螺丝固位一体化基台冠在后牙单冠种植修复中的应用

目的探讨螺丝固位一体化基台冠修复方法在后牙单冠种植修复中的应用并评价其临床效果。方法选取632例后牙单颗种植体,3～6个月后以螺丝固位的氧化锆一体化基台冠完成修复,修复后1年对修复效果进行临床评估。结果 632例后牙单冠种植修复体的改良出血指数记分为0、1、2、3级者分别为411例(65%)、208例(33%)、13例(2%)、0例(0%)。基台松动率0%,修复体松动率0%,种植体存留率100%。结论同时具备高强度、良好固位力、零粘接剂残留、低种植体周围炎反应的螺丝固位一体化基台冠是一种值得推广的种植修复方式。     

插销式分体桩冠修复[牙合]龈距离过短的磨牙残冠疗效

目的探讨插销式分体桩冠修复[牙合]龈距离过短的磨牙残冠的临床效果。方法30颗[牙合]龈距离过短的磨牙残冠进行插销式分体桩冠修复。用硅橡胶取模,取其接近牙长轴方向的根管作为主桩制作桩核冠,分叉较大的根管制作插销,插入冠部预留的孔道辅助固位。结果30颗磨牙残冠修复体经24个月随访观察,固位稳定。除1例出现轻度牙龈炎,1例插销封闭树脂脱落外,其余的修复体边缘密合,无明显牙龈炎,咀嚼功能正常,无明眵松动。患牙咀嚼有力、感觉舒适、无不良反应。结论插销式分体桩冠修复[牙合]龈距离过短的磨牙残冠能获得良好的固位及烤瓷冠美观效果,但远期效果需进一步观察。     

嵌体冠修复龈牙合径短183牙

根管治疗后，牙体脆性增大，为了防止牙折，常采用铸造全冠保护患牙。临床上经常见到龈[牙合]径过短，固位困难，又不接受牙冠延长术的患者。我诊所近年来对113例龈[牙合]径在2—3mm的磨牙进行修复，经过3—5年的观察，取得了较为理想的效果。     

螺丝固位个性化烤瓷基台结合Ⅲ型瓷贴面修复单颗缺失牙

一名24岁白人男性患者两年多前右下颌侧切牙因车祸致脱位，复位处理失败后拔除，邻近的中切牙因牙髓坏死行根管治疗术。检查：缺牙区颊舌侧牙槽骨凹陷，缺牙间隙减小。为解决本病例修复间隙小、固位螺丝通道与切缘成角度和种植体龈下肩台等美学修复难题，特采用螺丝固位的个别制作的金一瓷基台一金瓷贴面粘接技术等方法修复缺失牙。     

Braenemark种植系统多牙基台的临床应用：37例报道

目的：评价Braenemark种植系统多牙基台用于连续多牙缺失种植修复的效果与优点。方法：对37例连续多牙缺失患者，常规l临床检查，曲面体层与根尖片分析，制作外科导板，应用常规种植外科手术方法植入117个Braenemark种植系统标准和MKⅢ种植体，3～6个月行二期手术后，应用多牙基台进行上部结构贵金属烤瓷桥体修复。结果：二期手术时有2个种植体松动、脱落，一期成功率98．29%。修复完成后随访12～24个月，2例患者3个种植体松动、脱落，其他112个种植体无脱落，也无明显种植体周围骨吸收，无基台及金柱螺丝松动，但有3个桥体小部分烤瓷崩瓷，二期成功率97．43%总成功率为95．7％。结论：多牙基台在集所有传统多牙修复基台的优点基础上进一步优化设计，不仅扩大了临床适用范围、简化了操作程序，而且增强了上部整体结构的性能，多牙基台较适合连续多牙缺失的种植修复，成功率高，且较传统多牙基台有一定优越性。     

