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1.
Functional rehabilitation of a completely edentulous patient with removable prostheses is a clinical challenge. A patient with an edentulous maxilla and mandible received 6 endosseous implants in the maxilla and 5 implants in the mandible using CAD/CAM surgical templates. Definitive maxillary and mandibular implant-supported fixed complete dentures were connected immediately after implant placement using a CAD/CAM-guided implant surgical placement protocol.  相似文献   

2.
目的:研究十年观察期内用Steri-Oss种植体修复牙列缺失患者种植体生存率和影响因素。方法:自1995-2006年,共有57例无牙颌患者接受种植与修复治疗,共353颗Steri-Oss种植体。其中81颗种植体(22.95%)做固定修复,272颗种植体(77.05%)做可摘义齿修复,观察性别、种植体部位和修复类型对种植体成功率的影响。结果:其中有9例病人24颗种植体脱落,种植体成功率93.20%,女性病人的种植体生存率略低,但性别没有显著的差异(P〉0.05)。累计的种植体生存率上颌骨92.64%,略低于下颌骨93.68%,但统计学上的没有显著差异(P〉0.05)。种植体支持的固定修复的十年成功率是97.5%,种植体固位的可摘义齿成功率99.02%,累计的种植体生存率在可摘与固定义齿修复之间没有显著性差异(P〉0.05)。结论:确认了种植体支持无牙颌病人修复学中长期成功率。种植体固位的可摘全口义齿治疗方式在种植体生存率上和种植体支持的固定义齿的结果是相同的。  相似文献   

3.
STATEMENT OF PROBLEM: Distinct clinical parameters determine whether fixed or removable implant-supported prostheses are indicated to restore the edentulous maxilla. However, there is a strong belief that fixed implant prostheses meet with greater patient acceptance and satisfaction, but this may differ from the patients' perceptions, their psychological responses to treatment, and their assessments of the treatment outcome. PURPOSE: This prospective clinical study compared the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxilla with the main emphasis on the patient's point of view.Material and methods: Twenty patients who requested an implant-supported superstructure to restore the edentulous maxilla were asked to complete a questionnaire measuring their satisfaction with the present situation and the psychologic impact of their oral health status with their responses marked on a Visual Analog Scale (VAS). Ten patients were treated with a fixed, screw-retained implant prosthesis (group 1), and 10 were treated with a removable, implant-supported and bar-retained overdenture (group 2). Six months after prosthetic rehabilitation, patients were again given the questionnaire to assess their psychologic well-being and satisfaction with the implant-supported restoration. RESULTS: Both prosthesis designs were associated with significant improvements in comfort and retention, function, esthetics and appearance, taste, speech, and self-esteem. No difference was found between the 2 groups with respect to how the patients assessed the implant therapy. However, the results indicated that patients in group 2 experienced greater differences between pretreatment and posttreatment scores for the parameters esthetics, taste, and speech. Treatment costs per unit were significantly higher in group 1 than in group 2. CONCLUSION: Patients in groups 1 and 2 were similarly satisfied with their implant-supported prostheses in the edentulous maxilla with regard to their well-being and the cost-utility, irrespective of whether the restoration was fixed or removable.  相似文献   

4.
PURPOSE: The purpose of this follow-up study was to quantify the change in the peri-implant mucosal level after treatment of edentulous patients with fixed prostheses on osseointegrated endosseous implants. MATERIALS AND METHODS: Twenty patients were included in the study: 10 were treated in the maxilla, and 10 were treated in the mandible. Both groups had fixed prostheses on osseointegrated Br?nemark implants. Peri-implant mucosal level was measured with a calibrated probe after removal of the prostheses at the 1-year follow-up. These measurements were compared to those made on the original master casts. RESULTS: A larger mean retraction (-) was observed in the mandible (-1.6 mm) compared to the maxilla (-0.8 mm), but there was great variation. The individual values varied from -4.5 to +1.0 mm in the mandible and from -6.0 to +6.0 mm in the maxilla. CONCLUSION: Peri-implant soft tissue recession occurs during the first year in edentulous jaws after treatment with implant-supported fixed prostheses and more so in the maxilla than the mandible.  相似文献   

