前牙区延期即刻牙种植术的临床研究

目的:评价前牙区延期即刻种植的技术特点及近期临床效果.方法:对66例患者前牙区患牙拔除4～6周后,植入Fdalit-2及Xive两种种植系统共107颗种植体,4～6个月后行二期手术,暴露种植体,最终完成烤瓷牙冠修复.结果:术后无明显并发症发生,修复完成后观察6～48个月,种植体行使功能良好,无种植体丧失.结论:延期即刻种植的临床方法可行.近期临床效果满意,修复美学效果佳.     

Straumann种植体在上颌前牙区即刻种植修复中的应用

目的 评估Straumann种植体即刻种植修复上颌前牙区的近期临床效果。方法 临床选择28例上前牙残根患者,在拔牙后即刻植入Straumann种植体40枚。其中11例15个牙位行不翻瓣种植,17例25个牙位采取翻瓣GBR技术即刻种植。3～9个月后行永久性修复。随访3～36月,临床观察种植体、基台和牙冠的稳固性,牙龈组织、龈乳头情况及牙冠美观状况。结果 所有种植体均发生骨结合,无松动现象,未见种植体周围炎表现,即刻种植存活率为100%。不翻瓣种植病例的唇侧龈缘无明显退缩,牙龈乳头无明显丧失;翻瓣植骨的病例唇侧牙龈缘少许退缩,牙龈乳头轻度丧失。修复体外形美观,周围牙龈形态正常,功能良好,患者满意。结论 在严格掌握适应证和注意术中术后各种细节的情况下,应用Straumann种植体即刻种植修复上颌前牙区可获得理想的美学修复效果。     

Straumann种植体用于上颌前牙即刻种植的临床效果评价

目的评价Straumann种植体用于上颌前牙区即刻种植的临床效果。方法 42例患者53颗上颌前牙拔除后即刻植入53颗Straumann种植体,其中31颗行引导骨组织再生术。术后4～6个月后行永久性修复。随访12～36个月,通过临床和放射学检查评价临床疗效。结果 53颗种植体,1颗因初期稳定性差失败5,2颗成功。10颗种植体随访期内出现轻微的软组织退缩,患者对美学效果满意。结论适应证选择适当,Straumann种植体应用于上颌前牙区即刻种植可以取得较好的临床效果。     

前牙美学区即刻种植即刻美学修复的临床观察

目的：探讨前牙关学区即刻种植即刻美学修复的临床特点及修复后的美学效果。方法：18例患者22枚m和Replace种植体前牙区即刻种植即刻临时冠修复,对种植体成功率及周围牙龈附着状况进行观察,6个月后永久冠修复。结果：1枚种植体在愈合期内脱落,其余种植体在修复后12个月时均有骨结合,临床效果良好。结论：前牙美学区即刻种植即刻美学修复时多因素可影响种植体的成功率及软组织美学效果,严格掌控适应证,才能获得理想的美学效果。     

单根前牙即刻与延期植入牙种植体远期临床疗效分析

目的：分析单根前牙即刻种植与延期种植的远期临床效果。方法：对我院90年代初共73颗牙种植体进行远期临床观察，评估两种种植方法的临床效果。结果：经3年，5年和8年的临床观察，即刻种植与延期种植差别不大。但两种种植体的成功率均随时间延长而下降。结论：只要选择好即刻种植体的适应证和操作方法正确，可以达到与延期种植同样的远期效果。羟基磷灰石在即刻种植术中起到良好的初期稳固和促进种植体与骨愈合的作用。     

BLB系统在前牙区即刻种植的应用体会

目的:总结在前牙区应用BLB系统进行即刻种植的体会。方法:对26例因外伤、龋坏等原因的前牙拔除后立即植入BLB系统种植体35枚,四个月后行二期手术,二周后永久修复。并定期进行临床和放射学检查。结果:35枚即刻种植近期成功率100%,但种植方向、位置不佳5枚(14.3%),牙槽嵴高度的吸收17枚(48.6%)。结论:即刻种植除了社会效益外,有利于保持牙槽嵴的高度和丰满度;窝隙小于1mm的不一定采用GBR技术;早期稳定性至关重要;BLB系统的骨结合中远期效果有待观察。     

即刻种植与即刻修复在临床应用的研究

目的:评价口腔即刻种植与即刻修复技术的临床应用效果。方法:20例牙列缺损患者行拔牙后即刻种植并于种植后当日前牙区在种植体上部完成临时树脂单冠或联冠修复,后牙区种植体上愈合基台,1周至1个月内行种植体烤瓷冠修复,所有患者均于术后1、3、6、12个月,之后每12个月复查1次。结果:20例患者共植入42颗种植体,平均负荷28个月(最短4个月,最长49个月),除其中2例3枚种植体松动外,其余种植体均获得良好的临床效果,累计存留率为92.86%,患者对修复效果满意。结论:严格掌握适应证,即刻种植与即刻修复可应用于临床,近期效果满意。     

