生物活性玻璃——钛芯人工牙根临床应用初步观察

本文介绍自行研制的生物活性玻璃——钛合金芯人工牙根应用于临床,3年来共种植人工牙根49只,其中成功的42只,成功率为85.7％,失败7只,文中就适应症,种植方法等进行了论述。     

生物活性玻璃——钛芯人工牙根(BAG-TiI)重植24例分析

在首次种植失败的病例中选择合适病例重新种植２４例，观察１～３年．重植分段成功率为８５．０％以上，累积成功率因例数太少而较低为６４．２％．重植失败原因仍以种植根周围炎为主．本文作者认为重植术对提高种植成功率，满足病人需求不失为一种可取的方法．     

国产钛芯羟基磷灰石人工牙根修复个别牙缺失

对161例个别牙缺失病人共行230颗钛芯羟基磷灰石人工牙根种植,病人年龄7～71岁,男性91例,女性70例。根据植区不同的解剖条件,采用四种种植方式,其中立即种植73颗,早期种植42颗,延期种植87颗,牙槽嵴增宽后种植28颗。6颗种植失败,230颗种植体中186颗已完成上部修复,132颗术后随访1年以上,24颗超过2年。本文对种植材料选择、临床适应范围、防止骨热灼伤以及上部牙冠修复要点进行了讨论。     

氦氖激光防治人工种植牙术后感染的临床研究

目的 探讨氦氖激光防治种植术后感染的临床效果。方法 随机选126例牙列缺损患者人工种植牙齿30枚，设照射组和对照组各115枚，于术前、术后氦氖激光照射，并进行临床观察和统计分析。结果 照射组总有效率99．14％，对照组92．18％，两组疗效差异显著（P＜0．05）。结论 氦氖激光能使种植区域的免疫，循环，创口愈合及骨痂代谢均处于最佳状态，能提高种植成功率。     

非埋植型一段式螺旋形钛人工牙根种植术附22例29颗牙报告

作者对２２例患者植入非埋植型一段式螺旋形人工牙根２９个，术后１０～２４个月，获随访资料者２６个，保存率１００％（２６／２６）；稳固无松动者占８１％（２１／２６）。对人工牙根周有骨质缺损者，在人工牙根植入后即刻用ＨＡ颗粒填塞及生物膜覆盖，行组织诱导再生术，取得一定效果、作者对此种类型人工牙根种植术的注意点进行了讨论。     

引导骨再生可吸收膜在人工种植牙术中的临床应用（附78例？…

目的 为缩短人工种植牙疗程，扩大种植适应范围。方法 拔牙后即刻植入牙种植体，同时联合应用引导骨再生可吸收膜。结果 应用本法对７８例患者施行了９８颗种植体，经３年临床观察，成功率达９７．９％。结论 引导骨再生生物膜技术用于即刻种植所产生的临床效果同拔牙创愈合后种植效果一样。     

上颌第三磨牙牙尖与牙根的关系的探讨

本文对４２０颗上颌第三磨牙Ｈｅ面牙尖与牙根关系进行了探讨。结果表明：Ｈｅ面牙尖呈四型，依次为三尖型（５２．３８％），四尖型（３４．５３％），双尖型（９．５２％）和五尖型（３．５７％）。牙根呈三型，依次为融合根（４８．５７％），双根３２．８６％）和三根（１８．８６％）。Ｈｅ面牙尖为二尖型和三类型的上颌第三磨牙，其牙根多为融合根，占６８％，而多根占３２％（其中双根为２５％，三根为７％）；Ｈｅ面牙尖为四     

不同粘结剂对纵折牙根粘结后再植的疗效观察

目的：通过2种粘结剂处理纵折牙根进行粘结后再植术，了解不同黏结剂对后牙纵折愈合类型的影响。方法：3只Beagle犬的前磨牙48个牙根，分成3组，分别用Clearfil SE Bond（CE组，n=18）和SuperBond C＆B（SE组，n=18）进行粘结后再植，与正常牙根再植组（CC组，n=12）进行对照。术后16周处死动物，采集牙根一牙槽骨标本，按照”8等分法”和Andreasen愈合标准，记录各位点组织愈合情况，按有利愈合和不利愈合分类量化各组组织学愈合类型，并对各组牙根余留半径长按照0-4级评分，比较有效愈合率和余留牙根半径。结果：CE、SE、CC三组有效愈合率分别为：51％、31％、59％。余留半径评分分别为：3．38、2．47、3．59。CE组比SE组更能有效促进纵折牙根的愈合。结论：Clearfil SE Bond AP-x粘结系统能有效降低炎症性吸收和置换性吸收的发生率，提高后牙纵折粘结后再植术的手术成功率。     

