倍骼生与牙内骨内种植体植入修复牙周骨缺损的实验研究

目的 评价倍骼生(PerioGlas)与牙内骨内种植体复合应用于牙周组织再生的疗效.方法 在兔第二前磨牙区制备牙周骨缺损,翻瓣后去除部分牙周骨质及牙周纤维.缺损处分别植入倍骼生与牙内骨内种植体组(A组)、倍骼生组(B组),以常规翻瓣手术组(C组)为对照.术后4周取材做组织学观察和评价.结果 两实验组均有明显新附着形成,其中A组有大量新生牙周组织生长,B组新生组织量较A组少,C组新生组织量很少.结论 倍骼生具有较强骨引导、骨激发作用,牙内骨内种植体植入可稳定患牙,二者联合可有效地提高牙周组织再生.     

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牙齿松动是牙周疾病患者口腔内常见的临床表现。松动的原因可以是支持组织的不足、牙周组织炎症,或有创伤。大多数松动牙在经过基础治疗,炎症消除并建立平衡后,松动度能减轻。但动度较大的牙虽经牙周治疗,也很难恢复正常,因而影响咀嚼功能,或产生继发性咬合创伤,此时需对松动牙加以固定。临床上松动牙固定术常用的方法很多,本研究对比分析了栓丝结扎与牙内骨内种植体两种固定方法临床疗效。     

骨诱导人工骨用于重度牙周炎的疗效观察及失败原因分析

目的研究生物人工材料（biological artificial material,BAM）骨诱导人工骨用于重度牙周炎治疗的效果和失败原因。方法选择临床重度牙周炎患者45例、患牙67颗,基础治疗后行牙周翻瓣刮治术,骨缺损区植入BAM人工骨。术后2年检查牙周情况,记录牙周指数。结果治疗后2年复查患者37例、患牙51颗,因患牙松动、根面牙骨质变性和病变组织未彻底去尽等原因,拔除失败患牙7颗,其余44颗患牙牙周情况良好,牙周指数较治疗前明显改善,部分患牙恢复正常咀嚼功能。结论重度牙周炎患牙治疗效果受众多复杂因素的影响。     

慢性牙周炎患者后牙区种植修复后5年临床疗效分析

目的　观察并分析慢性牙周炎患者后牙区种植修复后5年的临床疗效。方法　选取2012—2013年于中国医科大学附属口腔医院种植中心行后牙区种植修复的患者120例,共计患牙232颗,其中慢性牙周炎患者67例为牙周炎组,种植修复患牙112颗;牙周健康患者53例为对照组,种植修复患牙120颗。上部结构修复5年后,比较两组种植体的牙周情况及边缘骨吸收情况。在牙周炎组中,比较种植体与相邻天然牙及吸烟与非吸烟患者的边缘骨吸收情况。结果　上部结构修复5年后,牙周炎组和对照组种植体成功率均为100%。牙周炎组种植体牙周探诊深度、牙龈指数及牙菌斑指数均较对照组高,但差异均无统计学意义（P > 0.05）。牙周炎组和对照组种植体边缘骨吸收量分别为（0.89 ± 0.68）mm和（0.56 ± 0.35）mm,差异有统计学意义（t = 3.338,P < 0.05）;牙周炎组种植体种植体边缘骨吸收量明显大于相邻天然牙边缘骨吸收量［（0.45 ± 0.32）mm］,差异有统计学意义（t = 4.172,P < 0.05）;牙周炎组吸烟患者的种植体边缘骨吸收量［（1.23 ± 0.75）mm］大于非吸烟患者［（0.62 ± 0.48）mm］,差异有统计学意义（t = 5.763,P < 0.05）。结论　与牙周健康患者相比,慢性牙周炎患者后牙区种植修复后5年的种植体成功率和牙周情况无差异,但边缘骨吸收量明显增加,且吸烟可增加慢性牙周炎患者种植体边缘骨吸收量。     

改良喷砂表面处理提高钛牙种植体骨结合的界面生物力学研究

目的：研究改良喷砂表面处理对钛牙种植体骨界面剪切强度的影响。从界面生物力学角度证实改良喷砂表面处理在钛牙种植体中应用的可行性和应用价值。方法：将光滑表面钛种植体与改良喷砂表面种植体随机植入狗股骨内侧髁,分别于植入后2、4、12周取材,Instron电子拉伸试验机检测种植体骨界面的剪切强度。扫描电镜与X－射线能谱分析仪观察植入12周拔出的种植体表面,并进行元素分析。结果：改良喷砂表面组骨界面剪切强度明显高于光滑表面组,约高出4倍,且植入2周即已获得超出光滑表面组12周所能达到的最大强度。植入12周后拔出的改良喷砂表面种植体表面经扫描电镜观察与X－射线谱分析,提示种植体表面大部分被覆骨组织,粗糙表面的二级窝洞内充满骨样组织。结论：改良喷砂表面处理所获得的粗糙表面可以大大地提高牙种植体骨界面的结合强度。此类粗糙表面所特有的二级窝洞在这里起着重要作用。     