上颌前牙区人工种植牙即刻修复的临床研究

目的 探讨即刻负重在上颌前牙区种植义齿修复中的临床应用.方法 43例前牙缺失患者植入55枚Frialit-2阶梯螺旋状种植体,手术当日即以聚丙烯酸树脂冠完成修复,消除正中、前伸和侧方(牙合)早接触点并以(牙合)夹板固定,术后6个月完成全瓷冠修复体.结果 植入上颌前牙区的55枚种植体直径分别为4.5 mm(28枚)、5.5 mm(27枚),长度为13 mm(30枚)和15 mm(25枚),种植体植入时的转矩介于32Ncm和45Ncm.植入后随访1～4年.种植体周围牙槽骨的吸收程度平均分别为0.35 mm和0.55 mm.植入后12个月未见种植体松动脱落,所有种植体均稳定地行使功能,除2例外,患者均获得满意的美观修复效果.结论 上颌前牙区种植体即刻负重修复可缩短种植修复疗程,及时恢复患者美观、发音等功能,有良好的临床应用前景.     

前牙区不翻瓣即刻牙种植术后软硬组织变化的研究

目的:评测前牙区不翻瓣即刻牙种植的近期临床效果及软硬组织变化。方法:2008-07—2012-11于同济大学附属口腔医院种植科就诊的患者中,选择上颌前牙无法保留,适合采取即刻不翻瓣种植的患者纳入实验。于术中,术后3个月、6个月分别测量缺失牙近、远中骨高度及牙龈乳头的高度。结果:共18例患者22颗患牙纳入本研究。X线结果表明种植体均形成良好骨结合。种植后3个月,牙槽骨唇颊侧骨板近、远中吸收分别为(0.47±0.03)mm和(0.56±0.06)mm;6个月时骨吸收分别为(1.60±0.05)mm和(1.73±0.04)mm。种植3个月时,近、远中牙龈附着退缩为(0.41±0.05)mm和(0.53±0.03)mm,6个月牙龈时附着退缩分别为(0.51±0.03)mm和(0.62±0.04)mm。结论:前牙区不翻瓣即刻牙种植能良好地保存种植体周围骨组织及软组织高度,在选择合适适应证的条件下,能在减少手术创伤的基础上获得良好的修复效果。     

Immediate Implant Placement in Infected Sites: A Case Series

Background: Immediate implant placement has several advantages, such as reduction in the number of surgical treatments and reduction of the time between tooth extraction and the placement of the definitive prosthesis. However, there are still some situations that could jeopardize the success of the aforesaid therapy, such as the presence of an infection caused by periodontal disease or periapical lesions. The aim of this case series is to evaluate the clinical success of implants placed in fresh extraction sockets that showed clinical signs of periodontal disease. Methods: Thirteen patients (six males and seven females, 24 to 65 years old) are included in this case series. After initial examination and treatment planning, all patients underwent the periodontal treatment deemed necessary to facilitate wound healing. Twenty teeth were extracted as a result of an infection. Second‐stage surgery was performed 4 months after the initial procedure. The following clinical parameters were evaluated for each patient at the time of implant placement and at the end of the 12‐month follow‐up period: 1) clinical attachment level (CAL); 2) presence or absence of mobility; 3) presence or absence of pain; and 4) presence or absence of suppuration. The bone level was measured as the distance from the implant shoulder to the first bone–implant contact (distance bone–implant [DIB]) by periapical radiographs. The stability and health of the soft tissue were clinically evaluated by means of the plaque score. Results: The healing period was uneventful for all the patients. All the implants were osseointegrated. At the end of the 12‐month follow‐up period, patients were asymptomatic and showed no signs of infection or bleeding when probed. The mean CAL at the mid‐buccal location per implant was 0.8 mm at baseline and 0.9 mm at the end of the follow‐up. The mean width of keratinized mucosa measured at the mid‐buccal location per implant at baseline and 1‐year visits was 3.2 ± 0.4 mm and 3.3 ± 0.5 mm, respectively. The periapical radiographs, obtained in a standardized manner, revealed a mean increase of 0.5 mm in the DIB value. At the 12‐month follow‐up, the presence of plaque was observed in 44 of the 80 sites analyzed. Conclusion: Based on the results of this case series, placement of implants in fresh extraction sockets affected by infection may be a valid operative technique that leads to predictable results if adequate preoperative and postoperative care is taken.     

