球帽和Locator附着体种植覆盖义齿的临床疗效评价

目的:评价球帽附着体和Locator附着体应用于种植覆盖义齿的临床效果.方法:纳入无牙颌患者67例,共植入150颗Straumann或Bego种植体,完成球帽式或Locator式种植覆盖义齿修复.定期随访复查,包括修复后生物并发症和机械并发症情况和患者满意度调查.采用SPSS 17.0软件统计分析.结果:完成随访58例,球帽组35例,Locator组26例,球帽改Locator组7例.生物并发症比较显示,球帽组的牙龈增生发生率明显高于Locator组(P＜0.05);球帽组和Locator组的机械并发症发生率无显著差异(P＞0.05),但Locator组各类机械并发症的发生次数少于球帽组,球帽组平均修理频次为1.9次,Locator组为0.9次;Locator组患者对咀嚼和固位的满意度高于球帽组,不同性别的患者满意度无差异,满意度与患者的年龄和随访时间无相关性.结论:Locator式种植覆盖义齿相比球帽式种植覆盖义齿,临床效果具有一定优势.     

杆卡、球帽和locator附着体种植覆盖义齿的临床对比研究

目的：比较杆卡、球帽、locator附着体种植覆盖义齿修复1．3年后的临床效果。方法：对38名无牙颌患者进行覆盖义齿修复,其中杆卡、球帽、locator附着体种植覆盖义齿分别为11、18和9例。在义齿完成后0．5、1年及每年复查1次。对各组种植体周围粘膜状况和边缘骨吸收（MBL）进行评估,同时检验患者满意度。结果：杆卡、球帽、locator附着体最近一次随访的种植体边缘骨吸收为（1．3±1．0）ram、（1.2±0．8）mm、（1．4±1．0）mm,3种方式修复后MBL比较无统计学意义（P〉0．05）。与原有全口义齿比较,患者满意度均有明显提升（P〈0．05）。三种义齿间种植体周围粘膜状况、患者满意度亦无统计学差异。结论：杆卡、球帽、locator附着体种植覆盖义齿均能明显改善无牙颌患者的咀嚼功能。出于经济学考虑,我们建议选用2枚种植体支持的球帽或locator附着体覆盖义齿,临床上角度偏差较大的种植体可以优先考虑locator附着体覆盖义齿修复。     

Locator式和球帽式下颌种植覆盖义齿在牙槽嵴应力分布的光弹性研究

目的 分析比较含2个种植体的下颌种植覆盖义齿分别使用球帽附着体和Locator附着体在正中,侧向及前伸(牙合)应力加载时对其种植体和余留牙槽嵴的应力分布差异.方法 应用三维光弹实验的方法,在Atwood 3级无牙颌模型双侧至尖牙区域内各植入1枚种植体后制作环氧树脂光弹模型,进行3种咬合状态下的1kg垂直加载.应力冻结后,比较两者的应力分布差异.结果 正中及前伸(牙合)位加载时,2种附着体均可达到颊舌侧应力分布相近,球帽式牙槽嵴顶应力分布略大;侧向(牙合)加载时,球帽式覆盖义齿较Locator式覆盖义齿工作侧与平衡侧应力差更小;3种(牙合)位加载时,球帽式覆盖义齿种植体周围的应力均小于Locator式覆盖义齿,其中侧向(牙合)尤为明显.结论 (1)在下颌牙槽嵴重度吸收时,使用球帽附着式覆盖义齿较Loctor式覆盖义齿可能对种植体周围的骨质及剩余牙槽嵴有更好的保护作用,建议作为首选(2)在使用Locator附着体时建议选用可减少侧向力的(牙合)型,如舌向集中(牙合)等.     