(牙合)龈高度对全冠固位的影响

目的：通过测定不同[牙合]龈高度牙体模型上全冠的固位力,探讨后牙全冠修复获得理想固位的合适牙体高度.方法：制作底部直径7 mm,轴聚角5°,高度分别为1 mm、2 mm、3 mm、4 mm、5 mm、6 mm的离体牙模型6组,每组6个.用滴蜡法在每个模型上制作金属全冠,全冠用磷酸锌水门汀粘固,应用万能电子拉力实验机进行冠固位力测定.结果：轴聚角5°,胎龈高度为1、2、3、4、5、6 mm的各组平均冠固位力分别为84.25 N、116.67 N、183.00 N、268.58 N、360.92 N、448.25 N.不同高度的牙体冠固位力之间有显著差异.结论：全冠固位力与（牙合）龈高度成正比,当内聚角为5°,冠高度小于3 mm时,冠固位力不能满足临床需要.     

Brnemark种植系统多牙基台的临床应用:37例报道

目的:评价Br覿nem ark种植系统多牙基台用于连续多牙缺失种植修复的效果与优点。方法:对37例连续多牙缺失患者,常规临床检查,曲面体层与根尖片分析,制作外科导板,应用常规种植外科手术方法植入117个Br覿nem ark种植系统标准和M KШ种植体,3～6个月行二期手术后,应用多牙基台进行上部结构贵金属烤瓷桥体修复。结果:二期手术时有2个种植体松动、脱落,一期成功率98.29%。修复完成后随访12～24个月,2例患者3个种植体松动、脱落,其他112个种植体无脱落,也无明显种植体周围骨吸收,无基台及金柱螺丝松动,但有3个桥体小部分烤瓷崩瓷,二期成功率97.43%,总成功率为95.7%。结论:多牙基台在集所有传统多牙修复基台的优点基础上进一步优化设计,不仅扩大了临床适用范围、简化了操作程序,而且增强了上部整体结构的性能,多牙基台较适合连续多牙缺失的种植修复,成功率高,且较传统多牙基台有一定优越性。     

利用预成帽自制个性化基台修复BLB种植系统的效果

目的:BLB种植系统因其相对低廉的价格易为广大患者所接受,但由于其基台种类的局限性,对于植入体长轴方向不甚理想,偏向人工牙冠的唇(颊)侧,以及多牙种植时,种植体长轴互不平行,角度大于15度时,难于修复,笔者利用预成帽进行调改,铸造而成的个性化基台,修复病例24例,经过6-36个月的随访观察,取得了满意效果。方法:选取我院2007年以来BLB系统种植术后金属烤瓷修复病例24例(种植体植入后观察3个月无种植体周围炎等并发症),其中植入体长轴方向偏向人工牙冠唇(颊)侧单牙修复病例16例,植入体长轴方向互不平行,角度大于15度的多牙修复病例8例。常规制取种植体转移印模,灌制硬石膏模型,选择适当型号的单牙螺栓固位基台紧固到种植体代型上进行修复帽外形的调整,在保证基台固位力与强度的情况下为修复体创造足够的空间,顺畅的就位道以及合适的颈部肩台边缘[1],单牙修复病例注意须有抗旋措施,多牙修复病例需在平行研磨仪上磨取共同就位道。将磨改好的预成帽进行包埋,铸造,打磨,抛光形成个性化基台,常规进行义齿修复制作,完成后试戴,调磨,粘接。效果:24例病例随访观察6-36个月,除一例饰瓷脱落外,其余修复体均正常。修复体形状,颜色与邻牙相协调,冠颈缘密合度良好,近远中邻接关系正常,龈周组织正常,修复成功率为97%。结论:对于基台品种较为单一的BLB种植系统,当植入体长轴方向不甚理想时,采用预成帽自制个性化基台修复,能实现最大限度的美观,功能和稳定,提高修复效果。     