前牙区即刻种植的临床研究

目的　评价前牙区即刻种植的临床效果。方法　共对 132例患者前牙区患牙 /种植体拔出后 ,分情况即刻植入BLB、Br&nemark、ITI及Frialit- 2　 4种种植系统共 173颗 ,对其进行定期的临床和放射学检查。结果　 173颗即刻种植前牙种植体 ,其中 83颗行引导骨再生技术 ,经 6个月以上观察 ,失败 4颗 ,1颗弃用。结论　如种植体取得良好的初期稳定性 ,对种植体与拔牙窝间存在大于 1mm的间隙 ,采用引导再生膜技术处理 ,即刻种植可以取得良好的临床效果。     

即刻种植技术的临床应用

目的:探讨即刻种植技术的临床应用,并对近期效果进行评价。方法:30例患者,62枚种植体,拔除患牙同时植入Camlog系统的牙种植体。前牙区36枚,前磨牙区18枚,磨牙区8枚,其中位于前牙区的6例患者12枚植体进行了即刻负重修复。所有永久修复均在术后3-6个月进行,并定期复诊。观察时间为4-49个月(平均28个月)。结果:有2例位于后牙区的3颗植体在术后2-4周内因松动拔除。其余病例临床效果良好。种植体累积留存率为95.2%。结论:在掌握适应症的情况下,即刻拔牙即刻种植乃至即刻负重,可以取得良好的临床效果。     

Long‐Term Outcomes of Immediate Implant Placement Into Infected Sockets in Association With Immediate Loading: A Retrospective Cohort Study

Background: There is a paucity of studies examining long‐term outcomes of immediate loading of dental implants immediately placed into infected sites. This study aims to evaluate long‐term outcomes of immediate loading of postextraction implants placed in infected sites. Methods: Patients were selected if they had postextraction implants in the anterior maxilla that were inserted in the period from December 2006 to June 2015 and immediately loaded. Information collected about patients included: 1) demographic data; 2) implant details; 3) soft tissue stability; and 4) prosthodontics data. Marginal bone loss (BL) and implant and prosthesis survival rates were calculated. Results: Thirty patients (mean age: 56 years) had 43 implants immediately inserted into infected sites and immediately loaded. Implants were inserted at torque ≥35 Ncm. Mean follow‐up time was 6 years (range: 1 to 8 years), and 65% of implants had a follow‐up time >5 years. No implant failure occurred, and implant success rate was 93%. Proximal BL was 1.42 mm (range: 0.21 to 5.61 mm). Three prosthetic complications (all fracture of veneer material) occurred. Conclusions: Immediate loading of implants inserted into fresh and infected extraction sockets is not a risk factor for implant survival. However, stability of peri‐implant soft and hard tissues indicates the need to take measures that minimize loss.     

磨牙区即刻种植与延期种植的临床观察

目的:比较磨牙区即刻种植和延迟种植两种方式种植义齿的成功率。方法:198例磨牙区行种植修复的病例中,在控制适应证和患者同意的情况下,即刻种植共植入种植体67枚,延迟种植共植入种植体131枚。种植术后随访2年,观察种植体的稳定性,对两种不同种植方式的种植体的成功率进行比较。结果:67枚行即刻种植的种植体中,有4枚出现松动,成功率为94.0%;131枚行延迟种植的种植体中,有6枚出现松动,成功率为95.4%。两组种植方式成功率的比较,差异无统计学意义(P>0.05)。结论:在严格控制适应证的情况下,即刻种植也可获得较高成功率。     

不同骨缺损条件下的即刻与延期种植修复的临床应用评价

目的：评估即刻种植修复与延期种植修复在不同骨缺损状态下的远期疗效。方法：对80例患者的96枚种植体在不同骨缺损条件下的远期追踪观察（平均1-3年）,以种植体的稳定程度,牙龈形态色泽,唇侧骨丰满度,牙周袋的深度,及种植体与牙槽骨之间的X线影像等作为评价指标,通过采用即刻种植与延期种植技术及不同的植骨方式,评估即刻种植与延期种植的临床效果。结果：经过3年的临床观察,即刻种植与延期种植的临床成功率基本相同,Ⅳ,Ⅴ骨缺损种植牙颈部存在一定骨吸收（见表）。结论：在行使种植修复时（前牙尤其要注意美观）,选择好适应症,运用正确的植骨方式,种植方式,均能达到预期的临床效果,但值得注意的是：严重骨缺损处经植骨修复后存在骨吸收,这种趋势可能存在一定的延续性,还需观察。     

