种植磁附着体在义耳修复中的应用

本文介绍了用于颅面部的种植磁附着体及其在义耳修复中的应用技术、固位效果和存在问题。作者认为，加用对抗侧向力的措施，将使种植磁附着体获得更好的固位效果。采用二次植入法，可使颅面部种植体有更高的成功率。     

27例磁性附着体固位种植覆盖义齿临床体会

目的：评价磁性附着体固位种植覆盖义齿在牙槽骨严重吸收的无牙颌患者中运用的临床效果。方法：27例牙槽骨严重吸收的无牙颌患者,植入2—4枚牙种植体,3-6个月后进行种植体支持式磁性附着体固位覆盖义齿修复,定期复查,随访8—79个月。采用临床检查、x线检查和患者主观感受问卷来评价此类义齿的修复效果。结果：27例患者61枚种植体,1枚在修复前由于种植体周围炎松动被拔除,3枚在覆盖义齿修复后发生种植体周围炎松动被拔除,其余种植体均稳固无松动;27件种植覆盖义齿的固位、稳定、咀嚼功能均良好,患者满意度高。结论：运用磁性附着体固位种植覆盖义齿修复牙槽骨严重吸收的无牙颌能很好的恢复咀嚼功能,且制作方法简单,值得临床大力推广。     

全耳缺损用义耳修复的现状

本文对全耳缺损用义耳修复的现状作一综述,介绍了义耳修复的材料、传统工艺及相应的固位方式,指出以种植体或附着体固位的义耳是一种有效的修复方法。     

种植体与杆卡式附着体用于义耳修复

将３只骨融合式螺旋种植体植入耳缺损区，采用杆卡式附着体作为种植上的部结构和义耳的固体装置，解决义耳固位，这种固位方式具有固位可靠，取戴方便，便于自洁，利于局部组织健康等优点，特别是在对抗侧向力方面具明显的优越性，是目前义耳修复最佳的固位方式。     

locator种植覆盖义齿在下颌无牙颌修复中的应用

目的：探讨locator附着体种植覆盖义齿在下颌无牙颌修复中的临床应用效果。方法：对12例下颌无牙颌患者,每名患者下颌植入2枚种植体,共24枚,3~4个月后完成locator附着体覆盖义齿修复。术后2年期间进行随访。结果：24枚种植体均无松动,骨无明显吸收,患者对义齿咀嚼及固位满意。结论：locator附着体固位的种植覆盖义齿是下颌无牙颌患者理想的修复方式。     

口腔种植修复失败原因分析

目的 分析口腔种植修复的失败原因,为提高临床口腔种植成功率提供依据.方法 以种植体松动脱落、折断或被动取出为种植失败的标准,搜集并分析自2001年1月至2008年12月在山东大学口腔医学院口腔种植中心接受口腔种植修复的32例病例资料,对导致失败的原因进行初步分析.结果 32例患者,共失败种植体38枚.其中,修复前脱落17枚、修复后脱落16枚、种植体折断2枚、种植体基台固位螺丝折断2枚、种植体唇侧穿通1枚.失败原因分析:术者原因所致21枚、患者自身原因11枚、种植体原因4枚、不明确原因2枚.结论 导致口腔种植修复失败的原因复杂,术者应为主要原因,其次是患者自身原因和种植体原因.     

Bicon短种植体在上颌后牙区骨量不足病例中的临床应用

目的：评估Bicon短种植体在上颌后牙区骨高度不足病例种植修复的临床效果。方法：选择上颌后牙区骨高度1．7—8ram的病例62例,共植入Bicon短种植体252枚,其中植入长度6ram的种植体192枚,长度8mm的种植体60枚。其中上颌窦区牙槽骨高度不足的患者行经牙槽嵴上颌窦底提升术同期植入种植体,部分植体使用上颌窦基台固位。3—6个月后完成永久修复。结果：62例252枚Bicon短种植体均获得了良好的骨结合,9—26个月的随访观察及X光片和牙科CT检查,临床效果良好,种植体周围骨组织稳定。结论：Bicon短种植体在上颌后牙区骨量不足病例种植修复中临床效果肯定。     