球帽式和Locator式下颌种植覆盖总义齿的临床效果观察

目的：评价球帽式和Locator式下颌种植覆盖总义齿的临床应用效果。方法：共完成2颗种植体支持的球帽下颌覆盖总义齿9例,Locator下颌覆盖总义齿11例,上颌均制作可摘局部义齿。修复完成后于3、6、12、24个月进行随访,对各组种植体周围边缘骨吸收（MBL）进行评估,同时进行义齿满意度调查。结果：Locator组、球帽组在咀嚼功能、固位功能和舒适程度的满意度均高于治疗前,有显著性差异（P〈0.05）;Locator组与球帽组患者满意度、种植体周牙槽骨吸收量差异无统计学意义。结论：使用球帽、Locator附着体种植覆盖义齿在下颌无牙颌的应用中临床效果明显。     

球帽附着体种植覆盖义齿在萎缩下颌无牙颌的应用

目的 探讨球帽附着体种植覆盖义齿在牙槽骨萎缩的下颌无牙颌病例中的应用。方法 用Endo—pore Dental Implant System种植体，球形基台和弹性橡皮帽，为15例牙槽嵴萎缩下颌无牙颌病人作球帽附着体种植覆盖义齿，观察义齿的固位力、稳定性和咀嚼功能，随访0．5—3年。结果 球帽附着体种植覆盖义齿能显著提高下颌全口义齿的固位力和稳定性，改善咀嚼功能，病人满意。结论 球帽附着体种植覆盖义齿修复能显著改善牙槽嵴萎缩的下颌全口义齿的功能。     

Locator附着体和球帽附着体在种植覆盖义齿中的临床修复效果比较

目的探讨球帽基台和locator基台在种植体覆盖义齿(IODs)修复中临床效果的比较。方法选择单颌牙根嵴严重萎缩全口无牙颌患者27例,共计54枚种植体,其中球基台附着体26枚,locator基台附着体28枚。上部修复完成后6个月复诊并每年随访,从种植体、牙周黏膜、附着体等方面进行复查,统计其总的并发症发生率并对患者的满意度进行评价。结果两种基台支持式覆盖义齿患者的满意度明显高于普通全口义齿(P<0.05)。2年后两种附着体种植覆盖义齿边缘骨吸收率(BML)没有差别(P>0.05)。locator基台支持的覆盖义齿并发症的发生率仅为14.28%,球帽种植覆盖义齿总的并发症发生率为38.46%。结论 locator基台和球帽基台支持式全口义齿均优于常规全口义齿,locator基台产生的并发症更少。     

球帽附着体种植覆盖义齿修复牙槽嵴重度萎缩无牙下颌

目的：总结分析BEGO种植体系统球帽附着体固位覆盖义齿，修复重度牙槽骨萎缩无牙下颌的临床应用与效果。方法：对重度牙槽骨萎缩、普通义齿固位极度不良的7例下颌无牙颌患者，在下颌骨前牙区植入2-3枚BEG0柱形螺旋种植体，共植入种植体17枚，后期采用球基台作球帽附着体固位覆盖义齿修复，定期复诊观察评价种植和覆盖义齿修复效果。结果：全部17枚种植体均顺利一期愈合，愈合周期平均3个月，球帽附着体覆盖义齿修复后经6-12个月观察，义齿稳定、咀嚼功能恢复理想，容貌改善明显，患者满意。结论：种植体支持球帽附着体固位覆盖义齿修复牙槽骨重度萎缩无牙下颌，可有效恢复咀嚼功能，改善患者容貌，提高患者生活质量，同时球帽附着体修复，简单经济，易于保持口腔清洁，可以推广。     

种植体支持球帽附着体固位下颌覆盖总义齿的临床应用

目的：探讨球帽附着体固位的下颌种植覆盖总义齿的临床效果。方法：随机选择18例下颌牙列缺失的患者,植入2颗种植体,利用球帽附着体固位制作的覆盖义齿,随访6个月—4年,从患者主观感受和X射线检查两方面观察修复效果。结果：覆盖义齿的美观、舒适、固位稳定性好,咀嚼效率高。结论：种植体支持球帽附着体固位的下颌覆盖义齿修复下颌牙列缺失患者临床效果好。     