Br(a)nemark种植系统多牙基台的临床应用:37例报道

目的:评价Br(a)nemark种植系统多牙基台用于连续多牙缺失种植修复的效果与优点.方法:对37例连续多牙缺失患者,常规临床检查,曲面体层与根尖片分析,制作外科导板,应用常规种植外科手术方法植入117个Br(a)nemark种植系统标准和MKⅢ种植体,3～6个月行二期手术后,应用多牙基台进行上部结构贵金属烤瓷桥体修复.结果:二期手术时有2个种植体松动、脱落,一期成功率98.29%.修复完成后随访12～24个月,2例患者3个种植体松动、脱落,其他112个种植体无脱落,也无明显种植体周围骨吸收,无基台及金柱螺丝松动,但有3个桥体小部分烤瓷崩瓷,二期成功率97.43%,总成功率为95.7%.结论:多牙基台在集所有传统多牙修复基台的优点基础上进一步优化设计,不仅扩大了临床适用范围、简化了操作程序,而且增强了上部整体结构的性能,多牙基台较适合连续多牙缺失的种植修复,成功率高,且较传统多牙基台有一定优越性.     

后牙种植CAD/CAM螺丝固位上部结构修复临床效果的初步观察

目的：探讨后牙种植CAD/CAM螺丝固位上部结构修复方法在后牙种植病例中的应用以及对其临床应用效果进行评价。方法：选取到四川大学华西口腔医院种植中心就诊的后牙种植术后病例11例,植入种植体18颗。植入缺牙区的种植体为ITI种植系统、 Noble种植系统,植入植体后3-6个月取模、灌制超硬石膏模型,选用Tibase基台或Tibase-全瓷基台、 CAD/CAM制作威兰德氧化锆全瓷冠,均采用牙冠面开孔螺丝固位修复方式,1-2年后复查,并对修复效果进行评价。结果：经1-2年随访观察,全冠的形状与邻牙相协调,全冠修复体未见明显磨耗,面螺丝孔开口处未见崩瓷现象,牙冠边缘与基台密合度良好,近远中邻接面接触关系正常,种植周围组织正常,未见有牙冠与中央螺丝松动,其中有1颗牙冠与基台分离、1颗牙龈萎缩暴露金属,修复两年成功率为16/18,效果满意。结论：个性化牙冠在后牙种植修复中的临床应用效果良好,是后牙种植义齿修复选择的一种好方法。     

侧方螺丝固位在粘结基台种植修复中的应用

目的:针对旋入式基台种植修复中的基台短小、固位不佳等问题,采用侧向螺丝进行固位种植修复咬距离不足患者的牙列缺损。方法:12例后牙缺失、咬距离不足(3～5)mm患者,其中,男4例,女8例,均采用侧方螺丝固位,1年后评价修复效果。结果:12例患者均成功修复,获得了满意的临床效果。结论:侧方螺丝固位较之其它方法可操作性好,固位良好,损伤小、治疗周期短,不失为一新的尝试。     

冲击载荷下骨外段种植基桩不同高度对下颌覆盖总义齿应力分布的影响

目的 分析骨外段种植基桩高度不同对下颌种植覆盖总义齿应力分布的影响。方法 应用ＣＴ扫描法建立下颌种植覆盖总义齿三维有限元模型,分析冲击载荷下骨外段种植基桩高度不同对下颌种植覆盖总义齿应力分布的影响。结果 随种植基桩高度的降低,种植体内部及种植体软硬组织界面应力分布更为均匀。结论 在保证义齿固位稳定的前提下,在一定范围内降低种植体骨外段基桩高度有利于保护种植体及其周围软硬组织健康。     

A technique for repairing a loosening abutment screw for a cement-retained implant prosthesis

Prostheses may be attached to implants or implant abutments using screw retention or cementation. With the increased use of cement-retained, implant-supported restorations for the replacement of missing teeth, clinicians may choose to use a definitive cement to lute the definitive restoration. Loosening of an abutment screw is a challenging complication of cement-retained, implant-supported prosthetic restorations. Often, the abutment screw becomes loose from the implant body, whereas the crown remains cemented to the abutment. In such situations, separating the cemented crown from the underlying abutment or locating the abutment-screw access for removal of the restoration is a difficult task. The purpose of this report is to describe a simple technique for locating the abutment-screw access in the event of its loosening. The advantage of this technique is that it can facilitate easy location of the abutment screw, thus minimizing damage to the existing restoration and allowing it to be reused.     