牙周病患者拔牙后即刻种植的临床研究

目的 :探讨牙周病患者拔牙后即刻种植的可行性,手术步骤及临床效果。方法 :40例牙周病患者,拔除患牙后即刻植入48枚种植体,术后随访2年,通过分析种植体的存留率、牙周探诊深度、美学评分、种植体颈部骨吸收等临床参数,评价术后效果。结果:2年内共有3枚种植体脱落,成功率为94%,其余种植体在临床工作中正常行使功能,随访期内各项检查参数均保持稳定。结论:只要对拔牙窝进行严格的清创处理,去除感染源,并保证种植体有良好的初期稳定性,牙周病患者即刻种植也可取得良好效果。     

14枚二期式HA-Ti牙种植体基桩折断原因分析

本文报道了14杖HA－Ti牙种植作基极折断的原因分析。结果表明：导致种植基桩折断原因主要是种植体自身结构薄弱以及侧向力作用、咬合力分布不合理、各种腐蚀、材料疲劳等诸因素长期、综合作用的结果。笔者认为：将上述因素贯穿地考虑牙种植体修复的全过程，对于减少HA－Ti分期式种植牙机械性失败，保证牙种植体的远期疗效有十分重要的意义。     

美学区域拔牙窝植骨联合应用PRF的临床观察

目的:通过观察拔牙同期行拔牙窝植入胶原骨联合应用富血小板纤维蛋白并进行种植修复的临床效果,探讨美学区域拔牙植骨的适应证、外科技术及种植时机等。方法:2006年7月至2010年1月,位于美学区域且唇侧骨板缺损或为菲薄型牙周生物类型的42颗患牙于北京大学口腔医院种植中心拔除,同期行拔牙窝植骨并联合应用PRF,术后观察并记录软硬组织愈合情况、种植体类型及术中初期稳定性、采用的植骨术式等。结果:36例患者的42个牙位植骨区均愈合良好,已全部完成种植手术。42枚种植体平均观察时间14.6个月,目前无一例松动脱落,平均直径为3.8±0.4mm,平均长度为13.5±1.7mm。其中14枚种植体种植术中唇侧骨板<1mm,采用GBR技术增厚;其余28枚种植体植入后唇侧骨板厚度>1mm,未行植骨手术(占66.7%)。33枚种植体均已完成修复,临床观察27枚种植修复体龈缘高度及牙间乳头均获得了良好的保存。结论:位于美学区域、唇侧骨板缺损或为菲薄型牙周生物类型的患牙,拔牙同期拔牙窝植入胶原骨,并覆盖PRF关闭拔牙创,可有效的保存牙槽嵴顶的宽度,能为II期早期种植及最终的美学修复创造有利条件,临床操作简便,并可有效的节省患者的植骨费用并缩短治疗周期,临床应用前景广阔。     

牙周病患者拔牙后即刻种植与延期种植的临床研究

目的:探讨牙周病患者拔牙后即刻种植与延期种植的临床效果。方法 :68例慢性中、重度牙周病患者,在牙周治疗后,随机选择34例拔除患牙后即刻种植41枚种植体;另外34例患者拔牙后3个月延期种植45枚种植体。术后随访2年,评价种植体的存留率、牙周探诊深度、美学评分、种植体颈部骨吸收率。结果:种植体脱落情况,即刻种植组3枚,延期种植组2枚,存留率分别为92.68%和95.56%;2年随访期内,仅第3个月的美学评分差异有统计学意义。结论:术前控制牙周炎,术中彻底刮除拔牙窝中的感染组织,配合使用抗生素,牙周病患者即刻种植可取得与延期种植类似效果。     

《中国口腔种植学杂志》2000年第 5卷文题索引 ( 按关键词汉语拼音排序 )