球帽附着体种植覆盖义齿修复牙槽嵴重度萎缩无牙下颌

目的：总结分析BEGO种植体系统球帽附着体固位覆盖义齿,修复重度牙槽骨萎缩无牙下颌的临床应用与效果。方法：对重度牙槽骨萎缩、普通义齿固位极度不良的7例下颌无牙颌患者,在下颌骨前牙区植入2-3枚BEG0柱形螺旋种植体,共植入种植体17枚,后期采用球基台作球帽附着体固位覆盖义齿修复,定期复诊观察评价种植和覆盖义齿修复效果。结果：全部17枚种植体均顺利一期愈合,愈合周期平均3个月,球帽附着体覆盖义齿修复后经6-12个月观察,义齿稳定、咀嚼功能恢复理想,容貌改善明显,患者满意。结论：种植体支持球帽附着体固位覆盖义齿修复牙槽骨重度萎缩无牙下颌,可有效恢复咀嚼功能,改善患者容貌,提高患者生活质量,同时球帽附着体修复,简单经济,易于保持口腔清洁,可以推广。     

BLB种植系统的临床应用及疗效观察

目的评价BLB种植系统的临床效果.方法用BLB种植系统进行延期或即刻种植,采用一期埋入,二期暴露的二次手术方式,对337例患者植入555枚种植体.金属烤瓷冠修复,其中6例患者20枚行全口义齿的球帽及杆卡可摘义齿修复,临床随诊观察一至四年.结果种植成功率95.4%,种植体周围齿槽骨水平吸收＜0.2 mm/年.修复基台松动7枚,烤瓷冠中央螺丝松动38枚,烤瓷冠崩瓷6枚,种植体周围炎24例;球帽式总义齿修复有2例4枚半年后义齿固位力下降,球基台发生磨损;杆卡式总义齿修复效果良好.结论 BLB种植体适合于常见的牙列缺损及牙列缺失的种植修复.     

下颌牙周病渐进缺牙致无牙颌的种植方案设计

目的：牙周病致牙列缺失的义齿修复是非常困难的,尤其是下颌骨低平条件较差的下颌牙列缺失修复。患者常抱怨义齿的压疼、固位稳定及咀嚼效率差。虽然牙种植体应用较好地解决了上述问题,但在临床中患者由于下颌后牙区骨高度不足且距下颌神经管较近,医疗风险及手术难度加大,使得种植覆盖义齿修复效果不如预期。本文目的是用种植体最佳分布结果指导临床牙周病渐进性拔牙病例设计种植修复方案。方法：通过分析牙周病致无缺牙行种植覆盖义齿修复的临床效果并对下颌无种植覆盖义齿三维有限元分析。结果：牙周病致无缺牙行种植覆盖义齿常规在两侧颏孔区之间种植2-4枚种植体,由于后牙区没有种植体支撑,从义齿修复受力原则及防止磨牙区及种植体周骨质吸收来讲不是最佳方案,最佳应在后牙区种植种植体。结论：牙周病治疗过程中在下颌缺牙的磨牙区植入1-2枚种植体,即便最后下颌自然牙全部缺失,可以常规在两侧颏孔区之间种植2-4枚种植体,结合前期植入的种植体共有6-8枚,可以考虑种植固定或者套桶冠固位进行下颌牙列缺失的种植修复,使种植修复效果达到最佳。     

Implant-retained auricular prostheses: an assessment of implant success and prosthetic complications

The aims of this study were to evaluate the success rates and peri-implant soft tissue responses of auricular implants, to assess prosthetic complications, and to calculate the survival rate of silicone auricular prostheses. Twenty-nine extraoral implants were placed in 10 patients with 11 auricular defects. Implant failure was defined as clinically detectable implant mobility, and a 5-point scale was used to record the health of peri-implant soft tissues. Prosthetic complications were assessed, and the survival rate of silicone auricular prostheses was calculated using Kaplan-Meier analysis. The implant success rate was 100%. A few soft tissue problems were noted. The overall cumulative survival rate for the first prostheses of the patients was 70% after 18 months. The mean survival time was 17 months. Extraoral implants had a very high success rate in the mastoid region. Prosthetic assessment indicated that although experience with wearing prostheses reduces retention degradation, discoloration and reduced quality of fit at the prosthesis edge over time remain the major problems in maxillofacial prosthetics.     