Prosthetic outcome of cement-retained implant-supported fixed dental restorations: a systematic review

The aim of the article is to assess the current literature in terms of the prosthetic outcome of cement-retained implant-supported fixed restorations, as well as to determine the type of cement that can be recommended for clinical application. A review of the literature published up to May 2010 was conducted to identify clinical studies about cement-retained implant-supported fixed restorations. The search strategy applied was a combination of MeSH terms and free text words, including the following keywords: implants, implant-supported fixed dental prostheses (FDPs), bridges, implant-supported single crowns (SCs), cement-retained, cement fixation, cement, cementation, cement failure, retention, and loss of retention, technical complications, mechanical complications, prosthetic complication, retrievability and maintenance. Thirty-two studies met the inclusion criteria. The studies were divided into two categories: 15 short-term clinical studies with an observation period of less than 5 years, and 17 long-term clinical studies with an observation period of 5 years and more. The most common technical complications of cement-retained implant-supported fixed restorations were loss of retention, chipping and abutment screw loosening. The results of the current review revealed no guidelines about cement or cementation procedures. It may be stated that despite the questionable retrievability of cement-retained implant-supported fixed restorations, this treatment modality is a reliable and effective option, especially for implant-supported SCs and short-span FDPs. The literature does not provide accurate information about the clinical outcome of cement-retained implant-supported fixed restorations nor about the ideal type of cement that facilitates stability and maintains retrievability. Standardised randomised clinical trials will provide valuable information to this issue.     

瓷基台和钛基台用于种植体支持全瓷单冠修复的临床观察

目的观察瓷基台和钛基台用于种植体支持全瓷单冠修复的美观效果以及两者对种植体周围软硬组织的影响。方法19例单颗上颌前牙缺失患者，分为瓷基台组（8例）和钛基台组（11例），行种植体支持全瓷单冠修复，随访观察2年，用改良的美国公共卫生署（United States Public Health Service，USPHS）标准评价两者的美观效果，并在修复后6、12、18和24个月测量种植体周围牙龈出血指数和骨吸收量，所得数据进行秩和检验和方差分析。结果在随访期间内未发现全瓷冠和钛基台折断，1例瓷基台在修复后15个月折断。瓷基台组和钛基台组达到USPHS标准A级的分别为8例和10例，差异无统计学意义（P〉0.05）。种植体周围牙龈组织颜色正常，无炎性反应，瓷基台和钛基台修复2年后种植体周围骨吸收量分别为0.70mm和0.77mm。统计学分析表明，瓷基台组和钛基台组两组间，以及同种基台修复后不同时间的牙龈出血指数和骨吸收量差异均无统计学意义（P〉0.05）。结论瓷基台和钛基台用于种植体支持全瓷单冠修复可取得理想的美观效果，两者均对种植体周围软硬组织无明显的不良影响。     

An esthetic solution for single-implant restorations - type III porcelain veneer bonded to a screw-retained custom abutment: a clinical report

A new esthetic solution to restore dental implants in combination with limited interdental, facial or labial, or interocclusal space is presented. This article describes the translational application of novel-design porcelain veneers and adhesive restorative principles in the implant realm. A patient is presented who was treated with a single implant-supported restoration replacing a missing mandibular lateral incisor and partially collapsed interdental space. A screw-retained custom metal ceramic abutment was combined with a bonded porcelain restoration. This unique design was motivated by the limited restorative space and subgingival implant shoulder. It was also developed as a solution to the interference of the screw-access channel with the incisal edge, therefore providing the surgeon with more options during implant axis selection. The porcelain-to-porcelain adhesive approach was used instead of traditional principles of retention and resistance form of the abutment.     