上颌前牙缺失人工种植牙修复的临床应用

目的：探讨CDIC一段式骨内种植体的临床应用疗效。方法：对上颌前牙缺失牙6个月以上的86例患者植入118枚CDIC一段式螺旋状或叶状纯钛种植体，用成品拜耳树脂牙或烤瓷冠修复。结果：种植修复后，经过1．7年的随访观察，种植成功率达到94．92％，并对种植修复过程中出现的并发症及影响种植体成功的因素进行讨论。结论：一段式纯钛种植体用于上前牙缺失修复的效果良好，严格选择适应症、掌握正确的手术操作和设计合理的修复是种植牙成功的关键。     

二种植牙临床应用的研讨

目的：对人工种植牙种植和修复的探讨。方法：将本科的病例定期随访，从而进行临床评价。结果：上前牙98颗，完全成功93颗(94．90％)，基本成功3颗(3．06％)，失败2颗(2．04％)；下颌前牙65颗，完全成功63颗(96．92％)，基本成功2颗(3．08％)；上下颌磨牙43颗，完全成功38颗(88．37％)，基本成功2颗(4.65％)，失败3颗(6．98％)。结论：种植牙材料和病例的选择至关重要，术中精细的操作及术后护理和合理的修复设计是人工种植牙成功的关键。     

A 5-year comparison of hydroxyapatite-coated titanium plasma–sprayed and titanium plasma–sprayed cylinder dental implants

OBJECTIVE: A preliminary report from this study showed that hydroxyapatite-coated (HA) titanium plasma-sprayed (TPS) cylinder implants had fewer failures than TPS cylinder implants before prosthetic loading. The purpose of this article is to report the long-term success associated with the 2 systems. In addition, local and systemic factors that may influence the success or failure of the implants were analyzed. STUDY DESIGN: Each of 65 subjects was randomized to either HA-coated TPS or TPS cylinder implants. Loss of an implant was considered a failure. Failures were analyzed in terms of the coating of the implant, age and gender of the patient, location and length of the implant, opposing dentition, and smoking status. Data were statistically analyzed through use of chi-square tests. RESULTS: Of 351 implants that were placed, 13 were lost before prosthetic loading and 17 were lost after prosthetic loading. The overall success rate was 92.8%. Three hundred thirty-eight implants were prosthetically loaded. The implant success rate after prosthetic loading was 95.3%. There was an overall nonsignificant higher failure rate for the TPS implants (8.0%). Patient age and patient gender were nonsignificant variables. Ten-mm implants had a significantly higher failure rate (17.4%; chi-square, 1.00; P = .39). Before prosthetic loading, more implants failed in the posterior mandible; after prosthetic loading, more implants failed in the anterior maxilla (chi-square, 8.97; P = .03). More implants failed when they were opposed by natural dentition or hybrids (chi-square, 7.36; P = .007). Smoking history was a significant factor (chi-square, 5.2; P = .002). CONCLUSIONS: Statistically, there is little difference between the 2 systems. Local and systemic factors appear to play a greater role in implant failure than does the surface of the implant.     

Brånemark system implants in the posterior maxilla: clinical study of 660 implants followed for 5 to 12 years

Originally, osseointegrated implants were used principally in the anterior region of the mandible and maxilla, but use in the posterior segments of both arches is common today. The long-term success of implants placed in the posterior region, an environment of stronger forces and poorer bone quality, has not been thoroughly reviewed. The purpose of the present study was to review a large series of Br?nemark System implants placed in posterior maxillae (660 implants in 202 patients) that have been restored with fixed partial ceramometal restorations and followed for as long as 12 years after loading. Thirteen of the implants (2%) failed between placement and loading, 12 implants were lost between loading and the end of the first year, and 10 failed thereafter, 2 as the result of fractures at 3 and 4 years. The cumulative success rate is therefore 94.4% at 5 to 6 years and 93.4% after 10 years. The quality and quantity of bone appeared to have little influence on the success rate. Surgical techniques are particularly important to the success of osseointegrated implants placed in the posterior maxilla. With careful surgical planning and execution, a success rate of approximately 95% at 5 years can be achieved.     

Immediate loading of implant overdentures using modified loading protocol

To our knowledge, this study shows the first longitudinal results (range 12-30 months) of immediate loading of implant-support overdenture with ball attachment connection placed in the anterior mandible. Immediately after surgery, the overdenture was connected to the implants with 2-ball attachments. The housings were filled with Impregum (3M Espe AG; Seefeld, Germany) impression material to provide retention as well as reduce forces in the initial phase of loading. Of the 28 implants placed, only 1 failed; the 1 failed implant for total implants placed represents a success rate of 96.4%. The minimal bone loss (1 mm) in 2 sites represents a success rate of 92.8%.     