B Branemark种植体用 Branemark种植系统对全口牙列缺失的患者进行固定修复的临床探讨 ( 徐侃 1: 15) 并发症下颌后牙区牙种植术后并发下唇麻木的临床讨论 ( 吕冰 2: 82) C CDIC种植体 a 金属熔附烤瓷冠桥应用于种植义齿修复的特点 ( 杨小东 1: 40) b 246枚 CDIC牙种植体烤瓷修复的临床报告 ( 陈宇 2: 86) 材料医用钛及钛合金种植体材料的研究进展 ( 吕宇鹏 1: 43) 成骨细胞三种生物陶瓷材料的细胞相容性的实验研究 ( 唐昭 1: 8) 纯化膜钛及其合金表面钝化膜的特点及其形成机理 ( 王革 1: 37) 纯钛纯钛表面涂层与烤瓷熔附的研究 ( 梁英 2: 61) D 定位导板人工种植牙临床应用的观察 ( 黄格林 3: 132) 碘仿海绵羟基磷灰石与碘仿海绵预防干槽症的对比观察 ( 吕冰 1: 36) 电镜生物活性玻璃陶瓷修复下颌骨缺损远期超微结构及元素含量分析 ( 李文 4: 151) 多孔中空柱状钛种植体多孔中空柱状钛种植体复合牛骨形成蛋白的实验研究 I. 生物力学测试 ( 廖湘凌 1: 11) 多根牙牙半切术后与种植体的联合单冠修复 ( 周尚敏 1: 22) 动物模型种植体周围炎组织再生的研究状况 ( 徐淑兰 2: 90) F 复合树脂衬里种植体 - 复合树脂衬里金瓷冠修复对力的影响 ( 李雅娟 4: 173) 负荷种植系统内部机械疲劳性能的研究进展 ( 王晟 4: 187) G 干槽症羟基磷灰石与碘仿海绵预防干槽症的对比观察 ( 吕冰 1: 36) 感染种植手术室的医院感染控制与监测 ( 姜宏敏 2: 89) 固定桥天然牙 - 末端骨内种植体固定桥的临床修复设计 ( 林军 3: 122) 固定修复 a 用 Branemark种植系统对全口牙列缺失的患者进行固定修复的临床探讨 ( 徐侃 1: 15) b 种植体 - 天然牙支持的种植义齿修复的临床研究 ( 范群 1: 30) 固定正畸种植义齿在固定正畸中的临床应用 ( 兰建宏 4: 164) 骨基质蛋白骨基质蛋白在骨愈合中的作用 ( 林军 3: 137) 骨结合骨结合牙种植体周围组织状况的一年观察 ( 李晓军 3: 119) 骨缺损 a 生物活性玻璃陶瓷修复下颌骨缺损远期超微结构及元素含量分析 ( 李文 4: 151) b Gore- Tex膜引导骨再生技术在种植体周围炎治疗中的应用 ( 黄盛兴 4: 177) 骨缺损修复引导骨再生膜及其应用研究进展 ( 包崇云 2: 94) 骨改建一氧化氮在骨改建中的作用机制 ( 陈伟辉 3: 141) 骨组织再生新型骨替代材料羟基聚磷酸钙钠的组织学实验研究 ( 欧国敏 1: 4) 骨形成 HTR植入修复即刻种植体周骨缺损的实验研究 ( 李祖兵 2: 54) 骨形成蛋白 a 多孔中空柱状钛种植体复合牛骨形成蛋白的实验研究 I. 生物力学测试 ( 廖湘凌 1: 11) b 中空多孔钛种植体复合牛骨形成蛋白的实验研究 - - 即刻植入的组织学观察 ( 廖湘凌 2: 74) 骨融性种植体种植体修复患者的正畸治疗 ( 周彦恒 1: 18) 骨性结合补骨合剂促进口腔种植体骨性结合的组织学研究 ( 潘在兴 4: 161) 骨内种植 a 多功能种植模板的制作及临床应用 ( 刘斌 2: 70) b 种植体在治疗牙槽嵴吸收中的应用 ( 刘斌 4: 191) 骨内牙种植体骨劈开技术在上颌前牙种植外科中的应用 ( 邱立新 2: 67) 骨劈开骨劈开技术在上颌前牙种植外科中的应用 ( 邱立新 2: 67) 骨移植种植体在治疗牙槽嵴吸收中的应用 ( 刘斌 4: 191) 骨愈合骨基质蛋白在骨愈合中的作用 ( 林军 3: 137) 个别牙缺失个别牙缺失的种植义齿修复 ( 丁仲娟 2: 77) H 缓冲层种植体 - 复合树脂衬里金瓷冠修复对力的影响 ( 李雅娟 4: 173) I IL- 2产生能力类金刚石碳 - 钛复合体的生物相容性评价 - NK细胞活性和 IL- 2产生能力测定 ( 赵宝红 1: 1) J 监测管理种植手术室的医院感染控制与监测 ( 姜宏敏 2: 89) 进展医用钛及钛合金种植体材料研究进展 ( 吕宇鹏 1: 43) 即刻种植 a HTR植入修复即刻种植体周骨缺损的实验研究 ( 李祖兵 2: 54) b 自体咀嚼粘膜游离移植于即刻种植早期软组织创口关闭的可行性研究 ( 徐晓刚 2: 57) c 中空多孔钛种植体复合牛骨形成蛋白的实验研究 - 即刻植入的组织学观察 ( 廖湘凌 2: 74) 金属烤瓷冠种植体 - - 复合树脂衬里金瓷冠修复对力的影响 ( 李雅娟 4: 173) 基台用 Branemark种植系统对全口牙列缺失的患者进行固定修复的临床探讨 ( 徐侃 1: 15) 机械应力一氧化氮在骨改建中的作用机制 ( 陈伟辉 3: 141) 畸形牙冠种植体与畸形牙牙冠联合修复的临床观察 ( 黄爱新 4: 180) 鉴定种植义齿的细菌学鉴定 ( 诸葛春耕 2: 84) 咀嚼粘骨膜自体咀嚼粘膜游离移植于即刻种植早期软组织创口关闭的可行性研究 ( 徐晓刚 2: 57) K 烤瓷熔附冠桥金属熔附烤瓷冠桥应用于种植义齿修复的特点 ( 杨小东 1: 40) 烤瓷纯钛表面涂层与烤瓷熔附的研究 ( 梁英 2: 61) 烤瓷修复体 246枚 CDIC牙种植体烤瓷修复的临床报告 ( 陈宇 2: 86) L 类骨质新型骨替代材料羟基聚磷酸钙钠的组织学实验研究 ( 欧国敏 1: 4) 类金钢石碳 - 钛复合体 a 类金钢石碳 - 钛复合体的生物相容性评价 - - NK细胞活性和 IL- 2产生能力测定 ( 赵宝红 1: 1) b 类金刚石碳 - - 钛复合体的生物相容性评价 - 外周血 T淋巴细胞亚群测定 ( 赵宝红 3: 101) 联合修复种植体与畸型牙牙冠联合修复的临床观察 ( 黄爱新 4: 180) 螺旋 CT 螺旋 CT与牙槽骨骨萎缩分类的数学模型建立 ( 吴朝辉 3: 105) M 模板多功能种植模板的制作及临床应用 ( 刘斌 2: 70) 膜材料引导骨再生膜及其应用研究进展 ( 包崇云 2: 94) 模拟种植人工种植牙临床应用的观察 ( 黄格林 3: 132) 膜引导成骨种植体在治疗牙槽嵴吸收中的应用 ( 刘斌 4: 191) N NK细胞活性类金刚石碳 - - 钛复合体的生物相容性评 . 价 - NK细胞活性和 IL- 2产生能力测定 ( 赵宝红 1: 1) 内毒素牙龈卟啉单胞菌内毒素对成纤维细胞在纯钛表面附着的影响 ( 盛列平 3: 108 ) 颞颌关节髁突置换生物活性玻璃陶瓷人工髁突置换对颞下颌关节盘及关节结节影响的实验研究 ( 王慧明 3: 113) P 疲劳种植系统内部机械疲劳性能的研究进展 ( 王晟 4: 187) 疲劳循环种植系统内部机械疲劳性能的研究进展 ( 王晟 4: 187) Q 前牙缺失修复螺旋状种植体在修复前牙缺失中的应用 ( 王伦昌 3: 134) 牵张成骨种植体在治疗牙槽嵴吸收中的应用 ( 刘斌 4: 191) 羟基聚磷酸钙钠新型骨替代材料羟基聚磷酸钙钠的组织学实验研究 ( 欧国敏 1: 4) 羟基磷灰石 a 羟基磷灰石与碘仿海绵预防干槽症的对比观察 ( 吕冰 1: 36) b 牙槽骨骨量不足的前牙种植 ( 何建明 3: 130) 羟基磷灰石涂层水热合成法制备羟基磷灰石生物涂层的体内及体外实验研究 ( 张玉梅 4: 154) 全口牙列缺失用 Branemark种植系统对全口牙列缺失的患者进行固定修复的临床探讨 ( 徐侃 1: 15) 全口义齿老年无牙颌患者两种义齿修复后牙槽嵴吸收的 8年 X- 线观察 ( 岑远坤 3: 125) R 人工种植牙螺旋状种植体在修复前牙缺失中的应用 ( 王伦昌 3: 134) 软骨细胞增殖转化因子 -β可以诱导骺板软骨细胞表达细胞增殖核抗原 ( 王凡 2: 51) S 上前牙 72枚 CDIC纯钛锥状螺旋种植体用于上前牙的五年临床结果分析 ( 熊刚 4: 184 ) 上置法植骨上置法植骨技术与种植修复 ( 林野 3: 117) 生物相容性 a 三种生物陶瓷材料的细胞相容性的实验研究 ( 唐昭 1: 8) b 水热合成法制备羟基磷灰石生物涂层的体内及体外实验研究 ( 张玉梅 4: 154) 生物活性玻璃陶瓷生物活性玻璃陶瓷修复下颌骨缺损远期超微结构元素 ( 李文 4: 151) 生物相容性材料生物活性玻璃陶瓷人工髁突置换对颞下颌关节盘及关节结节影响的实验研究 ( 王慧明 3: 113) 生物陶瓷材料三种生物陶瓷材料的细胞相容性的实验研究 ( 唐昭 1: 8) 生物力学多孔中空柱状钛种植体复合牛骨形成蛋白的实验研究 I. 