种植修复下颌磨牙游离缺失满意度的纵向研究分析

目的:纵向比较下颌磨牙游离缺失患者在未修复、活动义齿修复及种植义齿修复后的主观评价。方法:对40例戴用过活动义齿,现已完成种植义齿修复的下颌磨牙游离缺失患者,采取种植修复前自测问卷和种植修复后自测问卷形式,由患者本人填写。结果:种植义齿在咀嚼、语言、舒适性、固位等方面的满意度得分更高。结论:种植义齿是修复下颌磨牙游离缺失的最满意选择,活动义齿和未修复状态的满意度无显著意义。     

键槽缓压式附着体义齿的临床应用

目的采用键槽缓压式附着体义齿修复后牙游离缺失,评价其临床效果。方法采用键槽缓压式附着体(ASC-52),为18例游离端牙列缺损患者行附着体义齿修复,随访1~4年,通过患者主观感觉、口腔检查、X线检查3方面评估修复效果。结果患者感觉舒适,异物感较小,固位稳定性好,功能行使好,基牙及牙槽嵴无病变。结论键槽缓压式附着体义齿修复游离端牙列缺损效果良好,是一种理想的牙列缺损修复的固位体。     

两种附着体义齿修复后牙游离缺失的临床效果评价

目的研究MK1和Asc-52精密附着体在后牙游离缺失修复中的临床效果。方法36例后牙游离缺失患者分为2组,分别采用MK1和Asc-52精密附着体义齿修复,随访2年,进行临床观察和X线检查,对2种附着体义齿的修复效果进行综合评价。结果2组36例患者对附着体义齿修复均感觉美观舒适,语音正常,咀嚼功能佳,修复体稳固。临床复查基牙无松动,牙龈无退缩,义齿组织面牙龈无肿胀、无压痛,义齿稳固无摆动;X线检查示牙槽骨无吸收,根尖无病变。MK1组中4例患者由于钥匙孔太靠远中,摘戴有些不便。结论修复后牙游离缺失,MK1和Asc-52精密附着体义齿都是比较理想的选择。     

种植义齿在后牙游离端缺失修复中的临床应用

目的：观察种植义齿用于后牙游离端缺失修复的临床疗效。方法：后牙游离端缺失采用种植义齿修复的46例共106个种植体。结果：临床观察6—48月，成功率95％，修复效果良好。结论：采用种植义齿修复游离端缺失，可避免对余留牙的破坏，义齿稳固性好、舒适、无异物感、咀嚼效率高，具有固定和可摘局部义齿无法比拟的优点，应为游离端缺失患者首选的修复方式。     

种植体与天然牙联合修复后牙游离缺失53例

目的:采用种植-天然牙联合修复后牙游离缺失。方法:对53例患者共106颗第二磨牙游离缺失应用种植牙与天然牙联合修复游离缺失牙齿。结果:自1999年5月～2005年6月,共完成53例106枚种植一天然牙联合义齿修复。随访观察2～6年,平均随访期3年6个月。种植体的稳定性良好,患者主观满意者达98%。X线检查见种植体与骨组织结合紧密。无修复失败病例。结论:种植义齿逐渐成为后牙游离端缺失的首选修复方式。用种植义齿修复游离端缺失,既克服了可摘局部义齿对基牙及软组织的损伤,又满足了患者用固定义齿修复的要求,易于临床推广应用。     

MK1精密附着体用于后牙游离缺失修复的效果观察

目的研究MK1精密附着体在后牙游离缺失修复中的疗效。方法采用MK1精密附着体为26例后牙游离缺失的患者进行修复治疗,经过8个月～4年的临床观察,从主观感受、临床检查、X线检查观察修复效果。结果24例患者认为附着体舒适、稳固、易适应、咀嚼有力、不影响美观、无明显食物嵌塞。临床检查及X线检查基牙无叩痛,无松动,牙龈无萎缩,义齿受力区牙槽嵴黏膜无红肿、压痛,义齿稳固无摆动。基牙无根尖周病变及牙槽骨吸收现象。2例患者戴用2年后义齿可摘部分近中的塑料牙面碎裂,改做金属面增加强度后,使用至今无破损。结论MK1精密附着体是一种较理想的修复后牙游离缺失的附着体。     