Locator附着体种植覆盖义齿在肿瘤切除术后牙列缺失修复中的应用

目的:口腔颌面部肿瘤切除手术及其他治疗对颌骨造成的创伤可能会对口腔重建修复和功能恢复造成一定的困难。本文旨在介绍口腔颌面部肿瘤术后患者采用Locator附着体支持式种植覆盖义齿修复牙列缺失的应用方法,探讨解决无牙颌导致义齿固位不良的修复新方法。方法:对6例颌面部肿瘤切除术后牙列缺失患者,在颌骨内植入种植体,3⁴个月后进行Locator附着体支持的种植覆盖义齿修复,并对其进行定期复查及种植覆盖总义齿满意度情况调查。结果:种植术后,通过14个月后进行Locator附着体支持的种植覆盖义齿修复,并对其进行定期复查及种植覆盖总义齿满意度情况调查。结果:种植术后,通过1⁵年的临床观察,所有种植体均无松动、脱落,Locator附着体支持式种植覆盖义齿固位良好。种植体植入后及负载后X线片对比,显示种植体-骨结合良好,种植体颈部无明显骨吸收。患者戴用Locator基台种植覆盖义齿,义齿的稳定性有明显改善,咀嚼效率提高,使用效果满意。结论:对口腔颌面部肿瘤切除术后的患者,Locator附着体种植覆盖义齿修复提高了义齿的固位力和稳定性,从而改善了患者的咀嚼效率。另外,其摘带、清洁及维护较为方便,这些都大大增强了患者的生活质量及使用信心。但是,Locator附着体种植覆盖义齿仍无法弥补因肿瘤手术导致的面部外形的改变。     

杆卡和球帽附着体下颌种植覆盖义齿放射学对比研究

目的：了解杆卡和球帽附着体下颌种植覆盖义齿修复后种植体周齿槽骨的变化。方法：同顾性分析42例全颌牙缺失病例在下颌区各植入2颗种植体,行种植体支持覆盖义齿修复的病例,其中杆卡下颌种植覆盖总义齿19例,球帽式下颌覆盖总义齿23例。对其定期进行随访及放射学检查获得的数据进行总结。结果：杆卡和球帽附着体下颌种植覆盖义齿修复后2年,种植基牙周齿槽骨吸收情况经统计学处理没有差别。结论：杆卡和球帽附着体下颌种植覆盖义齿修复后,短期对种植体基牙周齿槽骨影响没有明显差别。     

妊娠妇女牙周组织的临床改变

评估妊娠期间牙周临床指标的变化,以探讨妊娠对牙周状况的影响。方法：选择30例无牙周炎症的妊娠早期妇女和20例无牙周炎症非妊娠妇女。其中妊娠组分别在妊娠早、中、后期进行3次临床牙周指数检查,包括牙周袋探诊深度（PPD）、出血指数（BI）、附着丧失（AD、牙龈指数（GI）及菌斑指数（PLI）;非妊娠组连续2个月检查牙周指数2次。结果：在维持良好的口腔卫生情况下,妊娠组孕早期的GI和BI明显高于非妊娠组（P〈0．05）。同时,妊娠组GI和BI随妊娠时间的增加逐渐增加（P〈0.05,P〈0.001）,但牙周附着水平无改变（P〉0．05）。结论：妊娠可对牙龈炎症产生一定影响,但不影响牙周附着水平。     

Marginal bone resorption around immediate and delayed loaded implants supporting a locator‐retained mandibular overdenture. A 1‐year randomised controlled trial

The aim of this 1‐year study was to evaluate and compare crestal bone loss and clinical outcomes of immediate and delayed loaded implants supporting mandibular overdentures with Locator attachments. In a randomised controlled clinical trial, 36 completely edentulous patients (mean age 59·6 years) who desired to improve the stability of their mandibular dentures were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible after a minimal flap reflection. Implants were loaded by mandibular overdentures either 3 months (delayed loading group, G1) or the same day (immediate loading group, G2) after implant placement. Locator attachments were used to retain all overdentures to the implants. Peri‐implant vertical (VBL) and horizontal (HBLO) bone losses and clinical parameters [plaque scores (PI), gingival scores (GI), probing depths (PD) and implant stability (ISQ)] were assessed at time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. After 12 months of overdenture insertion, two implants (5·5%) failed in G2. Vertical bone loss was significantly higher in G2 compared with G1, while HBLO demonstrated insignificant differences between groups. All clinical parameters (PI, GI, PD and ISQ) did not differ significantly between groups. Vertical bone loss was significantly correlated with PD and HBLO. Immediately loaded two implants supporting a Locator‐retained mandibular overdenture are associated with more vertical bone resorption when compared to delayed loaded implants after 1 year. Clinical outcomes do not differ significantly between loading protocols.     

