15个月的健康本地杂种犬6只,全身麻醉后将其一侧下颌骨作为实验侧切开后矩形截骨,移植游离髂骨置于下颌骨缺损区,在植骨区植入种植体3枚。对照侧同样位置上植入3枚种植体。所有动物于12周时接受单光子发射计算机断层仪/计算机断层扫描(SPECT/CT)融合显像检查后处死,并采用带种植体硬组织磨片对18枚种植体骨界面组织学和骨结合率进行分析。结果:12周时所有种植体骨界面组织均愈合良好;两侧种植体骨结合界面感兴趣区(ROI)放射性计数、CT值、骨结合率和周围骨面积差别均无统计学意义(P>0.05)。结论:非血管化下颌骨植骨后即刻种植的骨结合效果较好,SPECT/CT融合显像和带种植体硬组织磨片技术在分析种植成功率方面有重要价值。     

牙周炎患者不同种植系统修复的临床评价

目的:探讨牙周炎患者不同种植系统修复后种植体边缘骨吸收(MBL)及龈沟液(GCF)中主要生物标志物的差异性。方法:选择2017年—2018年就诊的Ⅲ期牙周炎患者36例,共植入种植体91枚,随机分为士卓曼组、奥齿泰组和威高组。士卓曼组植入士卓曼(Straumann)种植体33枚,奥齿泰组植入奥齿泰(OSSTEM)种植体30枚,威高组植入威高(WEGO)种植体28枚。修复完成后6个月、1年和2年复诊,记录口腔各项临床指标及种植体存留率,测量种植体MBL,并检测龈沟液中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和基质金属蛋白酶-8(MMP-8)水平。结果:三组成功率均为100%,奥齿泰组、威高组术后1年、2年的MBL值高于士卓曼组(P<0.05),士卓曼组术后龈沟液中IL-1β和TNFα及MMP-8低于奥齿泰组、威高组(P<0.05),其中MMP-8水平差异更显著(P<0.01)。结论:士卓曼组边缘骨吸收及种植体周围龈沟液中生物标志物水平低于其他两组,提示在种植体周围炎发生方面存在更低风险,可能取得更好的长期种植稳定性。     

Tissue reaction after implantation of Spongostan,as the carrier of xenogenic bone morphogenetic protein. Experimental study

Reconstruction or filling of bone defects, especially in the maxillofacial region, often requires use of biomaterials. An implant should fasten healing of the bone gap or it should replace autogenic bone grafts. The combination of bone morphogenetic proteins with suitable carrier may fulfill these requirements. Proteins causing differentiation of mesenchymal cells in chondroblasts and osteoblasts were called Bone Morphogenetic Proteins--BMPs. The authors extracted BMP from bovine bones and placed it into collagen carrier formed from generally accessible hemostatic sponge--Spongostan. The implants were grafted into rat femoral muscle pouches in order to trace the tissue response. Pathologic examinations were performed 3, 6 and 8 weeks after implantation. On the basis on macroscopic and microscopic examinations it was stated that collagen sponge speckled with BMP caused minimal tissue response and evolved characteristic thin connective tissue capsule formation around the implant. The connective tissue penetrated spongious structure of the implant, filling the spaces, which became growing due to sponge resorption. Characteristic hyalinization and sparse chondroblasts were visible 8 weeks after implantation.     

Comparison of immediate and delayed implantation using the square-threaded and resorbable-blasted-media-treated surface implant system

A variety of dental implant systems are now available that optimize bone-to-implant contact. The present study was performed to compare the outcomes, by measuring peri-implant osseointegration, following immediate and delayed insertion of square-threaded and resorbable-blasted-media (RBM)-treated surface implants in the dog's mandible. Three dogs were used and four implants were inserted in each dog. All implants were used for histological and histomorphometrical evaluations. The contact lengths and osseointegrated areas following immediate implantation were 74.99% and 56.08%, and those following delayed implantation were 78.22% and 66.08%, respectively. The implantation method in dogs using the square-threaded and RBM treated surface implant system achieved higher percentages of osseointegration than previously reported and the two implantation techniques did not differentially influence osseointegration. Thus, immediate implantation of this implant system, which minimizes the number of surgical procedures, is an optimal clinical method to replace extracted teeth in dogs.     

The preliminary evaluation of HAP + TCP composite material biodegradation after implantation in muscular tissue of rats

Ceramic biomaterials based on calcium phosphates have a special position among modern implantation material in osteosurgery. Non-reabsorbable hydroxyapatite (HAP) and reabsorbable tricalcium phosphate are the most popular calcium phosphate ceramics. The appropriate ratio of these two compounds should result in forming the gradually reabsorbable implants, overgrowing with the bone tissue which mechanical strength should not be negatively affected. The aim of this work was to evaluate a local tissue reaction and the HAP + TCP composite resorption rate as compared with HAP, after implantation in a muscle tissue of rats. On the basis of carried macroscopic and microscopic evaluations, it can be stated that the new HAP + TCP composite had high biocompatibility and were gradually reabsorbed. This enables faster overgrowing the implant with tissue.