种植套筒冠覆盖义齿在无牙颌修复中的应用

目的探讨以种植套筒冠覆盖义齿修复无牙颌的临床效果。方法对北京大学口腔医学院·口腔医院口腔种植中心就诊的21例无牙颌患者,采用种植套筒冠覆盖义齿修复。共28件修复体,其中上颌全颌覆盖义齿13件,下颌全颌覆盖义齿15件。共植人种植体139枚,其中Camlog 74枚,IMZ 28枚,Frialit-2 37枚。种植体修复基台切削后直接作为套筒冠内冠,套筒冠外冠分别采用金沉积技术和失蜡铸造技术加工。修复后平均追踪26．5个月(12-39个月)。以临床检查和影像学检查评价修复效果。结果至最后一次复查,21例患者临床检查未见修复体松动、折断、损坏,修复体固位好、稳定,种植体周围软组织健康。19例患者曲面断层X线片显示种植体周围骨组织稳定,无吸收。仅2例在修复3年后发现少量骨吸收,约1 mm。修复后至最后一次复查未见种植体脱落。结论种植套筒冠覆盖义齿稳定,种植体周围骨组织稳定,可用于无牙颌修复。     

下颌即刻负重种植套筒冠覆盖义齿修复的临床效果分析

目的 评价Ankylos种植系统应用于下颌种植即刻覆盖义齿修复的临床效果.方法 12例患者下颌颏孔前各植入4颗Ankylos种植体,即刻覆盖义齿修复.结果 随访6～18个月,没有种植体失败.3件临时修复体出现折断, 4个外冠松脱.义齿咀嚼有力.结论 下颌全口牙缺失采用4颗Ankylos种植体套筒冠覆盖义齿即刻负重修复可以取得较好的短期效果.     

无牙颌患者种植义齿修复

目的:无牙颌患者采用种植义齿修复可有效的增强义齿的固位,提高义齿的修复效果。方法:从1999年至2007年,对22例无牙颌患者,年龄45-82岁,行种植义齿修复,其中,有2例采用种植固定义齿修复,7例采用杆-卡式种植覆盖义齿修复,11例采用球-帽式种植覆盖义齿修复,1例采用双套筒冠种植覆盖义齿修复,1例采用磁性固位种植覆盖义齿修复。患者种植体植入2-9颗,共植入种植体97枚,种植体采用Frialit-2,Fri-alit-xive系统,观察时间108个月,采用临床检查、X线观察和患者主观评价等来评价种植体与骨组织结合状态,评价其义齿的修复效果。结果:观察期内发现1枚种植体脱(球-帽式固位种植体),1枚种植体未作修复,仍埋入在粘膜下的颌骨内。种植义齿修复后固位稳定作用良好,患者咀嚼有力,对义齿修复效果满意。结论:无牙颌患者种植义齿修复效果良好,患者满意度高。     

种植体支持套筒冠覆盖义齿联合栓道附着体咬合重建的临床效果

目的 探讨以种植体支持套筒冠覆盖义齿联合栓道式附着体进行咬合重建的临床效果.方法 采用套筒冠覆盖义齿联合栓道式附着体对8例患者进行咬合重建,共植入32枚Ankylos种植体, 采用SynCone 4°或6°基台作为内冠,预成黄金冠作外冠,共制作16件修复体,修复后平均追踪22个月,进行临床和影像学检查作疗效评定.结果 8例患者下颌全部采用种植体支持套筒冠覆盖义齿修复,上颌采用固定联合栓道式附着体修复单侧或双侧游离端缺失.经临床效果评价8例全部为完全成功.结论 种植体支持套筒冠义齿联合栓道附着体咬合重建修复效果良好.     

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。     

种植体支持的无牙颌套筒冠覆盖义齿研究进展

近20年来,种植覆盖义齿被广泛应用于临床。而种植体支持的无牙颌套筒冠覆盖义齿由于灵活的设计、理想的固位和咀嚼功能为无牙颌患者提供了更好的选择。合理设计套筒冠内冠角度,选用合适的套筒冠内外冠材料可使整个覆盖义齿获得最佳固位力,同时对种植体套筒冠固位位置的优化设计和力学分析能提供更理想的应力分布,保证义齿的远期成功。本文对种植体支持的无牙颌套筒冠覆盖义齿的研究进展作一综述。     

金沉积技术在无牙颌种植覆盖义齿修复中的临床应用

目的:探讨金沉积技术在无牙颌种植修复中的临床应用效果。方法:49例无牙颌患者,完成无牙颌覆盖义齿63个,植入种植体361个。应用金沉积技术制作双重冠和切削杆外冠。观察方法为临床检查及x线检查。修复后追踪最长44个月,最短12个月。结果:所有病例在修复后至最后一次复查未见种植体脱落。所有修复体无折断、松动或破损,修复效果良好,患者满意。结论:本研究结果提示金沉积技术用于制作种植体支持的无牙颌修复体具有良好的生物相容性,可用于种植体支持的覆盖义齿修复,近期临床效果满意。     