Photoelastic analysis of the effect of palatal support on various implant-supported overdenture designs

STATEMENT OF PROBLEM: The effect of palatal support on various types of implant-supported maxillary overdenture designs has not been sufficiently assessed. PURPOSE: The purpose of this study was to photoelastically evaluate the palatal support of 3 designs of maxillary implant-supported overdentures. MATERIAL AND METHODS: A photoelastic model of an edentulous maxilla was fabricated with four 3.75 x 13-mm 3i implants. Three maxillary overdenture designs were fabricated: a splinted Hader bar incorporating 2 distal ERA attachments with anterior clips; non-splinted Zaag 4-mm direct abutments and attachments; and nonsplinted Locator 2-mm direct abutments and attachments. All restorative components and attachments were fitted and observed for passivity of fit and alignment. The overdentures were first tested with complete palatal coverage. Unilateral 25-lb loads were applied at the left and right first molars and the incisive papilla area. The photoelastic effects were monitored and recorded photographically. The palatal area was removed from the 3 overdentures and the loading regimens were repeated. RESULTS: The highest stresses under central loading were seen with the splinted Hader bar and complete palatal coverage, followed by similar levels of stress with either Zaag or Locator attachments. After removal of the palate, the center load demonstrated greater differences between designs. The highest stresses were observed with the Hader bar, followed by the Zaag and then Locator attachments. Lack of palatal coverage demonstrated higher levels of stress around implants and visible supporting tissues. The unilateral load produced the highest stress for the splinted Hader bar, followed by Locator, and then Zaag. CONCLUSIONS: Removal of the palatal support produced a greater effect and more concentrated stress difference for maxillary overdentures than differences between the attachment designs tested.     

A finite element study on stress distribution of two different attachment designs under implant supported overdenture

Objective

This study aimed to evaluate stress patterns generated within implant-supported mandibular overdentures retained by two different attachment types: ball and socket and locator attachments.

Materials and methods

Commercial CAD/CAM and finite element analysis software packages were utilized to construct two 3D finite element models for the two attachment types. Unilateral masticatory compressive loads of 50, 100, and 150 N were applied vertically to the overdentures, parallel to the longitudinal axes of the implants. Loads were directed toward the central fossa in the molar region of each overdenture, that linear static analysis was carried out to find the generated stresses and deformation on each part of the studied model.

Results

According to FEA results the ball attachment neck is highly stressed in comparison to the locator one. On the other hand mucosa and cortical bone received less stresses under ball and socket attachment.

Conclusions

Locator and ball and socket attachments induce equivalent stresses on bone surrounding implants. Locator attachment performance was superior to that of the ball and socket attachment in the implants, nylon caps, and overdenture. Locator attachments are highly recommended and can increase the interval between successive maintenance sessions.     

含白芨、冰片的中药牙膏对牙菌斑和牙龈炎症的影响

目的研究含中药白芨、冰片的牙膏是否具有抑制牙菌斑和减轻牙龈炎症的功效。方法采用随机、双盲、对照的研究方法,对200名受试者进行为期3个月的临床研究。受试者随机分为两组,分别使用含中药成分(实验组)或另一已知有效(对照组)的牙膏,用相同的牙刷及刷牙方法早晚各刷牙一次,于试验前、1.5个月、3个月对受试者的菌斑指数、牙龈指数及出血指数进行临床检查。结果与试验前相比,1.5个月、3个月时,试验组的菌斑指数和两组的牙龈指数、出血指数均有明显下降,差异有统计学意义(P<0.01);对照组的菌斑指数与试验前相比,差异无统计学意义(P>0.05);1.5个月、3个月时,试验组菌斑指数均低于对照组,差异有统计学意义(P<0.01)。结论含白芨、冰片的牙膏具有较好的抑制牙菌斑和减轻牙龈炎症的功效。     