5.
PURPOSE: The aim of this study was to examine the long-term periimplant bone loss in patients treated with implant-supported fixed prostheses in both jaws. MATERIALS AND METHODS: The participants comprised 44 edentulous patients who have been followed for a 15-year period after treatment with a fixed implant-supported prosthesis in the mandible. Thirteen of them also received an implant-supported fixed prosthesis in the maxilla, on average 4.5 years after the mandibular treatment. The periimplant bone level was measured on intraoral radiographs. RESULTS: The long-term results of the implant treatment were successful, and only 1% (3/273) of the implants were lost in the mandible and 7% (5/75) in the maxilla. All but one of the failures occurred before the connection of the prostheses. The mean marginal bone loss around the implants was small (less than 1 mm for a 10-year period after implant placement), and was of similar magnitude in both jaws. However, the individual variation was relatively great. There was no significant difference in marginal bone loss between those who had a maxillary complete denture during the entire observation period and those who had received a fixed implant-supported maxillary prosthesis. Smokers lost more periimplant bone than did the nonsmokers; the difference was significant in the mandible but small and nonsignificant in the maxilla. CONCLUSION: The long-term periimplant bone loss was small and of similar magnitude in the mandible and the maxilla in subjects who had received implant-supported fixed prostheses in both jaws. The prosthetic status in the maxilla, i.e., complete denture or fixed implant-supported prosthesis, had no significant influence on the mandibular periimplant bone loss.  相似文献   

6.
牙列缺失患者种植体支持的固定和可摘义齿的回顾性研究   总被引:1,自引:0,他引:1  
目的:研究十年观察期内种植体支持的固定和可摘义齿修复牙列缺失患者种植体的生存率和影响因素。方法:1995-2006年,227例患者(92例男性,135例女性)平均年龄63.7岁,在Charite’大学口腔颌面外科门诊接受种植和修复治疗。共1652颗种植体种植在牙列缺失上颌骨、下颌骨或双侧颌骨,支持76例(24.68%)固定义齿,232例(75.32%)可摘义齿。观察性别,种植体部位、修复方法对种植体生存率的影响。结果:其中有50例患者73颗种植体丧失,累计种植体生存率94.76%,本研究显示种植体生存率女性(93.93%)略低于男性(95.93%),但没有显著性差异。在上颌骨种植的种植体生存率(95.87%)略高于在下颌骨种植(94.53%),但统计学没有显著性意义。10年累计固定和可摘义齿的种植体生存率分别是98.02%和93.55%,两种修复方法差异有显著性。结论:确认了种植体支持牙列缺失患者修复中长期的成功率,并得出结论种植体生存率与性别,种植部位关系不大,与修复方法有关。种植体支持的固定义齿预后比可摘义齿好。  相似文献   

7.
PURPOSE: To determine the overall success of dental implants placed in geriatric patients. PATIENTS: Dental implants were placed in 47 geriatric patients who were 79 or more years of age at the time of the procedure. The study group was composed of 27 men and 20 women, with a median age of 89 years and a range of 79 to 99 years of age at the time of implant surgery. A total of 73 dental implants were placed in the maxilla and 87 dental implants placed in the mandible. All implants were restored with fixed implant-supported prostheses or removable implant-supported prostheses. Eleven of the patients underwent maxillary sinus augmentation with porous hydroxyapatite and platelet-rich plasma. Seven patients had their implants immediately loaded. RESULTS: A total of 160 dental implants were placed in the 47 geriatric patients. One hundred fifty-nine integrated successfully. In the case of the failed implant, the site was grafted and another implant was placed 5 months subsequent to the initial failure. This replacement implant integrated and has been in function for 6 months. The survival rate for dental implants placed in the maxilla was 99% and in the mandible was 100% in our geriatric population. CONCLUSION: Treatment with dental implants can be predictable and safe for the rapidly growing geriatric population. Geriatric patients who are medically stable are suitable candidates for osseointegrated implant surgery, which facilitates oral function, comfort, and quality of life. A review of the 47 geriatric patients treated supports the conclusion that dental implants can be successfully placed and restored with fixed implant-supported or removable implant-supported prostheses.  相似文献   

