牙种植体即刻种植的实验研究

为了研究即刻人工种植体的愈合，作者应用ＩＴＩ系列的螺钉型种植体植入成犬的拨牙窝内进行了观察。实验分两组进行，一组植入种植体，另一组植入种植体后，再植入骨松质，观察期分别为１、３个月。结果发现：种体植入后１个月有显著的新骨形成，有骨松质植入的标本上骨量明显增多。３个月的标本上，新生骨已成熟，骨量有所减少，有骨松质植入的标本与无骨松质植入的标本无明显差别。     

临时种植体即刻负载在半颌即刻种植中的应用

目的：评价临时种植体即刻负载在半颌即刻种植中的应用效果。方法：20例半颌即刻种植患者行136枚即刻种植体植入,采用95枚临时种植体即刻负载恢复患者牙列。3-6月后行固定修复。结果：即刻负载临时种植体和即刻种植体成功率达100%。结论：临时种植体即刻负载半颌即刻种植是很好的临床方法。     

带种植体的不脱钙骨块切片组织学观察——新型骨代用材料在即刻种植中的应用实验研究

作者应用带牙种植体的不脱钙骨块切片进行组织学观察,直接观察到种植体—骨组织界面,在为人工种植牙即刻种植选择适合的骨代用材料的研究中,提供可靠的依据,得出以磷酸三钙为主的复合材料优于以羟基磷灰石为主的复合材料这一结论,证实这种实验方法可以获得脱钙切片无法获得的信息。     

即刻种植的动物实验研究

目的 探讨更加完善成熟的即刻种植技术和方法。方法 在拔除狗的下颌双尖牙的同时,必植入人工种植体,并在牙种植体和拔牙窝间填塞自制的ＨＡ－ｒｈＢＭＰ２－ＦＳ复合材料。以正常牙齿周围牙槽骨作对照,通过Ｘ线及组织学方法观察不同时期和种植部位骨缺损的修复及骨整合情况。并用图像分析技术分析种植界面处新骨形成量。结果 植入复合人工骨后,种植体４～８周时骨缺损修复基本完成,种植体骨整合形成,１２周时已形成坚实的骨     

改良式引导骨再生术+即刻修复技术在上前牙即刻种植中的应用评价

目的评估一种改良式引导骨再生术(guided bone regeneration,GBR)+即刻修复技术在上前牙即刻种植中的应用效果,特别是美学效果,并探讨其临床技巧及美学影响因素。方法选择15例单颗上前牙进行即刻种植,微创拔牙后即刻植入Replace、Straumann或Ankylos种植体共15枚,采用改良式GBR+即刻修复,均于2 h内完成临时修复。4⁶个月后完成最终修复。种植修复完成后随访66个月后完成最终修复。种植修复完成后随访6²4个月,观察种植体周围软硬组织情况,统计种植义齿存留率、种植修复体与相邻天然牙唇侧牙龈的协调性和患者主观满意度。结果在观察期内,15枚种植体均获得了良好的骨结合,无松动,未见病理性骨吸收,存留率为100%;12枚种植修复体唇侧龈缘位置与邻牙协调无差异,3枚轻度差异;14枚种植修复体与邻牙牙龈颜色质地协调无差异,1枚轻度差异。患者主观满意度VAS平均值为92。结论改良式GBR+即刻修复技术在上前牙即刻种植中,有助于获得理想的前牙美学效果,缩短治疗周期。     

骨融合式牙种植体即刻种植的研究进展

骨融合式牙种植体是目前修复牙列缺失的理想方法，被誉为人类第三副牙齿。按种植方式分为即刻种植和延期种植两种。本文综述了国内外关于即刻种植研究的最新进展，包括引导骨再生术（ｇｕｉｄｅｄ ｔｉｓｓｕｅ ｒｅｇｅｎｅｒａｔｉｏｎ，ＧＴＲ）的应用，植骨材料的选择和促骨生长因子的应用等，并讨论了即刻种植的可行民生及存在的问题。     