上颌阻生尖牙闭合式助萌与开窗式助萌后牙周指数差异分析

目的：探讨上颌阻生尖牙闭合式助萌与开窗式助萌后牙周指数差异。方法：选择30例上颌阻生尖牙成功助萌患者（闭合式助萌与开窗式助萌各15例）,分别测量尖牙矫治入列后6、12个月时的牙菌斑指数（PLI）、牙龈出血指数（BI）、牙龈指数（GI）及边缘骨吸收量。结果：所选取的病例的阻生尖牙均被成功矫治排入牙列,开窗组的PLI、BI、GI均值及边缘骨吸收的量在矫治结束后6个月时均高于闭合组,差异有显著性;开窗组的PLI、BI、GI均值及边缘骨吸收的量在矫治结束12个月时略高于闭合组,但差异无显著性。结论：上颌阻生尖牙闭合式助萌后尖牙牙周状况明显好于开窗式助萌。     

重度牙周炎磨牙拔除运用微翻瓣位点保存术后种植修复效果短期观察

目的:评价重度牙周炎磨牙进行微创拔牙和微翻瓣位点保存术后植体负重1年的效果。方法:纳入2015年1月~2017年1月于牙周科就诊的18名患者共20颗磨牙,种植修复后负重1个月(基线)和12个月对种植牙进行临床检查,记录菌斑指数(silness&leo plaque index,PLI)、植体周软组织探诊深度(peri-implant probing depth,PPD)、出血指数(mazza bleeding index,BI)、颊侧角化组织宽度(width of keratinized tissue,KTW);基线和负重1年拍摄平行投照根尖片测量边缘骨丧失(marginal bone loss,MBL)。结果:20颗种植修复体负重1年后存留率和成功率为100%。负重即刻和负重1年PLI、PPD、BI、KTW变化均无统计学差异(P>0.05),MBL为(0.12±0.24)mm。结论:微翻瓣位点保存术后种植修复负重1年获得了良好的临床效果。     

Locators versus magnetic attachment effect on peri‐implant tissue health of immediate loaded two implants retaining a mandibular overdenture: a 1‐year randomised trial

This study aimed to evaluate peri‐implant tissue health of immediate loaded two implants retaining a mandibular overdenture with either magnetic or locator attachment. Thirty two completely edentulous patients (20 males/12 females) were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible using flapless surgical technique. Mandibular overdentures were immediately connected to the implants with either magnetic (group I, GI) or locator (group II, GII) attachments. Peri‐implant tissue health was evaluated clinically in terms of plaque scores (PI), bleeding scores (BI), probing depth (PD), implant stability (ISQ) and interleukin‐1‐β (IL‐1b) concentrations in peri‐implant sulcular fluid. PI, BI and PD were measured at mesial, distal, buccal and lingual surfaces of each implant. Radiographic evaluation was performed in terms of vertical (VBL) and horizontal (HBLO) alveolar bone loss. Evaluations were performed 2 weeks (T0), 6 months (T1) and 12 months (T2) after overdenture insertion. Plague scores, PD, IL‐1b, VBL and HBLO increased significantly with time. ISQ decreased significantly with time. BI showed no significant differences between observation times. GI recorded significant higher PI, ISQ and IL‐1b at T2 compared to GII. GII recorded significant higher VBL than GI at T2 only. For HBLO, no significant differences between groups were noted. VBL and HBLO showed a significant positive correlation with PD. Locator attachments for immediate loaded implants retaining mandibular overdentures are associated with decreased plaque accumulation, decreased implant stability, decreased interleukin‐1β concentration in peri‐implant crevicular fluid and increased per‐implant vertical bone loss compared to magnetic attachments after 1 year.     

烤瓷冠修复对非依赖型糖尿病患者牙周状况的影响

目的：研究非依赖型糖尿病患者经牙周基础治疗后,进行烤瓷冠修复对牙周情况的影响。方法：选择非依赖型糖尿病与非糖尿病患者各一组,经牙周基础治疗,对比两组在烤瓷冠修复前、修复后学年及1年的口腔菌斑指数（PLI）、牙龈指数（GI）、探诊出血指数（BI）、探诊深度（PD）和临床附着丧失（AL）5项指标。结果：统计学分析,两组病人牙周情况在修复前、修复后半年及1年均无显著性意义。结论：经良好的牙周基础治疗与口腔健康维护,烤瓷冠修复对糖尿病患者牙周情况影响甚微。