生物力学测试 ( 廖湘凌 1: 11) 生长因子骨基质蛋白在骨愈合中的作用 ( 林军 3: 137) 水热合成法水热合成法制备羟基磷灰石生物涂层的体内及体外实验研究 ( 张玉梅 4: 154) T T淋巴细胞亚群类金刚石碳 - 钛复合体的生物相容性评价 - - 外周血 T淋巴细胞亚群测定 ( 赵宝红 3: 101) 弹性模量人工种植牙临床应用的观察 ( 黄格林 3: 132) 钛及其合金钛及其合金表面钝化膜的特点及其形成机理 ( 王革 1: 37) 钛 a 医用钛及钛合金种植体材料的研究进展 ( 吕宇鹏 1: 43) b 牙龈卟啉单胞菌内毒素对成纤维细胞在纯钛表面附着的影响 ( 盛列平 3: 108) 涂层纯钛表面涂层与烤瓷熔附的研究 ( 梁英 2: 61) W 微生物种植义齿的细菌学鉴定 ( 诸葛春耕 2: 84) 外科模板个别牙缺失的种植义齿修复 ( 丁仲娟 2: 77) 无牙颌老年无牙颌患者两种义齿修复后牙槽嵴吸收的 8年 X- 线观察 ( 岑远坤 3: 125) 五年成功率 72枚 CDIC纯钛锥状螺旋种植体用于上前牙的五年临床结果分析 ( 熊刚 4: 184) X 细胞附着牙龈卟啉单胞菌内毒素对成纤维细胞在纯钛表 . 面附着的影响 ( 盛列平 3: 108) 细胞培养三种生物陶瓷材料的细胞相容性的实验研究 ( 唐昭 1: 8) 细胞增殖核抗原转化因子 -β可以诱导骺板软骨细胞表达细胞增殖核抗原 ( 王凡 2: 51) 细菌种植义齿颈部的细菌生长附着 ( 刘渝 2: 79) 下唇麻木下颌后牙区牙种植术后并发下唇麻木的临床讨论 ( 吕冰 2: 82) 修复 a 牙半切术后与种植体的联合单冠修复 ( 周尚敏 1: 22) b 65例种植义齿的临床总结和失败原因分析 ( 李本光 4: 182) 修复设计天然牙 - 末端骨内种植体固定桥的临床修复设计 ( 林军 3: 122) Y 亚临床活动度牙周测试仪检查种植牙牙周状况的评估 ( 李祖兵 1: 26) 一段式纯钛种植体种植体 - 天然牙支持的种植义齿修复的临床研究 ( 范群 1: 30) 一氧化氮一氧化氮在骨改建中的作用机制 ( 陈伟辉 3: 141) 一氧化氮合酶一氧化氮在骨改建中的作用机制 ( 陈伟辉 3: 141) 颜色钛及其合金表面钝化膜的特点及其形成机理 ( 王革 1: 37) 硬组织再生材料 HTR植入修复即刻种植体周骨缺损的实验研究 ( 李祖兵 2: 54) 应力分析种植体 - 复合树脂衬里金瓷冠修复对力的影响 ( 李雅娟 4: 173) 引导骨再生 a 引导骨再生膜及其应用研究进展 ( 包崇云 2: 94) b Gore-Tex膜引导骨再生技术在种植 ( 黄盛兴 4: 177) 牙半切术牙半切术后与种植体的联合单冠修复 ( 周尚敏 1: 22) 牙科扫描软件螺旋 CT与牙槽骨骨萎缩分类的数学模型建立 ( 吴朝辉 3: 105) 牙科 pd操作牙科 PD操作在种植义齿固定修复中的应用 ( 帅英 3: 135) 牙列缺损 248枚 CDIC牙种植体烤瓷修复的临床报告 ( 陈宇 2: 86) 牙槽骨 a 软组织瓣早期裂开或穿孔对种植体颈缘部骨组织的影响 ( 邱立新 2: 64) b 骨劈开技术在上颌前牙种植外科中的应用 ( 邱立新 2: 67) c 牙槽骨骨量不足的前牙种植 ( 何建明 3: 130) 牙槽嵴吸收种植体在治疗牙槽嵴吸收中的应用 ( 刘斌 4: 191) 牙菌斑种植义齿颈部的细菌生长附着 ( 刘渝 2: 79) 牙种植骨结合牙种植体周围组织状况的一年观察 ( 李晓军 3: 119) 牙种植术牙半切术后与种植体的联合单冠修复 ( 周尚敏 1: 22) 牙种植体 a HTR植入修复即刻种植体周骨缺损的实验研究 ( 李祖兵 2: 54) b 软组织瓣早期裂开或穿孔对种植体颈缘部骨组织的影响 ( 邱立新 2: 64) c 多功能种植模板的制作及临床应用 ( 刘斌 2: 70) d 中空多孔钛种植体复合牛骨形成蛋白的实验研究 - 即刻植入的组织学观察 ( 廖湘凌 2: 74) e 牙龈卟啉单胞菌内毒素对成纤维细胞在纯钛表面附着的影响 ( 盛列平 3: 