磨牙区即刻种植的回顾性研究

目的:回顾性观察磨牙区即刻种植的临床效果。方法:对55例患者的55颗磨牙经微创拔牙后行即刻种植,采用多种外科技术如引导骨再生、骨劈开、骨挤压和经牙槽嵴上颌窦内提升术等进行骨增量,共植入直径为4.8mm的Straumman种植体24枚和5.5mm的Ankylosis种植体31枚。上磨牙区在种植体植入4~6月后进行修复,下磨牙区在种植体植入3~4月后进行修复。结果:55枚种植体,有1枚种植体在植入1个月时松动,其余种植体骨结合良好,成功率98.18%,修复后追踪4-52个月,功能正常。结论:磨牙区即刻种植是一种预后良好的治疗方法。     

磨牙即刻种植的研究进展

近年来,即刻种植因其可缩短治疗周期、简化治疗程序成为研究热点.多项研究表明磨牙即刻种植植体生存率较高,具有较高的可实施性.但磨牙区存在上颌窦及下牙槽神经等解剖结构,且磨牙拔牙窝比常规植体更宽,骨量不足等各种因素导致磨牙区的即刻种植获得初期稳定性较为困难,需要临床医生严阵以待.进行磨牙即刻种植首先应严格选择适应症,在拔除牙根时应谨慎处理,以保存完整的牙槽间隔从而获得良好的初期稳定性,上颌窦底的骨皮质也可为种植体提供良好的硬组织支持,同时植体植入时磨牙牙根可辅助植体定位.磨牙即刻种植时,翻瓣与否不会影响种植体的生存率、成功率及边缘骨吸收,并且牙槽窝内的反应性软组织可使角化龈的变化得到改善;对于植体植入后与拔牙窝之间的间隙内是否植入骨粉,众位学者众说纷纭,但无论植骨与否,均可获得良好的植体生存率.植体植入后,多数学者仍然建议磨牙即刻种植最好行常规负荷,常规负荷的时间一般为3-6个月.在前牙区根盾技术开展如火如茶的今天,磨牙区根盾技术也开始被研究,但仍建议有一定经验的临床医生进行操作.在本文中针对以上所述方面进行了展开叙述,为开展磨牙即刻种植的临床工作者们提供一定的参考.     

重度慢性牙周炎患者上颌磨牙区拔牙后即刻种植与位点保存术后延期种植短期疗效观察

目的:观察慢性重度牙周炎患者行系统性牙周治疗后上颌磨牙区拔牙后即刻种植和位点保存术后延期种植两种种植方式的短期临床疗效。方法:38例慢性重度牙周炎患者导致上颌后牙区牙齿保留无望,经过系统性牙周治疗及复查提示牙周状况良好后行种植治疗,共植入修复体49枚,其中即刻种植组23枚,位点保存术后延期种植组26枚,种植术后3~6个月行修复治疗。观察种植体留存情况及修复后种植体周围组织状况。结果:种植体脱落情况:即刻种植组2枚,延期种植组1枚,存留率分别为91.30%和96.15%。两组种植体种植修复后即刻及6月后复查的PD、BI、BOP(+)相比,差异均无统计学意义(P＞0.05);观察期内种植成功的种植体功能良好,种植体周围软组织健康状况良好。结论:慢性重度牙周炎患者经过完善的牙周系统治疗,在牙周状况良好的条件下,上颌后牙区拔牙后即刻种植和位点保存术后延期种植短期内临床效果相当。     

磨牙即刻种植的研究进展

随着口腔种植的不断发展与成熟,种植义齿已经成为缺牙修复的首选方案.根据种植的选择时机不同,可分为延期种植和即刻种植.若后者能保证与前者相当的成功率,则即刻种植能够相对减少手术程序、缩短缺牙时间等优点将具有更大的临床意义.然而由于磨牙区特殊的解剖结构及受力作用特点,给即刻种植带来了巨大的挑战.回顾相关文献,本文将从磨牙即...     

下颌磨牙即刻种植临床探讨

目的：介绍一种简单易行的下颌磨牙即刻种植方法并对其临床效果进行评估。方法：20颗下颌磨牙经微创拔牙后,不翻瓣植入特定形状的种植体和愈合基台,无须植入人工骨或覆盖胶原膜,种植体采用穿龈愈合方式。种植体植入3个月后常规印模,完成上部结构修复。种植体完成修复后随访3-24月。结果：所有的种植体均获得良好的骨结合,种植体周软硬组织保持完好,美学效果令人满意。随访期内所有种植牙正常行使功能。结论：下颌磨牙不翻瓣即刻种植方法简单易行,临床效果可靠,减少了手术次数,缩短了治疗时间,降低了治疗费用,值得临床推广。     