Extraoral prostheses using extraoral implants

The aim of this study was to evaluate extraoral prostheses and the use of extraoral implants in patients with facial defects. 10 cases were treated utilizing maxillofacial prostheses employing extraoral implants in five cases. 16 extraoral implants were installed. Seven implants were placed in irradiated sites in the orbital regions. Six implants were placed in mastoid regions and three in a zygoma region that was irradiated. Two implants failed before initial integration was achieved in irradiated areas. Using 14 extraoral implants as anchors, five extraoral prostheses were set. The other five cases were treated with extraoral prostheses without using extraoral implants due to cost and patient-related factors. The data included age, sex, primary disease, implant length, implant failure, prosthetic attachment, radiation therapy, and peri-implant skin reactions. The use of extraoral implants for the retention of extraoral prostheses has simplified the placement, removal, and cleaning of the prosthesis by the patient. The stability of the prostheses was improved by anchors. Clinical and technical problems are presented with the techniques used for their resolution. Using extraoral implants resulted in a high rate of success in retaining facial prostheses and gave good stability and aesthetic satisfaction.     

Sigmoid and transverse sinus thrombosis caused by mastoid implant -- case report.

INTRODUCTION: Extraoral craniofacial implants are often used for retention of auricular prostheses. In this case report, the rare complication of sigmoid and transverse sinus thrombosis after implant placement in the mastoid is described. CASE REPORT: A 36-year-old man with congenital hypoplasia of the right ear was treated with an implant-based auricular prosthesis. One of the three implants in the mastoid area had to be removed because of an infection, whereas the other two implants were removed at the patient's request. Twenty-four days after implant removal, he was seen with sigmoid and transverse sinus thrombosis and successfully treated with fibrinolytic and consecutive anticoagulation therapy. CONCLUSIONS: Implants in the mastoid area are a very important aid for retention of auricular prostheses, but may have life-threatening intracranial consequences.     

Alternative retention for an implant-retained auricular prosthesis

The introduction of intraoral endosseous implants was inevitably followed by their external use in maxillofacial prosthodontics. Bar and clip attachments provide satisfactory retention for auricular prostheses, although the bar may inhibit patient hygiene by limiting access to the defect area. A simple clinical and laboratory technique to enhance the retention of an implant-retained auricular prosthesis is described, with custom-made stud attachments used for retention. Improved access for hygiene is provided. A clinical case is presented.     

Modified technique for retaining silicone auricular prosthesis: a case report

Prosthetic rehabilitation of auricular defects can be a demanding procedure due to a broad variety of clinical presentations and a wide array of treatment options. The retention of auricular prostheses is a major factor influencing the successful outcome of rehabilitative treatment following cancer surgery or trauma. Auricular prostheses have been retained by methods including implants, adhesives and spectacle frames but the choice of repair ultimately depends on patient factors, amount of soft tissue loss, and location of the auricular defect. This article describes a newer technique of using resin template for silicone auricular prosthesis, for better retention and orientation. Moreover it is cost effective and aesthetically acceptable for patients who decline or need to postpone implant retained prosthesis reconstruction.     

Facial defects restored with extraoral implant-supported prostheses

A facial defect results in cosmetic, functional, and psychologic problems and acts as a difficult and challenging procedure for the maxillofacial surgeon and the prosthodontist. Retention of a facial prosthesis is an important key in the patient's satisfaction and acceptance. The introduction of extraoral implant applications have been accepted as an advanced retention method. The purpose of this article is to report the results from our clinical experience with patients wearing facial prostheses anchored to extraoral ITI implants (Straumann, AG, Basel, Switzerland).     