108) f 天然牙 - 末端骨内种植体固定桥的临床修复设计 ( 林军 3: 122) 牙周测量仪牙周测试仪检查种植牙牙周状况的评估 ( 李祖兵 1: 26) 牙周组织骨结合牙种植体周围组织状况的一年观察 ( 李晓军 ( 李晓军 3: 119) 预负荷种植系统内部机械疲劳性能的研究进展 ( 王晟 4: 189) Z 载体系统中空多孔钛种植体复合牛骨形成蛋白的实验研究 - - 即刻植入的组织学观察 ( 廖湘凌 2: 74) 自体组织移植自体咀嚼粘膜游离移植于即刻种植早期软组织创口关闭的可行性研究 ( 徐晓刚 2: 57) 正畸治疗种植体修复患者的正畸治疗 ( 周彦恒 1: 18) 支抗种植体修复患者的正畸治疗 ( 周彦恒 1: 18) 种植材料 a 类金刚石碳 - - 钛复合体的生物相容性评价 - NK细胞活性和 IL-2产生能力测定 ( 赵宝红 1: 1) b 类金刚石碳 - 钛复合体的生物相容性评 - - 外周血 ( 上接第 201页 ) ( 续 ) ④ 6个月后 , 进行第二期手术 ( 图 13) : 局麻后 , 用探针确定各种植体的具体位置 , 用环行切龈刀分别在各种植体的表面钻开粘骨膜 ( 即粘膜开孔 ) , 直达骨面 , 取出粘膜显露该种植体 , 卸除封闭螺钉后 , 将上部基桩直接插入根部中央内六方孔 , 通过中心螺钉固定上部基桩 . 7～ 10天后即可行种植义齿修复 . 图 13 粘膜开孔 , 卸除封闭螺钉 , 插入上部基桩 T淋巴细胞亚群测定 ( 赵宝红 3: 101) 种植覆盖义齿老年无牙颌患者两种义齿修复后牙槽嵴吸收的 8年 X- 线观察 ( 岑远坤 3: 125) 种植手术种植牙随访观察分析 ( 姜淑芳 3: 128) 种植体 a 多孔中空柱状钛种植体复合牛骨形成蛋白的实验研究 I. 生物力学测试 ( 廖湘凌 1: 11) b 医用钛及钛合金种植体材料的研究进展 ( 吕宇鹏 1: 43) c 下颌后牙区牙种植术后并发下唇麻木的临床讨论 ( 吕冰 2: 82) d 上置法植骨技术与种植修复 ( 林野 3: 117) e 种植体复合树脂衬里金瓷冠修复对力的影响 ( 李雅娟 4: 173) f 补骨合剂促进口腔种植体骨性结合的组织研究 ( 潘在兴 4: 161) g 65例种植义齿的临床总结和失败原因分析 ( 李本光 4: 182) h 种植体与畸型牙牙冠联合修复的临床观察 ( 黄爱新 4: 180) 种植体 - 天然牙支持种植体 - 天然牙支持的种植义齿修复的临床研究 ( 范群 1: 30) 种植体稳固度牙周测试仪检查种植牙牙周状况的评估 ( 李祖兵 1: 26) 种植系统种植系统内部机械疲劳性能的研究进展 ( 王晟 4: 187) 种植体周围炎种植体周围炎组织再生的研究状况 ( 徐淑兰 2: 90) Gore-Tex膜引导骨再生技术在种植体周围炎治疗中的应用 ( 黄盛兴 4: 164) 种植义齿个别牙缺失的种植义齿修复 ( 丁仲娟 2: 77) 口腔护理牙科 PD操作在种植义齿固定修复中的应用 ( 帅英 3: 135) 种植牙种植牙随访观察分析 ( 姜淑芳 3: 128) 种植义齿 a 金属熔附烤瓷冠桥应用于种植义齿修复的特点 ( 杨小东 1: 40) b 个别牙缺失的种植义齿修复 ( 丁仲娟 3: 77) c 种植义齿颈部的细菌生长附着 ( 刘渝 2: 79) d 种植义齿的细菌学鉴定 ( 诸葛春耕 2: 84) e 螺旋 CT与牙槽骨骨萎缩分类的数学模型建立 ( 吴朝辉 3: 105) f 种植义齿在固定正畸中的临床应用 ( 兰建宏 4: 164) g 65例种植义齿的临床总结和失败原因分析 ( 李本光 4: 182) 转化生长因子 - β转化生长因子 - β可以诱导骺板软骨细胞表达细胞增殖核抗原 ( 王凡 2: 51) 组织反应生物活性玻璃陶瓷人工髁突置换对颞下颌关节盘及关节结节影响的实验研究 ( 王慧明 3: 113) 组织形态学补骨合剂促进口腔种植体骨性结合的组织研究 ( 潘在兴 4: 161) 组织再生种植体周围炎组织再生的研究状况 ( 徐淑兰 2: 90) 锥状螺旋种植体 72枚 CDIC纯钛锥状螺旋种植体用于上前牙的五年临床结果分析 ( 熊刚 4: 184)     