种植体设计对即刻种植与即刻负荷成功的影响

即刻种植和即刻负荷成功的关键是种植体的初期稳定性,除了宿主因素和医源因素外,影响初期稳定性的关键是种植体的设计。本文就目前种植体的尺寸、外形、表面处理对种植体即刻种植和即刻负荷成功影响的研究进展作一综述。     

牙种植体即刻负重临床疗效观察

目的：种植体即刻负重技术有益于缩短种植手术与修复的“等待期”,及时满足美观和咀嚼要求,进一步扩大种植义齿临床适应证。本文旨在探讨该技术的适应证、操作技巧,评价其临床疗效。方法：CDIC种植体植入23例牙缺失患者,共植入49枚种植体,术后1周内完成上部结构修复,经检测种植体动度、GI及有无种植体周围炎、口腔全景片等指标,评价临床成功率。结果：随访1-6年,23例患者中,仅1例患者的1枚种植体松动、脱落,其余种植体均获临床成功,临床成功率为98％。结论：即刻负重修复患者应为牙槽嵴丰满之中青年患者．种植体周围应有足够的骨壁包绕,以增加初期稳定性。从黏骨膜瓣环切至种植体窝洞预备,都应贯彻“宁小勿大”原则,增加种植体的嵌合能力。一期法、非翻瓣式手术有利于软组织愈合,减少种植体周围炎发生几率：前牙即刻负重修复时,多枚种植体的连冠（T-T）修复优于单枚种植体修复,后牙即刻负重适用于2颗以上的种植体支持式固定修复,以分散[牙合]力,增加稳定性。     

Evaluation of a Variable‐Thread Tapered Implant in Extraction Sites With Immediate Temporization: A 3‐Year Multicenter Clinical Study

Background: The purpose of this clinical study is to evaluate the radiographic bone remodeling, survival rate, and soft tissue health surrounding a variable‐thread tapered implant immediately placed in extraction sites. Methods: Sixty implants were placed in 55 patients at six centers according to a predetermined protocol. All implants were placed in extraction sockets and were subjected to immediate temporization and function. Definitive prostheses (58 single crowns and one two‐unit fixed bridge) were placed within the first year. Clinical and radiographic examinations were performed at implant placement and after 3, 6, 12, 24, and 36 months. Measurements of implant stability, papilla index, plaque, peri‐implant mucosa, and marginal bone levels were recorded at each visit. Results: Thirty‐five implants were evaluated at both implant insertion and 3‐year follow‐up. Bone levels were observed at 6 months after surgery and yearly intervals thereafter and remained stable throughout the study. There was a slight decrease in mean bone level from ?0.68 mm at implant insertion to ?0.93 mm at the 6‐month recall and then an increase of bone to ?0.53 mm from the reference point at the 2‐year follow‐up (an average increase of 0.15 mm from implant insertion). Bone levels remained steady between the 2‐year recall and the 3‐year recall. Papilla scores increased significantly (P <0.001; Wilcoxon signed‐rank test) from insertion to the 3‐year follow‐up, with most of the increase occurring during the first year. Patient assessments of function, esthetics, feel of implant, speech, and self‐esteem also showed significant improvement over the course of the study. Conclusions: The results, over 36 months, indicate that the variable‐thread tapered implant can be used safely and effectively under demanding conditions as an immediate postextraction tooth replacement. Bone remodeling remained stable with a slight increase, and patients expressed high levels of satisfaction with the restorative results over the course of the study.     

后牙即刻种植的临床观察

目的 :评价后牙即刻种植的方法、效果以及临床意义。方法 :对能满足即刻种植的20颗后牙经微创拔牙后,翻瓣或不翻瓣植入种植体,种植体周围植入骨粉,翻瓣者则覆盖生物膜。种植体植入3~6个月后常规取模,完成上部修复结构。种植体完成修复后随访6~34个月。结果:所有种植牙随访期间内正常行使功能,美学效果令人满意。CT示颊侧骨板骨吸收为(-0.65 mm±1.29 mm);近远中骨吸收为(1.23 mm±0.23 mm)。统计显示:即刻种植术前与术后龈乳头指数及种植体近远中骨吸收无明显差异,即刻种植后种植体颊向骨板吸收及种植体稳定系数与拔牙后牙槽嵴吸收有差异。结论:后牙即刻种植能有效维持种植体周围软硬组织的高度和宽度,对有即刻种植适应证的患者,可减少手术次数,缩短治疗时间,临床效果可靠。