Immediate occlusal loading the same day or the after implant placement: comparison of 2 different time frames in total edentulous lower jaws

Immediate loading of endosseous implants is becoming a widespread therapeutic procedure for the rehabilitation of patients with edentulous jaws. The purpose of this prospective clinical trial was to evaluate the long-term success rate of endosseous implants placed in the edentulous lower jaw and loaded on either the same day of surgery or the next day. Nineteen patients were enrolled in the study. Eleven patients, accounting for 64 implants, received their provisional prosthesis the same day of implant placement, and 8 patients, accounting for 52 implants, were rehabilitated the day after surgery. All patients were rehabilitated by a hybrid prosthesis supported by 5 to 6 Osseotite implants. Two implants failed in the group of patients who had their implants loaded the same day (96.9% success rate), whereas 1 implant failed in the other group (98.1% success rate). The overall implant success rate was 97.4%. All failures occurred within 2 months of function. No other complication was reported. The mean follow-up for this interim report was 37.8 +/- 16.5 months (range 8-65 months). Crestal bone loss was similar to that reported for standard delayed loading protocols. The results of this study suggest that the rehabilitation of the edentulous lower jaw by an immediate occlusally loaded implant-supported hybrid prosthesis is equally successful when loading is applied the same day or the day after implant placement. Immediate loading with 5 to 6 implant-supported prostheses represents a viable alternative treatment to classic delayed loading protocols.     

种植失败原因探析及再种植处理的体会

目的　分析种植义齿失败原因,探讨再种植手术技巧。方法　 1998年1月—2010年1月623例种植修复病例中,失败病例31例,共计52枚种植体。从脱落时间、部位和术中、术后并发症等方面分析失败原因;并对失败病例进行再种植及疗效评估。结果　 52例脱落种植体,85%（44枚）发生于上部结构修复前,上颌第一磨牙种植体脱落率远高于其他牙位;上颌窦穿通和牙槽骨壁侧穿是种植手术失败的主要并发症。失败病例的再种植时间为3～6个月,2枚种植体脱落后进行第3次种植手术并仍获得临床成功。结论　 骨整合作用是种植义齿存活的关键因素,它受全身和局部因素的影响,前者主要为骨质疏松所致的骨密度降低,后者包括局部病变（牙周病）和局部解剖条件限制,即上颌窦和下牙槽神经所致的骨量不足,种植失败后再种植仍能取得首次种植同样的疗效。     

Success rate of immediate nonfunctional loaded single-tooth implants: immediate versus delayed implantation

PURPOSE: The aim of this study was to evaluate the success rate of maxillary immediate nonfunctional single-tooth loaded implants used into fresh extraction sites (immediate placement condition) or healed ridge (delayed placement condition). MATERIALS AND METHODS: Eighty-two dental implants were placed in the maxilla of 64 consecutive patients from private practice office and from a specialization course in Implantology. Forty-six implants were inserted under immediate placement condition, and 36 were inserted under delayed placement condition. The criteria used to evaluate success rate were those previously described by Albrektsson and Zarb (Int J Prosthodont. 1993;6:95-105), and follow-up period ranged from 18.0 to 39.7 months. RESULTS: Seventy-nine implants fulfilled the success rate criteria (96.3%). Moreover, differences concerning implantation condition were not significant (P = 0.33, Qui-square test): three of the failed implants were from immediate placement group (success rate of 93.5%), and none was from delayed placement group (success rate of 100.0%). CONCLUSION: In the present sample, no statistically significant differences were detected for immediate nonfunctional single-tooth loaded implants under immediate placement condition in comparison with those inserted under delayed placement condition; both protocols had high success rate in maxillary incisors, canines, and premolars areas.     

Clinical and radiographic evaluation of small-diameter (3.3-mm) implants followed for 1-7 years: a longitudinal study

Implants with a small diameter may be used where bone width is reduced or in single-tooth gaps with limited mesiodistal space, such as for the replacement of lateral maxillary or mandibular incisors. The purpose of the present longitudinal study was to compare the prognosis of narrow implants (3.3-mm-diameter) to standard (4.1-mm-diameter) implants. Over a 7-year period, 122 narrow implants were inserted in 68 patients to support 45 partial fixed prostheses (PFD) and 23 single-tooth prostheses (ST). Furthermore, 120 patients received 208 standard implants and were restored with 70 PFD and 50 ST, respectively. Clinical and radiographic assessment data were provided. Six (1.8%) out of 330 implants failed. Cumulative survival and success rates were calculated with life-table analyses processed by collecting clinical and radiographic data. For narrow implants, the cumulative survival rate was 98.1% in the maxilla and 96.9% in the mandible. The cumulative success rate was 96.1% in the maxilla and 92% in the mandible. Conversely, standard-diameter implants showed a cumulative survival rate of 96.8% in the maxilla and 97.9% in the mandible. The cumulative success rate was 97.6% in the maxilla and 93.8% in the mandible. Cumulative survival and success rates of small-diameter implants and standard-diameter implants were not statistically different (P > 0.05). Type 4 bone was a determining failure factor, while marginal bone loss was not influenced by the different implant diameters. The results suggest that small-diameter implants can be successfully used in the treatment of partially edentulous patients.     