Removal of fractured cylindrical implants

The implant fracture is a rare but significative complication which requires a specific treatment for the surgical removal of the fractured fixture and the modification of the initial prosthetic plan. On the basis of the most recent studies and of a case personally observed in which both the osteointegrated supporting implants of a maxillary overdenture were fracturated, epidemiological, etiopathogenic, diagnostic and therapeutical aspects of this complication are analyzed. Clinical situations most at risk are emphasized, including implant-supported maxillary overdenture, and the major etiologic factors, represented by defects in implant design or material and physiologic or biomechanical overload. The diagnostic criteria are described along with the three therapeutical possible options: 1) removal of the fractured implant, replacement of the implant and refabrication of the prosthesis; 2) modification of the existing prosthesis leaving the fractured portion of the implant in place; 3) modification of the fractured implant and refabrication of a portion of the prosthesis. Three surgical removal technics are then illustrated (block-section, vestibular approach, occlusal approach), with the emphasis on the one choosed in the case examined, in which the ostectomy around the remaining fixture has been carried out with a trephine drill in order to contain the bone loss.     

A clinical, radiographic, and histological evaluation of permucosal dental implants of dense hydroxylapatite in dogs

A clinical, histological, and radiographic examination was performed on 77 permucosal dental implants, made of dense sintered hydroxylapatite: 34 solid cylinders and 43 hollow cylinders. The hollow cylinders were pre-compressed between two titanium caps. The implants were placed in partly edentulous mandibles of dogs, and were physiologically loaded. Healing was clinically and radiographically evaluated during a six-month to five-year period. At various times, implants with their surrounding tissues were removed and prepared for light and electron microscopy. All implants showed a good initial fit and were maintained in place without undercut or mechanical stabilization. After 18 months, 76% of the solid cylinders had fractured at the implant/bone junction due to fatigue. However, the submerged portions of the solid cylinders were preserved without clinical problems, and became entirely embedded in bone. The pre-stressed implants did not fracture, and 91% were functioning 24 months after placement. The average scores of pocket depths and gingival bleeding showed no significant differences between implants and surrounding natural teeth. Bone deposition occurred on the entire surface of the implant below the crest of the alveolar bone, and intimate bone contact was confirmed by electron microscopy. It was also observed that a layer of bone tissue was deposited on the implant surface in the permucosal area just above the alveolar bone level. Embedding of gingival fibers in this layer resulted in gingival attachment to the implant, comparable with that of natural teeth.     

Fixed implant‐supported prostheses in the edentulous maxilla. A five‐year follow‐up report.

Seventy‐six patients were consecutively treated with fixed prostheses supported by osseointegrated implants in the edentulous maxilla and followed up for 5 years. The mean bone quality and resorption indices were 3.1 and 2.7 at the time of implant placement, respectively. Altogether, 449 standard Brånemark implants were placed. Two patients resumed to complete dentures, and the cumulative implant and prosthesis survival rates were 92.1% and 95.9% for 5 years, respectively. The mean marginal bone level was 0.6 mm below the reference point at the time of placement and 1.2 mm below the same point 5 years later. Speech problems was the most frequent complaint during the first year of function, while resin fractures caused most adjustments during the follow‐up period. No implant, abutment or gold alloy screws were found to be fractured, and only 4 patients had their prostheses re‐tightened due to loose gold alloy screws.     

Clinical outcome of implants placed immediately after implant removal

BACKGROUND: The purpose of this study was to evaluate the clinical success of implants placed immediately after the explantation of failed implants due to fracture at 12 months. METHODS: Nine immediate implants were placed in nine patients following explantation of nine fractured implants. Five experimental implants did not require any regenerative procedures; the remaining four immediate implants were grafted with deproteinized porcine bone particles and covered with bioabsorbable membranes. All implants were restored with fixed prostheses. The follow-up period was 12 months. RESULTS: No residual bone defects were observed or probed around any implant at the second-stage surgery, and all implants were asymptomatic and stable. All the implants were successful after prosthetic rehabilitation showing no mobility, pain, suppuration, or absence of peri-implant radiolucency. The radiographic measurements showed no significant bone loss pattern at the 12-month follow-up visit. CONCLUSION: The findings of this study suggested that implants placed immediately after implant explantation due to biomechanical fracture could be performed with results that are similar to results obtained with implants placed immediately after tooth extraction.     

The relationship between the interleukin-1 periodontal genotype and implant loss. Initial data.

BACKGROUND: This study investigated the relationship of the interleukin-1 (IL-1) genotype, smoking status, and the patient's age to the survival of osseointegrated dental implants. METHODS: Twenty-seven patients with 33 implants that had been lost or who had at least 50% bone loss on radiographs were compared to a group of 38 patients who had experienced no bone or implant loss. All lost implants in a private practice were included in the data, except those that had fractured with no previous bone loss. RESULTS: Smoking was demonstrated to increase the risk of implant failure by a factor of almost 2.5. CONCLUSIONS: Statistical testing failed to provide evidence of an increased risk for implant failure for patients who are positive for the IL-1 genotype. There was no apparent relationship between the patient's age at the time of placement and implant loss. This study raises several questions concerning the etiology of implant loss and the comparative biology of tissues surrounding implants when compared to those surrounding natural teeth.     

Forced orthodontic eruption of fractured teeth before implant placement: case report

The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. Placement of a single-unit implant is indicated for fractured or periodontally compromised teeth. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured tooth, which was achieved by forced orthodontic extrusion before implant placement. This technique may be used to improve primary anchorage of a dental implant, fill the alveolar socket with bone, preserve interdental bone height and increase the amount of attached gingiva.     