后牙即刻种植的临床观察

目的 :评价后牙即刻种植的方法、效果以及临床意义。方法 :对能满足即刻种植的20颗后牙经微创拔牙后,翻瓣或不翻瓣植入种植体,种植体周围植入骨粉,翻瓣者则覆盖生物膜。种植体植入3~6个月后常规取模,完成上部修复结构。种植体完成修复后随访6~34个月。结果:所有种植牙随访期间内正常行使功能,美学效果令人满意。CT示颊侧骨板骨吸收为(-0.65 mm±1.29 mm);近远中骨吸收为(1.23 mm±0.23 mm)。统计显示:即刻种植术前与术后龈乳头指数及种植体近远中骨吸收无明显差异,即刻种植后种植体颊向骨板吸收及种植体稳定系数与拔牙后牙槽嵴吸收有差异。结论:后牙即刻种植能有效维持种植体周围软硬组织的高度和宽度,对有即刻种植适应证的患者,可减少手术次数,缩短治疗时间,临床效果可靠。     

前牙区人工即刻种植27例临床观察

目的探讨口腔前牙区人工即刻种植的应用原则,初步评价其临床效果。方法采用Replace select、Ankylos、ITI、GS、Bicon五种种植系统植入前牙缺失区．共32枚,对其进行定期的临床和放射学检查。结果32枚即刻种植前牙种植体,2枚种植体失败,1枚弃用。结论人工即刻种植的临床方法可行,近期临床效果满意,修复美学效果佳,值得推广。     

上颌前牙区即刻种植临床疗效观察

目的：观察上颌前牙区即刻种植的临床效果。方法：对32例上颌前牙区因外伤、残根、或牙周炎致过松动牙拔除后行即刻种植,骨缺损部位行植骨手术,共植入种植体62枚,植入3-6个月后行二期手术,最终完成修复体制作。结果：本组共62枚种植体,61枚术后无明显并发症,1枚于术后4周失败拔除。修复完成后观察1-6年,种植体行使功能良好,取得较好的美学效果。结论：在上颌前牙区行即刻种植术有利于软硬组织保存,获得较好的美学效果。     

即刻种植与延期种植的回顾性临床研究

目的:研究即刻种植与延期种植骨结合种植体的临床成功率。方法:门诊牙种植病例104例,植入种植体114颗。其中即刻种植组48例,男27例,女21例,年龄47.1+1.9岁,植入56颗种植体;延期种植组56例,男33例,女23例,年龄46.7+1.9岁,植入58颗种植体。修复后1年随访,观察两组病例种植体保存率,牙龈美学评价,X线片骨吸收检查。结果:即刻种植组56颗种植体中1颗由于邻牙根尖周感染形成脓肿,2个月后种植体脱落,1颗因术中发现患牙拔除后无可利用的种植骨量,充填骨粉后完成种植手术,其余病例均愈合良好。术后1年随访,即刻种植组保存率96.4%,延期种植组保存率100%。结论:尽管即刻种植组的保存率低于延期种植组,但是缩短了患者的就诊时间和就诊次数,同样可以取得良好的功能与美学效果,具有很好的临床效果。     

基于CBCT的下颌第一磨牙区即刻种植相关的影像学研究

目的利用CBCT研究下颌第一磨牙区即刻种植适宜的植入位点、植入角度与植入深度,为术前数字化设计和临床操作提供参考依据。方法选取100例符合纳入标准的患者CBCT影像学资料,测量下颌第一磨牙区的牙槽骨厚度、颊侧及舌侧骨板厚度、牙根间隔宽度,同时测量下颌第一磨牙与下颌神经管及舌侧骨倒凹的关系,并进行统计学分析。结果由近中至远中,下颌第一磨牙的牙槽骨厚度及颊侧骨板厚度逐渐增大,舌侧骨板厚度逐渐减小;由牙槽嵴顶至根尖,牙根间隔宽度逐渐增大,最大为(5.00±1.42)mm;近中根、远中根、远舌根、牙根间隔顶至下颌神经管的距离分别为(7.47±2.38)mm、(7.19±2.49)mm、(9.59±1.94)mm、(15.90±2.39)mm;由近中至远中,下颌神经管颊侧及舌侧骨板最大厚度分别为(6.54±1.25)mm、(2.53±0.84)mm;下颌舌侧骨倒凹角度为(149.67±8.30)°,倒凹深度为(1.51±0.43)mm。结论在下颌第一磨牙区即刻种植前可通过CBCT规划合适的种植路径,注意避开下颌神经管和舌侧骨倒凹。若根尖至下颌神经管的安全距离足够,可从牙根间隔处植入,若安全距离不足,植入位点可偏近中舌侧,植入角度可适当舌倾。     

即刻种植技术的临床应用

目的:探讨即刻种植技术的临床应用,并对近期效果进行评价。方法:30例患者,62枚种植体,拔除患牙同时植入Camlog系统的牙种植体。前牙区36枚,前磨牙区18枚,磨牙区8枚,其中位于前牙区的6例患者12枚植体进行了即刻负重修复。所有永久修复均在术后3-6个月进行,并定期复诊。观察时间为4-49个月(平均28个月)。结果:有2例位于后牙区的3颗植体在术后2-4周内因松动拔除。其余病例临床效果良好。种植体累积留存率为95.2%。结论:在掌握适应症的情况下,即刻拔牙即刻种植乃至即刻负重,可以取得良好的临床效果。     