骨融合式牙种植体即刻种植的临床应用

骨融合式牙种植体按种植方式分为即刻种植与延期种植两种，该文对即刻种植的优点，适应证及种植技术所取得的主要进展进行了综述，并讨论了影响即刻种植成功的因素和研究方向。     

膜引导骨再生技术在即刻牙种植中的临床研究

目的：评价膜引导骨再生（GBR）技术在即刻牙牙种植术中的临床效果。方法：132例即刻植入BLB、Branemark、ITI及Frinlit-2四种种植系统共193个，对其进行定期临床和放射学检查。结果：193例即刻种植体中124个行GBR技术，经12个月以上观察，失败4个。结论：只要种植体取得初期稳定性，对种植体与拔牙窝间存在的间隙，采用膜引导再生技术处理，即刻种植可以取得良好的临床效果。即刻植入种植体同时常常需要使用GBR技术。采用即刻植入技术同时使用GBR技术的病例，其临床效果令人满意。GBR技术用于即刻种植所产生的临床效果良好。     

PRP与骨替代品材料复合对即刻种植牙周围骨再生影响的实验研究

目的：比较PRP复合骨替代品（Bi-oss）与单纯使用骨替代品对即刻种植牙周围骨再生过程的影响。方法：选择12只健康杂种犬，在实验动物的双侧上颌骨侧切牙即刻拔除并进行了种植窝预备的部位植入BLB牙种植体，左侧窝内放置PRP与骨替代品生物材料，右侧仅放置骨替代品。于术后4、8、12周分别将动物处死获取标本，置于显微镜下观察并进行BIC的测量、分析。结果：术后4、8周，实验组较对照组BIC有显著行差异，且实验组BIC较对照组明显增高，术后12周时，两组BIC无显著行差异。结论：使用PRP复合骨替代品比单纯使用骨替代品在术后4、8周对即刻种植牙周骨修复、重建有显著促进作用。     

A model to evaluate bone substitutes for immediate implant placement

A calcified alloplast was evaluated as a gap-filling material around implants placed immediately into fresh extraction sockets. Periodontal measurements and computed tomography scans were obtained to evaluate the clinical effectiveness of the alloplast when compared with demineralized freeze-dried bone. To determine whether this alloplast would be a suitable grafting material, 14 patients were selected to evaluate the extraction socket as a model for routine histologic confirmation of the efficacy and biocompatibility of bone substitutes. The results of this study showed the following: (1) human extraction sockets can be models for the study of bone/implant interaction; (2) the alloplast was well tolerated and demonstrated no inflammation through histologic evaluation of core biopsies; (3) the alloplast was a suitable material when used as a gap-filling graft in sockets around immediately placed implants; and (4) dental computed tomography scans and periodontal measurements around grafted implants 6 months after the procedure provide valuable clinical information about graft healing and osteointegration.     

Finite element analysis of different bone substitutes in the bone defects around dental implants

PURPOSE: To evaluate the distribution of stress and strain for the evaluation of implant and graft stability at each stage before stabilization of the graft is achieved after implantation was performed. MATERIALS AND METHODS: Dembone (Pacific Coast Tissue Bank, Los Angeles, CA), Bio-Oss (Geistlich Pharma, Wolhusen, Switzerland), particulate dentin, and plaster of Paris were used to fill bone defects. The distribution of stress was compared in the mandible and maxilla, between vertical load and load applied at 30 degrees angle, and according to time, with 3 different graft materials. RESULTS: Stress occurred more when it was applied at an angle, rather than applied vertically. Stress was relatively high immediately after implantation, and particulate dentin-plaster of Paris showed larger mechanical properties and lower stress distribution overall. The largest stress distribution was shown when stress was applied at an angle when demineralized freeze-dried bone was used. The pattern of stress distribution was different according to differences in the mechanical properties of implants. CONCLUSION: Caution is needed not to apply stress at an angle immediately after implantation. Differences of stress were reduced with time as the implant became stabilized.     