8.
BACKGROUND: The completely edentulous patient has few treatment options in conventional dentistry. When implants are considered, treatment plans range from a 2-implant overdenture to a completely implant-supported prosthesis. Fixed prosthesis is often the preferred selection of the edentulous patient. This study assesses the 5-year cumulative survival rate of implants placed to support full-arch fixed restoration. METHODS: During 1990 to 1995, 171 implants were placed in 22 completely edentulous jaws of 20 patients. All patients were discharged wearing immediate dentures. The implants were analyzed as to the number of implants per jaw, implant location, length, and diameter. RESULTS: The 5-year cumulative survival rate was 89.9%. The mean number of implants per jaw was 7.7 for the maxilla and 8 for the mandible. In the maxilla, the preferred implant locations were the canines, centrals, laterals, and first premolars; in the mandible, they were the canines, laterals, and first molars. The mean implant length was 14.2 mm for the mandible and 13.2 mm for the maxilla. The mean implant diameter was 3.6 mm for the maxilla and 3.8 for the mandible. CONCLUSIONS: The results of the present study indicate that fixed full-arch ceramo-metal restorations can be a predictable implant treatment modality for the edentulous patient.  相似文献   

9.
PURPOSE: The purpose of this article was to determine whether clinical success can be achieved with immediate loading in the completely edentulous maxilla with endosseous screw-type implants. MATERIALS AND METHODS: The study sample consisted of 34 patients who were edentulous or about to lose all remaining maxillary teeth. The patients underwent an extensive presurgical and prosthetic workup to determine whether they qualified for the study. Sufficient osseous structure to place 6 to 8 implants with a minimum length of 8 mm was required. Provisional prostheses were fabricated either chairside on the day of implant placement or in a laboratory from an impression. The abutments and temporary restorations were placed 48 to 72 hours postsurgery. RESULTS: A total of 236 implants were placed in 34 patients. Sixteen implants were lost in 11 patients; thus the survival rate was 93%. All patients subsequently received definitive maxillary restorations. DISCUSSION: The major cause of implant failure appeared to be micromotion during healing. This was the result of either a non-passively fitting restoration or noncompliance (eg, eating chewing hard foods before the implants had integrated). CONCLUSIONS: This clinical report suggests that immediate loading of implant-supported restorations in the completely edentulous maxilla was a viable treatment alternative for this patient population.  相似文献   

10.
Dental implants provide patients with restorative options for the edentulous maxilla. Both fixed and removable prostheses can be attached to the edentulous maxilla, but the efficacy of different designs has not been determined. In this two-session within-subject crossover trial we compared maxillary implant retained fixed prostheses with removable implant overdentures opposed by mandibular implant-supported overdentures. Sixteen patients, who had previously received mandibular implants, entered the study and received four to six maxillary implants. After dropouts as a consequence of a lack of osseointegration and general health problems, 13 remained. Of these, five received the removable prosthesis first and eight the fixed prosthesis. After 2 months, the prostheses were exchanged and the second was also worn for 2 months. Psychometric measurements of general satisfaction with the prostheses as well as comfort, ability to speak, stability, esthetics, ease of cleaning and occlusion were obtained once each prosthesis had been worn for 2 months. Chewing ability was assessed for seven types of food. Removable long-bar overdentures received significantly higher ratings of general satisfaction than fixed prostheses (P = 0.003). Patients also rated their ability to speak and ease of cleaning significantly better with the removable overdentures. Nine patients chose to keep the removable prosthesis and four preferred to keep the fixed prosthesis. The results suggest that maxillary removable overdentures on multiple implants may provide patients with better function than fixed prostheses.  相似文献   