双侧后牙游离缺失及前牙重度磨耗的咬合重建修复

目的探讨固定义齿与水平球帽式附着体在双侧后牙游离缺失及前牙重度磨耗咬合重建中的应用效果。方法双侧后牙游离缺失及前牙重度磨耗患者10例,经过完善的基础治疗,使用垫式可摘义齿3个月,经过咬合重建的适应期,采用前牙金属烤瓷冠固定义齿及后牙水平球帽附着体可摘义齿进行咬合重建修复。结果对10例患者临床随访6个月至3年,8例患者对外貌及义齿功能满意,2例基本满意,无不满意。结论对于双侧后牙游离缺失及前牙重度磨耗的患者,行前牙金属烤瓷冠固定义齿及后牙水平球帽式附着体义齿咬合重建修复,具有良好的临床应用价值,其中正确的颌位关系是修复成功的必要条件。     

Dalbo附着体义齿修复老年人牙列远中游离缺失的临床观察

目的:研究Dalbo附着体义齿修复老年牙列远中游离端缺失的临床效果。方法:选择24例牙列远中游离端缺失的老年患者制作28件Dalbo附着体义齿,进行6个月-2.5年的随访,从患者主观感受,临床检查基牙情况、附着体固位稳定等方面评价修复效果。结果:Dalbo附着体义齿美观、舒适、稳固、咀嚼有力,基牙健康。2例患者附着体连接臂下方粘膜充血,水肿;1例基牙烤瓷冠崩瓷,1例患者缺牙区牙槽骨吸收,经找出原因对症处理后,义齿重新正常使用。结论:Dalbo附着体义齿修复老年人牙列远中游离端缺失,效果优良。     

上下颌游离缺失Brnemark种植义齿早期临床效果的比较研究

目的:比较上下颌游离缺失Branemark种植义齿修复早期临床效果。方法 :5例上颌 (17颗 )和7例下颌(22颗 )游离缺失Branemark种植体植入金合金烤瓷桥修复行使功能18个月后 ,比较上下颌游离缺失Branemark种植体支持固定桥义齿的稳固情况、种植体周牙龈指数和种植体周骨吸收量。结果 :上下颌游离缺失Branemark种植体支持固定桥义齿种植体周骨吸收量无显著性差异 (P>0.05) ;两者种植体周牙龈均处于正常状态 ;上下颌游离缺失种植义齿均未见种植体松动或脱落 ,基台和全冠的稳固性均良好。结论 :上下颌游离缺失Branemark种植体支持种植固定桥义齿修复效果良好     

用三维有限元方法对单端固定桥进行应力分析

目的分析磨牙游离缺失单端固定桥修复的受力情况。方法运用三维有限元应力分析法,对一侧磨牙游离缺失通过改变牙槽骨支持高度,采用不同基牙数目,不同桥体长度建立不同的单端固定桥有限元模型进行应力和位移的计算和分析。结果较高的应力集中在游离端近中的基牙上,牙槽骨高度降低会增加基牙的移位及应力集中;单纯增加基牙的数目不会导致牙周组织中应力明显相应减少;基牙数目增加会减少修复体移位及应力集中;增加桥体长度会引起义齿应力明显增加和向远中移位。结论游离缺失端行单端固定桥修复最好选择桥体为一个磨牙长度,且基牙数至少两个,以提高单端固定桥修复的成功率。     

Abutment positioning in a cantilevered shortened dental arch: a clinical report and static analysis

This article describes the extension of a shortened dental arch with a cantilever fixed partial denture in a patient who refused to be treated with an implant-supported and retained prosthesis. Orthodontic movement of the distal abutment to enlarge the interabutment span was performed before the final restoration. The mechanical advantage of the enlarged span in a cantilever fixed partial denture is analyzed, discussed, and demonstrated by 2-dimensional static analysis.     