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。     

即刻种植即刻负重单颌种植总义齿的短期疗效观察

目的:评价采用即刻种植即刻负重方法进行单颌种植总义齿修复的短期疗效.材料和方法:8位临床需拔除单颌所有牙齿的患者,在拔牙同时植入种植体,于种植后即刻或3天内完成种植过渡义齿修复,分别采用单颌固定总义齿或套筒冠固位的种植覆盖义齿.种植后3～6月行永久修复.即刻修复体戴入时及半年后行X线检查,观察种植体周骨水平的变化.结果:8位患者共植入42颗种植体,3例行即刻种植固定总义齿修复,5例行套筒冠固位的种植覆盖义齿修复.即刻种植及即刻修复完成后随访8～24个月.平均12个月.观察期内无种植体丧失,所有义齿均行使功能良好.植入后6个月种植体周平均边缘骨吸收0.55mm.讨论:即刻种植即刻修复可明显缩短患者无牙时间,易于为患者所接受,为保证成功率,需严格遵循相应的原则.结论:即刻种植即刻负重单颌种植总义齿可取得满意的短期修复效果.     

不同类型附着体种植覆盖义齿的临床疗效评价

目的总结与评价应用不同类型附着体的种植覆盖义齿的临床效果。方法对28例无牙颌患者分别采用种植体支持的磁附着体、杆卡式、套筒冠、球帽式覆盖义齿随访及效果进行对比评价。观察随访,定期拍摄X线片及口腔检查,观察种植体骨吸收和软组织状况,并对使用4种类型覆盖义齿的患者进行满意度调查和并发症分析。结果除1例磁附着体覆盖义齿患者发生3枚种植体脱落现象外,其余种植体均稳定。不同类型附着体种植覆盖义齿的骨吸收量、牙龈指数和满意度评价的差异均无统计学意义﹙P>0.05﹚;患者戴牙前后的义齿总体满意度、义齿固位及稳定情况、咀嚼效率、舒适度方面有明显的改善(P<0.05﹚。结论各类种植体支持的覆盖义齿稳定舒适,咀嚼功能增强,患者对满意度有较高的评价,提高了无牙颌患者的生存质量。     

种植体支持切削杆固位无牙颌种植修复体的临床应用和加工技术研究

目的：探讨种植体支持切削杆固位覆盖义齿的临床效果及工艺特点.方法：28例无牙颌患者（男12例,女16例,年龄22-71岁）,共31个修复体,植入种植体168枚.所有病例在种植体植入4-6个月后开始种植修复,均采用切削杆固位的覆盖义齿修复.修复后追踪最长39个月,最短12个月.观察方法为临床检查和x线片检查.结果：31个修复体固位力好、稳定.23例患者对修复效果非常满意,5例满意.5例患者由于口腔卫生差导致种植体周围软组织炎,4例经过局部冲洗上药,炎症消退,1例在修复后五年发展为种植体周围炎,最终修改修复设计,改用磁性基台固位.X线片示27例患者的160枚种植体周围骨组织稳定,无骨吸收,1例8颗种植体周围骨吸收2-4 mm.28例患者中2例在修复后一年发生修复体树脂基托断裂,2例在修复后四年发生修复体树脂基托断裂,修补后重新使用,无需重做修复体.所有病例在修复后至最后一次复查未见种植体脱落.结论：应用种植体支持切削杆固位修复无牙颌的修复效果满意,种植体受力均匀,但加工工艺及设备要求较高,材料成本高,是该技术推广应用不足之处.     

种植体支持磁性附着体固位覆盖义齿的临床应用

目的评价种植体支持的磁性附着体固位覆盖义齿的临床应用及其效果。方法1999年11月至2005年3月，完成种植体支持磁性附着体固位的覆盖义齿修复25例。本组25例，男性14例，女性11例，年龄45～79岁（平均67．6岁）。本组共使用95枚种植体。随访时间6～70个月。随访期间采用临床检查和X线检查评估。结果95枚种植体植入过程中未发生感染和神经损伤等并发症；覆盖义齿固位效果良好，达到患者对义齿功能和美观的要求；患者清洁基台和义齿方便，疗效满意。1例Komet种植系统上部基台戴义齿0．5年后折断，1例Frialit-2种植体戴义齿2年后脱落，其余种植体骨结合状态稳定。结论种植体支持的磁性附着体固位的覆盖义齿临床效果可靠，制作方法简单，便于患者清洁基台和义齿，尤其适合老年无牙颌患者。     

磁性附着体种植覆盖义齿修复下颌牙槽骨重度吸收无牙颌患者的临床观察

目的：探讨磁性附着体种植覆盖义齿修复下颌牙槽骨重度吸收无牙颌患者的临床效果。方法：对下颌牙槽骨重度吸收、牙槽嵴低平的患者,在下颌尖牙位置植入2枚种植体,3—6个月后完成磁性附着体覆盖义齿修复。每隔6个月复诊一次,观察覆盖义齿使用情况,并结合口内检查和X线检查评价使用效果。结果：修复完成后2—3年,种植体骨结合良好,未见明显骨吸收;义齿固位良好,患者对美观及功能效果满意。结论：磁性附着体种植覆盖义齿修复下颌牙槽骨重度吸收无牙颌患者,能明显示改善义齿固位和咀嚼效果。     