11.
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11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(上无牙颌8例,下无牙颌15例,双颌无牙颌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、追踪种植体和即刻修复体的存留率、患者满意率。平均追踪14.8个月(10~29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%。上颌种植体存留率89.3%,下颌种植体存留率97.8%,存在统计学差异(p〈0.05)。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。患者满意率100%。结论:"All-on-4"种植即刻修复技术应用于无牙颌患者近期效果好,患者满意度高。远期效果需要进一步观察。  相似文献   

12.
In a 6-year prospective clinical study, 181 hydroxylapatite coated endosseous dental implants were placed into the anterior mandible of 48 patients. Twenty-one patients were treated with fixed prostheses and 27 patients with an overdenture. When the implants were exposed all 181 had integrated. To date, there is 100% survival of all implants and they all retain a functioning prostheses. The initial results were very promising, in both groups the interval success was over 95% in the first 4 years of the study. However, by year 6, the interval success rates had fallen to 83% for both the fixed and removable groups. This study also compares the construction and maintenance complications for the two types of restorations. The clinical time taken, after implant exposure, to construct the prostheses was similar whether the fixed (mean of 8 visits) or removable option (mean of 7 visits) was chosen. However, the removable restoration cost less than half the price of the fixed when both technical time and implant component costs were evaluated. Maintenance for both groups was higher than expected, but patients required more appointments in the removable group both in the first year and beyond. Regarding the prostheses itself, the incidence of remakes, relines and general adjustments was higher in the removable group. This study has shown that the overdenture offers an effective and initially a more economical alternative to the fixed prostheses, in the treatment of the edentulous mandible. However, long-term maintenance of such a prosthesis can be significant.  相似文献   

13.
Treatment of mandibular edentulousness with endosseous permucosal implants has evolved to a common treatment option during the last decades. In The Netherlands, the relative cheap prosthetic treatment of implant-supported overdentures is considered a qualitatively adequate treatment. The aim of the study described in this article was to survey the treatment of edentulous mandibles by fixed implant-supported prostheses and implant-supported overdentures, and to register the different mesostructures used. All clinics of special dental care and all larger clinics for implant dentistry in The Netherlands received a questionnaire. The data provided showed that more than 90% of patients treated with implants because of mandibular edentulousness, were provided with an overdenture. In 85% of cases a bar-clip mesostructure was used. Cost control was the most important reason to choose an overdenture above a fixed implant-supported prosthesis.  相似文献   

14.
目的:评价临时种植体即刻负载在半颌即刻种植中的应用效果。方法:20例半颌即刻种植患者行136枚即刻种植体植入,采用95枚临时种植体即刻负载恢复患者牙列。3-6月后行固定修复。结果:即刻负载临时种植体和即刻种植体成功率达100%。结论:临时种植体即刻负载半颌即刻种植是很好的临床方法。  相似文献   