Biomechanics of Cantilever Fixed Partial Dentures in Shortened Dental Arch Therapy

PURPOSE: The purpose of the present study was to investigate, by means of 3-dimensional finite element analysis, aspects of the biomechanics of cantilever fixed partial dentures replacing the maxillary canine in shortened dental arch therapy. The null hypothesis was that no differences would be identified by finite element analysis in the mechanical behavior of the 2 designs of cantilever fixed partial denture under different scenarios of occlusal loading. MATERIALS AND METHODS: Single- and double-abutted cantilever fixed partial dentures were modeled and analyzed using the finite element packages PATRAN and ABAQUS. Displacement and maximum principal stresses (magnitude and location) within the fixed partial dentures, supporting structures, and the periodontal ligament/bone and abutment/retainer interfaces were examined under 20 different scenarios of axial and lateral occlusal loading. RESULTS: The results indicate that more displacement occurred in the 2 rather than the 3-unit cantilever fixed partial denture, with the greatest displacement having occurred under lateral loading. The maximum principal stresses observed in the periodontal ligament/bone interfaces were greatest buccocervically, with the highest value being observed in the 2-unit fixed partial denture under lateral loading. The highest maximum principal stresses observed in the retainer/abutment interfaces were located cervically in relation to the distal margin of the retainer of the 2-unit fixed partial denture under axial loading. CONCLUSIONS: It was concluded that in adopting a cantilever fixed partial denture approach for the replacement of a missing maxillary canine in shortened dental arch therapy, there may be merits, in terms of mechanical behavior, in selecting a double-rather than a single-abutment design. Furthermore, prostheses' displacement and functional stresses may be minimized by reducing lateral loading and avoiding pontic only loading.     

The mechanical behaviour of cantilever fixed partial dentures in shortened dental arch therapy: a 2-D finite element analysis

In the present study two-dimensional finite element models of two- and three-unit cantilever fixed partial dentures were created to simulate the replacement of a maxillary second premolar in a shortened dental arch. The purpose of the study was to investigate the mechanical behaviour of the two designs of fixed partial denture using the finite element method. The results indicate that the mechanical behaviour of the three-unit fixed partial denture was more favourable than that of the two-unit fixed partial denture under similar conditions of occlusal loading. Prosthesis displacement and maximum principal stresses increased substantially when loading was limited to the pontic, in particular, in the model of two-unit fixed partial denture.     

Finite element stress analysis of the effect of short implant usage in place of cantilever extensions in mandibular posterior edentulism

Although the destructive effect of cantilevered implant supported fixed partial prosthesis is well known, in some cases usage of cantilever extension seems to be inevitable for many clinicians. The purpose of this study was to evaluate the effect of additional placement of a shorter implant in place of a cantilever extension on stress distribution compared with cantilevered fixed prosthesis in mandibular posterior edentulism. A mandibular Kennedy II finite element model was constructed. Six different implant supported fixed partial prosthesis were designed according to two main configurations; anterior and posterior cantilever extensions compared with the placement of additional shorter implant configurations. An oblique occlusal load of 400 N was applied. Tensile and compressive stress values in the cortical bone surrounding the cervical regions of implants and Von Misses stress values in the implants were evaluated. Significant lower stress values were recorded at the shorter implant placement configurations compared with the cantilevered prosthesis. Posterior cantilever extension performed higher stress values than the anterior counterpart. In clinical applications where cantilevered fixed partial prosthesis seems to be inevitable because of anatomical restrictions and/or complications such as loss of implant, an additional placement of a shorter implant should be considered.     