Osseointegration in a sinus augmented with bovine porous bone mineral: histological results in an implant retrieved 4 years after insertion. A case report

BACKGROUND: A subject of controversy in implant dentistry is what is the most appropriate material for sinus augmentation. Little is known about the healing pattern and the osseointegration processes at the interface of implants placed in different grafting materials in man. Bovine porous bone mineral (BPBM) is a xenogenic material similar to human cancellous bone with a high biocompatibility and osteoconductivity. METHODS: A 50-year-old patient presented a posterior left maxilla with an insufficient bone height for implant insertion. In January 1999, a sinus lifting procedure was performed and the left sinus was augmented with BPBM; in November 1999, three implants were inserted, and in July 2000 a fixed prosthetic restoration was positioned. In June 2003 the connecting screw of the middle implant fractured and it was decided to remove the implant using a 5 mm trephine bur. RESULTS: All BPBM particles were surrounded by newly formed bone. No BPBM particle was in direct contact with the implant surface, and between the implant surface and the particles there was newly-formed bone. BPBM seemed to undergo a very slow resorption; the particles constituted 36% +/- 3% of the peri-implant tissues. The bone-implant contact percentage was 72% +/- 4%. CONCLUSIONS: In our specimens, we found an intimate, direct contact between bone and implant without an interposition of the graft material particles. A very high bone-to-implant contact percentage was present. Our results show that the slow resorption of the graft particles did not jeopardize the osseointegration of the implant.     

Replacement of a fixed partial denture secondary to abutment fracture

BACKGROUND: The authors present a case that demonstrates the efficient replacement of a fixed prosthesis after a patient's abutment tooth fractured and required extraction. The fractured tooth had a local infection, and the maxillary bone was low-density and limited in height. CASE DESCRIPTION: The authors removed the tooth and grafted the site with particulate bone, while concurrently placing two implants in the edentulous region. After four months, they placed one additional implant and secured a fixed provisional prosthesis within one week. CLINICAL IMPLICATIONS: The patient wanted to minimize the time that she would have to be without a fixed prosthesis. The authors met her expectations by using an accelerated treatment plan.     

Preferred collagen fiber orientation human peri-implant bone after a short- and long-term loading period: a case report

Immediate loading of dental implants offers treatment cost advantages to patients and avoids the functional and psychological problems caused by the wearing of provisional dentures. There is evidence that the amount of transverse collagen fiber orientation in bone is influenced by mechanical stresses and strains. Two osseointegrated dental implants in humans were used in the present study. Two implants inserted in the maxilla were analyzed: 1 short-term implant (implant A) immediately loaded and retrieved after 4 months of loading and 1 long-term implant (implant B) immediately loaded and retrieved after 12 years. We hypothesized that the bone functional strain caused by immediate loading correlated well with the collagen fiber organization occurring after both short- and long-term functional healing. Circularly polarized light (CPL) was used to assess the area fraction extension related to the transverse collagen fiber orientation in the bone matrix. After evaluating a total of 68 digitized images taken at x50 magnification, birefringence measurements were performed all around the implant surfaces by using 2 central sections from each implant. The results showed that the bone-to-implant contact (BIC) percentage for implant A was 67.9% +/- 9.5% (mean +/- SD), whereas the BIC percentage for implant B was 74.6% +/- 11.2% (mean +/- SD). The area fraction extension was 2.7% +/- 1.4 % (mean +/- SD) for implant A, whereas the area fraction extension was 4.7% +/- 1.2% (mean +/- SD) for implant B. The CPL measurements of the birefringence for transverse collagen fibers of implant A vs implant B indicated that the bone fraction area difference was not high. In the bone near both dental implants, no differences were found in the amount of transverse collagen fibers. Immediate loading seemed to determine and maintain the collagen fiber's orientation over a long period.     

Collagen fiber orientation near a fractured dental implant after a 5-year loading period: case report

PURPOSE: Fracture of an implant is one of the possible complications of dental implants. It is a quite rare event but of high clinical relevance. Nevertheless, it represents an important opportunity for evaluating the peri-implant bone-tissue response to implant overloading in human beings. The aim of the present study was a scanning electron microscopy evaluation of a screw-shaped implant retrieved because of fracture and a birefringence analysis of the tissue near the fractured implant. MATERIALS AND METHODS: There was 1 fractured screw-shaped implant retrieved from a patient with a trephine bur, and it was processed for histology. The specimen was analyzed under both scanning electron microscopy and circularly polarized light microscopy. RESULTS: The scanning electron microscopy fractography analysis showed the typical signs of a fatigue-fracture, with large plastic deformations on the implant. The fracture seemed to start from the internal coil of the implant. Under circularly polarized light microscopy investigation, a bone-implant contact percentage of 81.6% +/- 1.5% (mean +/- standard deviation) was found. The amount of the transverse collagen fibers was of 68.3%, and the amount of the longitudinal collagen fibers was of 31.7%. The difference was statistically significant for z = 2.247 (P = 0.025). CONCLUSION: The fracture of the implant was most probably correlated to a fatigue of the material mainly associated to a lesion of the internal coil. The high level of bone-implant contact percentage was correlated to a predominant transverse collagen fiber orientation of the collagen fibers in the peri-implant bone.