The immediate dental implant

Numerous clinical studies have shown that dental implants can be placed immediately in extraction sockets with success when sites are carefully selected. Dental implants have been placed at the time of extraction with a variety of techniques. All the techniques report survival rates of 94 percent to 100 percent over a varied healing period of three months to approximately seven years. this article will review clinical criteria for determining patient selection for immediate implants and the advantages and disadvantages of immediate implant placement.     

即刻种植与即刻修复的临床应用

目的 探讨即刻种植与即刻修复的临床运用原则，并初步评价临床疗效。方法 14例患者共37个牙位在拔牙同时植入了种植体，其中6例共14个牙位即刻种植后又行即刻修复。平均4个月后进行Ⅱ期手术和最终修复。修复后平均追踪观察时间为22个月。结果 除1例2枚种植体于即刻种植并即刻修复后3周松脱外，其余病例自修复完成至最后一次复查，临床效果良好，4年累积存活率达到94．6％。结论在适当选择病例的情况下，即刻种植与即刻修复可成功应用于临床，并获得较高的存活率。     

e-PTFE膜联合Bio-oss骨代材料在种植手术中引导骨再生的应用研究

目的：评价e-PTFE膜联合Bio-oss骨代材料在种植手术中引导骨再生的临床效果.方法：43例需要行引导骨再生的种植病例,随机分为实验组和对照组,实验组采用e-PTFE膜与Bio-oss骨代材料联合行骨再生,对照组仅采用Bio-oss骨代材料,12个月后检测比较两种手术方式水平向和垂直向骨增量的效果.结果：骨增量术后两组病例手术切口均甲级愈合,植骨厚度和植骨高度两组病例无统计学差异（P＞0.05）,而成骨厚度、成骨高度,水平向、垂直向骨生长效果两组间有统计学差异（P＜0.05）,实验组显著高于对照组.结论：联合应用e-PTFE钛加强膜和Bio-oss骨代材料在种植引导骨再生中能获得较大的水平向和垂直向的骨增量.     

即刻骨移植与延期牙种植术联合应用修复牙槽骨缺损的初步研究

目的:探讨即刻骨移植与延期牙种植术联合应用修复外伤性上颌前牙区唇侧牙槽骨及牙列缺损的效果.方法:选择16例因各种外伤引起的上颌前牙区牙槽骨唇侧部分缺损及部分上前牙缺失患者.在清创缝合伤口的同时,切取大小合适的自体颅骨外板或颏部骨板,移植到骨缺损部位,钛钉固定.严密缝合牙龈及黏骨膜组织,并在12周后植入ITI SLA种植体42颗.种植体植入后12周,用金属烤瓷牙做固定修复.另选22例患者共50颗采用标准种植手术且无需植骨的ITI SLA种植体作为对照组,于种植体植入后不同时间点,采用无线共振频率分析仪测定2组患者的种植体稳定值(ISQ),应用SPSS13.0软件包对实验组与对照组的ISQ值进行配对t检验.结果:16例患者软组织伤口均一期愈合,黏膜及牙龈组织形态良好,牙槽骨丰满,牙槽弓弧度满意.义齿修复后形态及功能良好.2组种植体在0,4、12、52周时ISQ均值差异比较,其P值分别为为0.82、0.85、0.96和0.89.结论:外伤引起的上颌前牙区牙槽骨唇侧部分缺损,在清创缝合伤口的同期进行自体骨移植,再延期采用种植义齿修复,可以缩短疗程,减少手术次数,获得良好的修复效果.     

The immediate loading of dental implants

The aim of this article is to identify current opportunities for the immediate loading of endosseous dental implants. A biologic basis for the clinical parameters associated with success and failure of immediately loaded implants is presented, and select clinical situations where immediate loading is presently advocated will be illustrated. The wide-ranging applications of the immediate-loading concept for endosseous dental implants will be introduced; however, further experimental validation is necessary before incorporating all of these various expedited therapeutic approaches into practice.