Cantilever fixed prostheses utilizing dental implants: a 10-year retrospective analysis.

OBJECTIVE: The dental literature has been unclear about long-term success of fixed cantilever prostheses supported by dental implants. The disappointing results reported when cantilever fixed partial dentures (FPDs) are supported with natural teeth are not directly applicable to implant cantilever FPDs. This article reports on 10 years of implant-retained fixed prostheses primarily in the maxillary arch using the ITI dental implant system. METHOD AND MATERIALS: Sixty cantilever prostheses using 115 ITI dental implants on 36 patients were placed and monitored over a 10-year period. RESULTS: No implant fractures, abutment fractures, porcelain fractures, prosthesis fractures, soft tissue recession, or radiographic bone loss were recorded. All 60 cantilevered prostheses remain in satisfactory function. CONCLUSION: Positive, long-term results, using implant-retained cantilever FPDs can be achieved by: (1) using a rough surface implant of 4.1 mm or greater; (2) using an implant/abutment design that reduces stacked moving parts and reduces the implant-to-crowns ratio; and (3) using a cementable prosthesis design that eliminates the need for occlusal screw retention.     

Indigenous ball and socket implant supported mandibular overdenture: A case report

Edentulism is a major health concern of old age. Indigenous implant based over dentures offer a cost effective option for severely resorbed dental ridges. Here, we report rehabilitation of a resorbed mandibular arch with indigenous implant supported overdenture and maxillary arch with a conventional denture. Two ball and socket implants were placed bilaterally in the parasymphyseal area. Existing denture was relined to accommodate the ‘ball head’ of the implant in the interim period. Four months later, when patient was taken up for denture fabrication, the ‘socket part’ of the ball and socket implant was incorporated into the new denture base. The socket provided a fitting surface for the implant. Implant supported overdenture significantly increased the retention, support and stability of the lower denture. Further, it worked well with the upper conventional denture. The simple design and efficacy of indigenous implant based overdenture holds promising aspects in the treatment of edentulism.     

Efficacy of a posterior implant support for extra shortened dental arches: a biomechanical model analysis

The purpose of this study was to test the efficacy of utilizing implants underneath distal free-end denture bases to establish a stable occlusal support for extreme shortened dental arches (ESDA). The authors constructed a two-dimensional finite element model of the ESDA where only lower anterior teeth remain. Posterior occlusal support was provided by a fixed partial denture with an osseointegrated implant (IFPD), fixed cantilever partial denture (CFPD), or a removable partial denture with or without an implant underneath (IRPD and RPD). A dentate mandible model was the control. When muscle vectors simulating clenching force were applied, stress levels on the temporal bone surface area under each configuration were compared, to evaluate the efficacy in establishing the occlusal support. The largest stress increase in temporal bone was found in the ESDA situation followed by the RPD. The least amount of stress increase was found with the IFPD followed by IRPD when the implant was placed in the molar region. The stress increase with IRPD was about 20-45% of the amount with RPD. Our results suggest that IFPD provides most favourable and stable occlusal support, however, IRPD with a single posterior implant also provide stable occlusal support with reducing the stress levels in the temporomandibular joint.     

种植体天然牙联合支持固定桥修复短期临床评价

目的：评价种植体天然牙联合支持固定桥修复的短期临床疗效。方法：2008年1月～2013年1月接受种植体天然牙联合固定桥修复35例,种植体桥基牙38颗。随访6～66个月,拍摄X线片测量种植体周围骨吸收量,进行临床疗效评价,应用寿命表法计算种植体5年累积存留率。结果：种植体年均骨吸收量为（0．22＆#177;0．12）mm,种植体天然牙联合支持固定桥修复5年有效率为94．3％,种植体5年累积存留率94．5％。结论：种植体天然牙联合固定桥是一种可行的修复方式,可以取得较好的临床修复效果,长期效果有待于进一步观察。