角度螺丝通道基台在上颌切牙种植修复的临床应用

目的:评估应用角度螺丝通道基台种植修复上颌切牙的临床效果。方法:临床选择2015年12月前使用角度螺丝通道基台行上颌切牙种植修复15例。随访6个月,观察方法为X线片、临床检查及患者满意度调查,分析其存留率、骨吸收情况、软组织及美学效果。结果:使用角度螺丝通道基台的上颌切牙种植义齿存留率为100%;种植体近远中牙槽骨吸收量为(0.447±0.121)、(0.355±0.127) mm,软组织状况良好; 93.3%患者对种植修复表示满意。结论:使用角度螺丝通道基台行上颌切牙种植修复是一种微创、简洁的种植治疗方案设计,有一定的临床推广价值。     

A 4-Year Prospective Study to Assess Peri-Implant Hard and Soft Tissues Adjacent to Titanium Versus Gold-Alloy Abutments in Cemented Single Implant Crowns

PURPOSE: The purpose of this prospective clinical study was to compare titanium and gold-alloy abutments when used with cemented, implant-supported single-tooth crowns. For 4 years following prosthodontic rehabilitation, these abutments were evaluated with respect to peri-implant marginal bone levels and peri-implant soft tissue parameters. MATERIALS AND METHODS: During the years 1998 to 2000, 20 patients were selected from a patient population receiving treatment in the Implantology Department at the University of Padova, Italy. They all presented with single-tooth bilateral edentulous sites in the premolar/molar region with adequate bone width, similar bone height on each side, and an occlusal scheme that allowed for the establishment of identical occlusal cusp/fossa contacts on each side. Each subject received two identical implants (one in each edentulous site). One was randomly selected to be restored with a titanium abutment and a cemented implant-supported single-tooth crown, and the other was restored with a gold-alloy abutment and a cemented implant-supported single tooth crown. Data on peri-implant marginal bone levels and soft tissue parameters were collected for 4 years after abutment and crown insertion placement and analyzed to determine whether there was a significant (p< .001) difference with respect to the type of abutments (titanium vs. gold alloy) used. RESULTS: All subjects completed the study. All 40 implants survived, resulting in a cumulative implant success rate of 100%. Statistical analysis revealed no significant differences between the two groups with respect to peri-implant marginal bone levels and soft tissue parameters. CONCLUSIONS: Within the limitations of this study, the results indicate that there was no evidence of different response with the peri-implant marginal bone and soft tissue when titanium or gold-alloy abutments were used in conjunction with the cemented, single-tooth implant restorations provided for this limited patient population. There was no evidence of different behavior of peri-implant marginal bone and of peri-implant soft tissue when titanium abutments or gold-alloy abutments were used for cemented single-tooth implant restorations in this limited patient population.     

临床平台转移技术在上颌后牙区种植中的应用

目的：评价临床平台转移技术在上颌后牙区种植的效果。方法：选择60例上颌后牙种植患者随机分实验与对照组,共植入141枚种植体,植体肩部与牙槽嵴平齐。实验组30例选用小于植体直径的愈合基台（0.7mm）与种植体相连,重建种植区的结合上皮,上部结构（基台）精细研磨,重建无缝隙冠龈连接,精度贵金属烤瓷修复。对照组选用与植体直径相同的愈合基台与种植体相连,常规修复。分别于种植修复后3、6、12月测量上颌后牙种植体周围边缘骨高度和评价软组织情况。结果：实验组种植体周围边缘骨高度变化明显小于对照组（p〈0.01）,两组软组织情况变化不明显（p〉0.05）。结论：临床平台转移技术可保持种植体周围边缘骨高度,其远期效果可期。     

Single implant-supported molar and premolar crowns: a ten-year retrospective clinical report

Evidence of the successful use of osseointegrated dental implants for the restoration of individual teeth has been reported for anterior teeth more frequently than for posterior teeth. Contiguous implants placed in posterior quadrants are often splinted without clear rationale. This clinical report describes the data collected from the charts of patients provided with implant-supported single crowns in posterior quadrants in a prosthodontic practice in southern California. Forty-nine patients with 126 implants restored with molar or premolar crowns were recalled for examination after periods ranging from 6 months to 10 years. The implant failure rate was 4.6%, with complications of abutment screw loosening (7%) and loss of cement bond (22%). Osseointegrated implants in molar and premolar positions may be restored as single crowns.