即刻种植早期修复的临床研究

目的探讨即刻种植早期修复的临床应用原则和疗效。方法8例患者共11颗患牙在拔牙同时植入Xive种植体,立即取印模制作临时牙冠,7d后拆线并戴临时塑料牙冠。根据骨质情况4~6个月后行永久修复。追踪12~24个月,观察临床效果。结果11颗种植体修复成功。结论适当的病例选择,规范化的手术操作,掌握早期修复的临床要点,即刻种植早期修复可以获得较高的成功率。     

前牙区延期即刻牙种植术的临床应用研究

目的：评价前牙区延期即刻种植的技术特点及近期临床效果.方法：对36例患者前牙区患牙拔除4～6周后,植入Frialit-2及Xive两种种植系统共53枚种植体,4～6个月后行二期手术,暴露种植体,最终完成烤瓷牙冠修复.结果：术后无明显并发症发生,修复完成后观察6～32个月,种植体行使功能良好,无种植体丧失.结论：延期即刻种植的临床方法可行,近期临床效果满意,修复美学效果佳.     

种植体设计对即刻种植与即刻负荷成功的影响

即刻种植和即刻负荷成功的关键是种植体的初期稳定性,除了宿主因素和医源因素外,影响初期稳定性的关键是种植体的设计。本文就目前种植体的尺寸、外形、表面处理对种植体即刻种植和即刻负荷成功影响的研究进展作一综述。     

Maxillary Sinus Augmentation with Autologous and Heterologous Bone Graft: A Clinical and Radiographic Report of Immediate and Delayed Implant Placement

Purpose

The aim of this study was to evaluate cumulative survival rate of implants placed on augmented maxillary sinus using a mixture of autologous bone harvested from the maxillary tuberosity and bovine-derived HA and to assess the height of the grafted material through radiographic evaluation.

Methods

Thirty-five patients were treated with maxillary sinus augmentation and 93 implant fixtures were installed. The height of the augmented sinus and the gain of bone volume were measured by Cone Beam CT Scan and intraoral radiographs immediately after augmentation and up to 48 months subsequently. Changes in the height of the sinus graft material were calculated radiographically.

Results

The cumulative survival rate was 98.92 % in all 93 implants. Additionally, normal healing process without any complication was observed in all patients. The original sinus height was a mean of 4.52 mm (range 2.0–6.4 mm) and the augmented sinus height was a mean of 14.1 mm (range 12.0–16.5 mm) after the surgery. The bone volume gain was a mean 9.613 mm (range 7–13 mm).

Conclusions

Within the limitations of this study, it would appear from the clinical and radiographic results that the sinus lift procedure with autologous bone graft harvested from the maxillary tuberosity combined with deproteinized bovine bone allows for a predictable outcome regarding the amount of bone formation in sinus floor augmentation and the immediate placement of implants, when possible, is recommended.     

An Interdisciplinary Treatment Approach Combining Orthodontic Forced Eruption with Immediate Implant Placement to Achieve a Satisfactory Treatment Outcome: A Case Report

Background: Periodontal disease often results in severely bony defects around the teeth and leads to eventual extraction. Remaining bone morphology often compromises ideally restoration‐driven positions and deteriorates the success rates for dental implants. Purpose: The present investigation illustrates the clinical outcome of immediately installing an implant following orthodontic forced eruption and atraumatic extraction. Material and Methods: The subject of this study is a 40‐year‐old Asian female with a right mandibular first molar that had a deep probing depth on the mesial side and mobility. Via the aid of radiographic examination, the tooth that had an angular bony defect and apical lesion was diagnosed as having deep caries and chronic periodontitis with a poor prognosis. After consultation with the patient, we developed a treatment plan incorporating a forced eruption with immediate implantation, intended to augment the alveolar bone volume and increase the width of keratinized gingivae, in a nonsurgical manner. Results: Following 12 months of orthodontic treatment, the tooth was successfully moved occlusally in conjunction with an 8 mm vertical interdental bone augmentation. Because of sufficient volume of bone and satisfactory gingival dimensions, the implant showed adequate initial stability in the correct position to facilitate physiological and aesthetic prerequisites. After 6 months of ossteointegration, a customized impression coping was utilized to transfer the established emergence profile to a definitive cast for the fabrication of a customized abutment. The final prosthesis was made using a customized metal abutment and ceramometal crown. Conclusion: In the face of difficult clinical challenges, meticulous inspection and a comprehensive treatment plan were crucial. Interdisciplinary treatment through the careful integration of multiple specialists suggests the possibility of optimal results with high predictability.