15.
The overall aim of this thesis was to investigate different therapeutic strategies in treatment of the edentulous maxilla with dental implants and their importance for treatment outcome. The introduction of one-stage surgery, in place of two-stage surgery, was a paradigm shift in the area of implant treatment since submerged implant healing underneath the mucosa was considered a prerequisite for healing in the original concept. The advantages of a one-stage method are that a second surgery is unnecessary, costs are lower, and patients complain less about the surgical procedures. The development of implant treatment, regardless of whether it is performed in the mandible or the maxilla, strives to shorten the period from implant placement to implant loading. For the edentulous patient--due to esthetic, economical, or psychological reasons--shortening this time and thus avoiding a long period of wearing a transitional removable prosthesis is advantageous. Use of conventional one-stage surgery makes possible and is a prerequisite for immediate loading of implants. Successful treatment outcome has been demonstrated for immediate loading of implants in the mandible, but documentation of the method in the maxilla is still sparse. Two prospective clinical studies compared (i) one- and two-stage surgery and (ii) immediate and conventional loading in patients consecutively treated in the edentulous maxilla with implant-supported fixed prostheses. The first study found that the cumulative survival rate (CSR) after one-stage surgery performed according to a conventional protocol was consistent with two-stage protocol CSRs reported in previous studies. The second study evaluated an immediate loading protocol that provided patients with interim fixed prostheses within 24 hours after implant placement. A comparison of the studies found no significant difference in CSRs. But it was found that when a conventional protocol was used, transitional removable prostheses could traumatize the bone-implant interface during healing by adverse loading on the implants, which pierced the mucosa. Moreover, splinting the implants immediately after surgery with an interim fixed prosthesis might protect them from adverse loading. In a finite element analysis comparing uncoupled and splinted implants--imitations of the clinical situations in the two studies--splinted implants drastically reduced stresses in the bone tissue surrounding the implant, which might facilitate bone healing. Two factors considered important for a successful treatment outcome, especially when loading implants immediately, are (i) jawbone quality and (ii) primary implant stability at placement. In implant literature, bone quality is generally equivalent to bone density. Results of the third clinical study in this thesis indicate that use of computed tomography with calculations of bone mineral density can be a useful tool in bone tissue evaluation before implant placement. After 1 year of loading, changes in marginal bone level, compared to baseline, did not differ between implants that were stable and implants that were not stable at placement. The results of this thesis do not strengthen earlier recommendations that immediate and early loading is a treatment alternative that can be considered only in jaws with good bone quality. In conclusion, immediate loading with interim fixed prostheses in the edentulous maxilla is a viable treatment alternative. Splinting of implants seems to be important in immediate loading, especially when bone density is low.  相似文献   

16.
PURPOSE: This study evaluated the long-term survival and success of different implant-supported prostheses supported by ITI implants. MATERIALS AND METHODS: Two hundred fifty consecutive patients were rehabilitated using implant-supported prostheses. Seven hundred fifty-nine implants were loaded. Single-tooth prostheses (n = 106), cantilever fixed partial prostheses (n = 42), fixed partial prostheses (n = 137), fixed complete prostheses (n = 5), implant/tooth-supported prostheses (n = 13), and overdentures (n = 37) were used. The mean follow-up period was 3.85 years. Life table analyses were performed. Implant survival rates were calculated by means of standard life table principles. Statistical analysis was performed to compare the implant survival and success by implant placement site for each type of prosthesis. RESULTS: The cumulative implant survival rates were calculated for implants supporting single-tooth prostheses (95.6%), cantilever fixed partial prostheses (94.4%), fixed partial prostheses (96.1%), fixed complete prostheses (100%), implant/tooth-connected prostheses (90.6%), and overdentures (95.7%). Similar survival and success rates were documented for implants placed in maxillae and mandibles. Implant size did not influence survival. DISCUSSION: Seven-year survival rates were similar for implants supporting single-tooth prostheses, cantilever fixed partial prostheses, fixed partial prostheses, and implant/tooth-supported prostheses. Medium-long term implant survival and success were not influenced by the site (maxilla or mandible). Implant and prosthetic survival rates for overdentures supported by 2 implants were comparable to those for overdentures supported by 3 or more implants. CONCLUSION: Prostheses supported by ITI implants represent a reliable medium-term treatment. (More than 50 references.)  相似文献   

17.
STATEMENT OF THE PROBLEM: The clinical success of implant-supported fixed partial dentures has been documented. However, few studies have reported long-term results or any association between implant outcomes and host determinants. PURPOSE: This study reports on implant and prosthesis outcomes in a group of partially edentulous patients treated with Br?nemark implants in the posterior zones. It also examines factors described in the medical history that may influence implant survival. MATERIAL AND METHODS: The charts of patients treated with implants from 1983 and followed prospectively through December 2001 at the University of Toronto were reviewed. One hundred thirty partially edentulous patients treated with implant-supported restorations in the posterior zones (area distal to mental foramen) were selected. Implant and prosthesis treatment outcomes were recorded and analyzed through the Kaplan-Meier and Cox regression methods (P<.05). RESULTS: A total of 130 patients received 432 Br?nemark dental implants in 174 posterior edentulous spans. The mean age of the patients at the time of insertion of the implants was 50.97 +/- 13.27 years. At 15 years, the overall implant and prosthesis survival rates were 91.6% and 89%, respectively. At 5 years, the survival rate of the wide-platform 5-mm-diameter implants was 76.3%. Implant diameter (P=.0001) and a history of a chronic medical condition (P=.01) were correlated with implant survival outcomes. CONCLUSIONS: High success of implant-supported prostheses in the posterior zones of both the maxilla and mandible. It corroborated other studies that have shown higher failure rates for wide-platform implants, emphasizing the need for proper establishment of clinical trials prior to marketing of new implant designs.  相似文献   

