无牙颌患者“All-on-Four”种植即刻负重技术的发展与变迁

无牙颌患者的最佳修复方式一直是颇有争议的话题，随着口腔种植技术的不断发展，目前无牙颌患者种植修复重建面临的挑战是如何在保证修复质量的前提下同时降低手术难度以及患者的费用。“All-on-Four”种植即刻负重技术是目前临床研究的热点，其避免了复杂植骨手术，最大程度利用剩余牙槽骨量实现即刻负重，患者接受程度高，临床效果理想。然而“All-on-Four”技术也面临着诸多挑战，手术适应症、手术程序、修复方案以及修复并发症等仍有待商榷。本文将就“All-on-Four”种植即刻负重技术在临床应用中的发展变迁及其优缺点等方面展开讨论，为临床医生在临床实际合理应用中提供参考。     

Special considerations for treating dental patients exhibiting the "Post-polio Syndrome"

A condition called "Post-polio Syndrome" (PPS) is a special type of neuromuscular disturbance that affects some elderly patients who had polio myelitis either as children or as young adults. It has been reported that approximately 1,600,000 polio survivors are alive today. Most will seek dental care, and up to half of the survivors will present with some form of PPS. This paper describes polio, its characteristics, and the long-term consideration of PPS, and discusses the special clinical implications related to this condition. Special emphasis is placed on physical impairments, breathing problems, and difficulty swallowing. Also included are sections discussing such topics as patient scheduling, office design and housekeeping, patient management, oral hygiene, diagnostic procedures, drug and pain management, and general health considerations.     

*"All-on-4"种植即刻修复技术的临床应用研究

Objective To evaluate the preliminary clinical results of application of All-on-4 immediate junction in edentulous patients. Methods Twenty nine edentulous patients with 140 immediately loaded implants supporting fixed complete-arch all-acrylic prostheses from April 2008 to October 2009 in Peking University School of Stomatology were included. The implant-supported fixed complete-arch all-acrylic prostheses were delivery on the operation day. At time of abutments connection, a panoramic radiograph was taken. And radiographic assessment of the marginal bone level was performed in every 2 months. Clinical observe items included marginal bone level, integrity of the restoration,survival of the implants and degree of satisfaction of the patients. Results A total of 140 implants were immediate loading. Eight implants were lost during 6-8 weeks after immediate loading, giving survival rate of 94. 3% . The marginal bone level was (0. 8 ± 0.4) mm . The All patients were satisfied with the clinical results. Conclusions The data and the experience described in this study indicate that All-on-four immediate function technique can be a predictable technique for edentulous patients. Further study is needed to determine the long-term result of the technology.     

*"All-on-4"种植即刻修复技术的临床应用研究

Objective To evaluate the preliminary clinical results of application of All-on-4 immediate junction in edentulous patients. Methods Twenty nine edentulous patients with 140 immediately loaded implants supporting fixed complete-arch all-acrylic prostheses from April 2008 to October 2009 in Peking University School of Stomatology were included. The implant-supported fixed complete-arch all-acrylic prostheses were delivery on the operation day. At time of abutments connection, a panoramic radiograph was taken. And radiographic assessment of the marginal bone level was performed in every 2 months. Clinical observe items included marginal bone level, integrity of the restoration,survival of the implants and degree of satisfaction of the patients. Results A total of 140 implants were immediate loading. Eight implants were lost during 6-8 weeks after immediate loading, giving survival rate of 94. 3% . The marginal bone level was (0. 8 ± 0.4) mm . The All patients were satisfied with the clinical results. Conclusions The data and the experience described in this study indicate that All-on-four immediate function technique can be a predictable technique for edentulous patients. Further study is needed to determine the long-term result of the technology.     

*"All-on-4"种植即刻修复技术的临床应用研究

目的 评价应用"All-on-4"种植即刻修复技术对牙列缺失患者进行种植即刻修复的临床效果,探讨其技术要点及临床意义.方法 2008年4月至2009年10月共29例患者(男15例,女14例)接受了"All-on-4"种植即刻修复.29例(上颌牙列缺失8例,下颌牙列缺失15例,全口牙列缺失6例)共植入140枚种植体,在种植体植入当天完成即刻修复,一共完成35件"All-on-4"即刻义齿.即刻修复后观察种植体边缘骨吸收情况、修复体功能状况、患者满意度,追踪种植体的存留率.患者平均追踪10个月(6～24个月).结果 140枚种植体中,8枚于植入后6～8周脱落;其余132枚种植体至最后一次复查临床稳定,种植体存留率94.3%;即刻修复义齿的存留率94%(33/35);边缘骨吸收程度为(0.8±0.4)mm.结论 "All-on-4"种植即刻修复技术应用于牙列缺失患者近期效果好,患者满意度高.远期效果需要进一步观察.     

Effects of metronidazole in patients with "refractory" periodontitis associated with Bacteroides forsythus

Abstract The aim of the present study was to monitor the microbiological and clinical effects of renewed supra and sub gingival debridement in conjunction with systemic metronidazole therapy (500 mg TID for 7 days) in 27 “refractory” periodontitis patients, culture positive for Bacteroides forsythus and negative for Actinobacillus actinomycetemcomitans. Clinical evaluation included assessment of plaque, bleeding upon probing, probing pocket depth and clinical attachment loss at the deepest, bleeding site in each quadrant. Microbiological evaluation was carried out by anaerobic cultivation of sub gingival plaque samples from the same sites. 6 months after renewed debridement and systemic metronidazole (RD + M). a statistically significant improvement of all clinical parameters was observed, except for the plaque index. After RD + M, B. forsythus was suppressed below detection level in 17 of the 27 patients, P. gingivalis in 9 out of 15 patients and P. intermedia in 14 of the 21 patients. Before RD+M. 12 patients harboured simultaneously B. forsythus, P. gingivalis as well as P. intermedia. Out of these 6 patients were culture negative for the 3 species after therapy and showed the greatest reduction in pocket depth (3.1 mm) and gain of clinical attachment level (2.5 mm). In the treatment of refractory periodontitis. associated with patients culture positive for B. forsythus and negative for A. actinomycetemcomitans, metronidazole can significantly improve the clinical and microbiological parameters.