Long-term marginal periimplant bone loss in edentulous patients

PURPOSE: The aim of this study was to examine the long-term periimplant bone loss in patients treated with implant-supported fixed prostheses in both jaws. MATERIALS AND METHODS: The participants comprised 44 edentulous patients who have been followed for a 15-year period after treatment with a fixed implant-supported prosthesis in the mandible. Thirteen of them also received an implant-supported fixed prosthesis in the maxilla, on average 4.5 years after the mandibular treatment. The periimplant bone level was measured on intraoral radiographs. RESULTS: The long-term results of the implant treatment were successful, and only 1% (3/273) of the implants were lost in the mandible and 7% (5/75) in the maxilla. All but one of the failures occurred before the connection of the prostheses. The mean marginal bone loss around the implants was small (less than 1 mm for a 10-year period after implant placement), and was of similar magnitude in both jaws. However, the individual variation was relatively great. There was no significant difference in marginal bone loss between those who had a maxillary complete denture during the entire observation period and those who had received a fixed implant-supported maxillary prosthesis. Smokers lost more periimplant bone than did the nonsmokers; the difference was significant in the mandible but small and nonsignificant in the maxilla. CONCLUSION: The long-term periimplant bone loss was small and of similar magnitude in the mandible and the maxilla in subjects who had received implant-supported fixed prostheses in both jaws. The prosthetic status in the maxilla, i.e., complete denture or fixed implant-supported prosthesis, had no significant influence on the mandibular periimplant bone loss.     

The effect of different mandibular dentures on antagonistic maxillary ridge

PURPOSE: Is to evaluate the antagonistic, maxillary ridge resorption for different prosthetic modalities mainly mucosa-supported mandibular complete overdentures, combined mucosa implant-supported mandibular complete overdenture, and lower conventional complete dentures. MATERIALS AND METHODS: Fifteen completely edentulous patients were divided into 3 groups; 5 patients each. Group I patients received maxillary conventional denture and mandibular overdentures retained by magnet attachment on 2 implants (mainly mucosa-supported overdenture). Group II patients received maxillary conventional denture and mandibular overdentures retained by bar attachment on 2 implants (combined mucosa implant-supported overdenture). Group III patients received upper and lower conventional complete denture. All patients were evaluated clinically and radiographically immediately after insertion and after 1 and 2 years. Panoramic radiographic film was used to evaluate the antagonistic maxillary ridge resorption. RESULTS: Indicated a more pronounced annual bone resorption of the antagonistic maxillary ridge after 2 years in patients with conventional complete denture wearers when compared with patients with combined mucosa implant-supported mandibular complete overdenture and mainly mucosa-supported mandibular complete overdenture groups. CONCLUSION: Using a combined mucosa implant-supported mandibular complete overdenture the amount of antagonistic maxillary alveolar bone resorption increases when compared with the mainly mucosa-supported complete overdenture.     

Posterior jaw bone resorption in osseointegrated implant-supported overdentures

For several years, osseointegrated implant-supported overdentures have been used in the rehabilitation of full edentulism with excellent results, at least in the lower jaw. This study involved 3 groups of patients with different prosthetic reconstructions: (1) mandibular overdentures supported by 2 implants connected by a bar (30 patients), (2) mandibular fixed prostheses supported by 4-6 implants (25 patients) and (3) mandibular complete dentures without implant support as controls (85 patients). The primary aim of this study was to examine on orthopantomograms (by means of the area index to minimize distortion and magnification errors), posterior mandibular ridge resorption in the 3 treatment groups. The present data demonstrated a minimal posterior mandibular ridge resorption in patients with fixed implant-supported prostheses. A more considerable posterior ridge resorption was observed in the complete denture group and especially in the overdenture wearers. For the latter, the annual posterior jaw bone resorption after the post-extraction remodeling period of 6 months, was 2- to 3-fold that of full denture wearers. When patients were edentulous for more than 10 years, the difference between the 2 latter groups disappeared. It is suggested that although the overdenture design on 2 implants offers advantages from a financial and failure rate point of view, its indications in younger patients should cautiously be evaluated in a long-term perspective concerning posterior mandibular bone resorption.     

CDIC种植体联合磁性附着体在种植覆盖义齿修复中的临床应用

目的：探讨CDIC种植体联合磁性附着体制作种植覆盖义齿修复牙列缺失的临床效果。方法：选取12例牙槽嵴萎缩或全口义齿固位不良的牙列缺失患者,在CDIC组合式骨内结合种植体支持的基础上,行磁性附着体覆盖义齿修复,对义齿的固位、咀嚼功能和使用情况进行2年的随访观察。结果：31枚种植体修复前均达到骨结合,平均愈合周期5个月;磁性附着体覆盖义齿修复后,义齿稳定,咀嚼功能、容貌改善明显,达到患者对美观和功能的要求。结论：CDIC种植体联合磁性附着体制作的种植覆盖义齿是修复牙列缺失的一种行之有效的方法,其性价比高,更宜临床推广应用。