A prospective multicenter clinical trial of 3i machined-surface implants: results after 6 years of follow-up

PURPOSE: In this prospective multicenter clinical study, 1,179 3i standard threaded and self-tapping implants were followed for up to 6 years and monitored according to established success criteria. MATERIALS AND METHODS: A total of 493 patients (240 men and 253 women) with a mean age of 45.1 years at implant surgery were enrolled at 6 research centers after being screened for exclusion criteria. Implants were placed according to a 2-stage surgical protocol with a minimum of 4 months of submerged healing in the mandible and 6 months in the maxilla. Restorations included 633 prostheses, the majority of which were fixed partial dentures in the posterior mandible or maxilla or single-tooth replacements in the anterior maxilla. RESULTS: One hundred four implants (8.8%) did not meet success criteria and were designated as failures, and 222 implants (18.8%) were lost to follow-up. The cumulative success rate according to life table methods was 91.1% at 6 years. DISCUSSION: Sixty percent of the failed implants were short (< or = 10 mm long), and their cumulative success rate as a group at 6 years was 89.0%, compared to 93.1% for longer implants (P < .05). Thirty-three percent of all failures were implants placed in the posterior maxilla, for a 5-year cumulative success rate of 87.4%. CONCLUSION: It appears that limited bone dimensions and poor-quality bone have an impact on the performance of these machined-surface implants.     

A 3- to 6-year study of overdentures supported by hydroxyapatite-coated endosseous dental implants

PURPOSE: The purpose of this study was to evaluate the clinical effectiveness of hydroxyapatite-coated cylindrical implants to support overdentures. These implants were placed between 1990 and 1994 and have been followed up over a period of 3 to 6 years. MATERIALS AND METHODS: One hundred thirty-nine Calcitek dental implants were placed in 43 patients to support 14 maxillary and 30 mandibular overdentures. Standardized clinical review procedures were used. RESULTS: At exposure all the implants were found to be osseointegrated. To date only 7 implants (5%) have completely failed and two associated overdentures (5%) have been lost. The cumulative survival rate of all implants over 6 years was 92%. However, if failure is defined by the loss of more than 4 mm of cervical bone, 33 implants could be classified as being in the process of failing. Using these figures, interval success rates as low as 82% were found by year 6, and the cumulative success rate would fall to 39%. Maxillary survival and success rates were significantly lower than mandibular rates, at 38% and 10%, respectively, by year 5. CONCLUSION: Failure rates were higher in the maxillary arch, in poor quality bone, in smokers, and where implants were opposed by a natural dentition or an implant-supported prosthesis. The results suggest that the cervical bone level adjacent to the Calcitek cylindrical hydroxyapatite-coated implant failed to establish a steady state, particularly in the maxillary arch. Doubts remain regarding the long-term prognosis of these cylindrical implants.     

Oxidized titanium implants (Nobel Biocare TiUnite) compared with turned titanium implants (Nobel Biocare mark III) with respect to implant failure in a group of consecutive patients treated with early functional loading and two-stage protocol

OBJECTIVES: The purpose of this study was to compare two implant types of similar shape but with different surfaces with respect to implant failure. MATERIAL AND METHODS: A total of 136 patients were treated with Nobel Biocare Implants between January 2001 and December 2002. Totally 394 implants were placed, of which 199 were oxidized titanium implants (Nobel Biocare TiUnite and 195 with turned titanium surface (Nobel Biocare Mark III. Sixty-three patients underwent a one-stage surgical protocol, of which 24 were objected to early functional loading. The remaining 73 patients were treated with a traditional two-stage surgical protocol. All patients were followed for a minimum of 5 months after loading of the implants. Implants were classified as survivals when clinically stable and fulfilling purported function without any discomfort to the patient, with no signs of infection or ongoing pathologic process. RESULTS: Seven implants were lost in five patients (two males and three females), six in the maxilla and one in the mandible. All failed implants were Mark III implants, inserted following the traditional two-stage protocol. The implant success rate was 98.2% for the whole-patient group, divided as a 100% success rate following the implants with oxidized surface (Nobel Biocare TiUnite compared with a success rate of 96.4% with implants with turned surface (Nobel Biocare Mark III).