Osseointegrated Implants and Auricular Defects: A Case Series Study

Purpose: The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment. Materials and Methods: Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow‐up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance. Results: Thirty‐nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction. Conclusions: The survival rate for bone‐anchored titanium implants and prostheses was 100%. Bone‐anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive‐free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of implants was optimized to allow prosthodontic rehabilitation using implant‐retained prostheses.     

Surgical and prosthetic considerations to rehabilitate an ocular defect using extraoral implants: a clinical report

This clinical report shows the use of extraoral implants to rehabilitate an ocular defect, focusing the surgical and prosthetic procedures. Using local anesthesia and a surgical template obtained from the diagnostic wax ocular pattern, two cylinder dental implants were strategically placed in the lateral aspect of the right infraorbital region. Four months later, an acrylic framework including two spherical magnets was made using plastic UCLA abutments. After casting laboratory steps, a customized silicon prosthetic appliance was fabricated from the diagnostic wax ocular pattern and attached to the Co-Cr framework, observing its profile and seating aspects. The patient was satisfied with the treatment result, due to the retention, esthetics, and adhesive-free method to anchor his ocular prostheses.     

Retention and load transfer characteristics of implant-retained auricular prostheses

PURPOSE: The use of osseointegrated implants for maxillofacial prostheses reduces the need for adhesives, provides for a more stable and more esthetic prosthesis with thinner margins, and results in increased patient acceptance and confidence. The purpose of this study was to compare the retention and load transfer characteristics of differently designed implant-retained auricular prostheses. MATERIALS AND METHODS: A photoelastic model was fabricated of the auricular-temporal region of a human skull. Craniofacial implants 3.75 mm in diameter and 4 mm long were embedded in locations typically selected to retain auricular prostheses. Two retention mechanisms were evaluated on the implants: a Hader bar with 3 clips and the use of 3 Locator attachments. The retentive capacity of the prostheses was determined on an Instron test machine. Initial retention and changes with multiple removals were examined. Dislodgment forces were applied to each retentive device in the field of a circular polariscope. Resulting stresses were monitored and recorded photographically. RESULTS: The highest initial retention demonstrated by the Locator device was 12.4 +/- 0.9 lb, and the highest retention value for the Hader bar with clips was 7.5 +/- 1.1 lb. All attachments decreased in retention after multiple removals. The Locator devices produced higher peri-implant stresses compared to the Hader bar-with-clips design. CONCLUSIONS: Since higher retention is associated with higher stresses, results of this study suggest that a balance between retention and stress production is necessary in selecting a retention mechanism for the specific requirements of the patient being treated. The Locator attachment was correlated with higher retention values as well as with higher peri-implant stress compared to the Hader bar-and-clip attachment design. Retention decreased and then stabilized after multiple     

Clinical trial of modified ankylos implants for extraoral use in cranio- and maxillofacial surgery

PURPOSE: Epithetic solutions in the maxillofacial region are indicated if plastic surgery reconstruction is not a valid option for an extensive defect. The purpose of this study was to examine whether the extraoral implants used provided sufficient retention to be used as anchoring aids. MATERIALS AND METHODS: Between November 1999 and September 2002, 33 identical modified Ankylos implants for extraoral anchorage were placed in 10 patients for the fixation of various epitheses in the midfacial (eye, nose) and ear regions in the course of a clinical trial. RESULTS: Over a follow-up period of 2 to 34 months, all implants remained osseointegrated (as confirmed radiographically), and the implants and epithetic restorations were clinically stable. DISCUSSION: The results demonstrated that the lasting retention of maxillofacial epitheses provided by implants assures patients that their epitheses are securely fixed. CONCLUSION: The demonstrated extraoral implant system not only achieved sufficient osseointegration but also showed good clinical handling and easy fixation possibilities for epithetic anchorage.