18.
PURPOSE: The purpose of this follow-up study was to evaluate the stability of the screw joint in edentulous patients 1 year after treatment with implant-supported fixed prostheses (Br?nemark system). MATERIALS AND METHODS: A total of 20 patients were included, 10 treated in the maxilla and 10 in the mandible. The fixed prostheses were removed approximately 1 year after insertion, and the stability of the screw joints was evaluated using a rating scale based upon the CDA quality evaluation criteria of dental care. RESULTS: All implant-supported fixed prostheses were recorded as stable before the prosthetic screws (gold screws) were unscrewed. "Unacceptable loosening" was observed in 4% of the prosthetic screws and in 29% of the abutment screws. CONCLUSION: In this study, only a few of the prosthetic screws showed unacceptable loosening after 1 year of function. The clinical relevance of the observed high occurrence of loose abutment screws could be questioned, as all fixed prostheses were initially recorded as stable.  相似文献   

19.
PURPOSE: The purpose of this study was to compare the maintenance requirements of implant-supported fixed prostheses with cantilever arms in edentulous jaws when opposed by fixed prostheses of similar design, by natural teeth, or by complete dentures. MATERIALS AND METHODS: The maintenance requirements for the 5-year follow-up period were obtained by examining the dental records of 37 people. Six were provided with fixed prostheses in both arches, 22 with a fixed prosthesis in the mandible opposed by a complete denture, and 9 with a fixed prosthesis opposed by natural teeth. Everyone was treated with Nobel Biocare implants using standard implant and prosthetic protocols. RESULTS: The denture teeth and acrylic resin were repaired on 44 occasions in the group with implants in both jaws, on 14 occasions in the group with implants opposed by natural teeth, and twice in the group in which the implants were opposed by a complete denture. The group with implants in both jaws was more likely to fracture the gold-alloy framework, which occurred on six occasions. The group with implants in both jaws was significantly different from the other two groups in relation to higher incidence of fracture of the teeth and gold-alloy framework. CONCLUSION: The maintenance requirements of implant-supported fixed prostheses with cantilever arms opposed by fixed prostheses of similar design were much greater than when opposed by natural teeth or complete dentures.  相似文献   

20.
口腔种植修复临床效果五年回顾研究   总被引:3,自引:0,他引:3  
目的:评估柱状种植体应用5年的临床效果。方法:2001年2月至2005年12月植入柱状种植体共931枚,其中Pitt-easy种植体174枚,Frialit-2种植体148枚,Camlog种植体350枚,XiVE种植体176枚,Ankylos种植体45枚,I.M.Z种植体38枚。全部种植体均在2005年12月前完成上部结构修复,其中固定修复456例,活动修复8例,共计464例患者。平均追踪30个月(4-59月)。观察方法为X线检查和临床检查,采用Wheeler存留标准评估,纳入Kaplan-Meier存留曲线统计。结果:种植修复体完成时451例患者对修复效果满意,13例患者对修复体不满意,重做后10例表示满意,3例表示可以接受。随访中有34例患者共46枚种植体确诊为种植体周围炎。有明确记录的共24枚种植体脱落。5年随访累计修复体松动14件,修复体折断8件。据Wheeler存留标准统计5年存留率为95.2%。结论:种植修复患者的满意度高,本组种植体的5年存留率达到95.2%。  相似文献   

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