338枚即刻种植义齿的临床疗效观察

目的:探讨即刻种植义齿修复牙缺失外科植入和修复方法;初期:(≥6月)和远期(≥36个月)疗效;评价其相关影响因素.方法:291例拔牙患者在拔除牙根后立即在牙槽窝内植入种植体338枚(HBIC,CDIC,CAMLOG,ITI,DIO,OSSTEM,XIVE),3-6月后延期修复,观察6-60个月.结果:338枚种植体随访300枚,6-60个月存留率95.67%.结论:即刻种植义齿修复具有自身优点和适应症,长期效果与延期种植效果无显著性差异,是可行、简便的种植叉齿修复方式之一.     

种植义齿即刻修复的临床研究

目的 依据即刻修复种植理论，对种植固定义齿进行即刻修复以恢复美观和功能。方法 对单个牙缺失患者植入Replace螺旋型种植体后即刻修复，定期进行临床及X线片观察。结果 20枚种植义齿随访6～36个月，种植体无松动，X线片显示骨一种植体结合良好，种植体颈周骨吸收小于1．0mm。结论 单牙即刻修复近期临床观察效果满意。     

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。     

CDIC人工种植牙技术的临床应用与观察

目的:探讨CDIC人工种植牙技术的临床应用经验以及五年的观察效果。方法:采用卫生部口腔种植科技中心研制的CDIC系列种植体及一期法植入技术,前牙植入一段式锥状螺旋种植体后即刻修复,后牙植入组合式柱状螺旋种植体,术后6～8个月做上部牙冠固定修复。结果:对18例患者,51枚种植体植入与修复后五年的临床观察,16枚前牙及34枚后牙均存活,上部义齿使用正常。仅一枚种植体在植入后一月因咬硬物松动取出。结论:应用人工种植义齿修复技术,可最大程度地使失牙患者获得比传统义齿修复更为满意的临床治疗效果。     

无牙颌患者种植义齿修复

目的:无牙颌患者采用种植义齿修复可有效的增强义齿的固位,提高义齿的修复效果。方法:从1999年至2007年,对22例无牙颌患者,年龄45-82岁,行种植义齿修复,其中,有2例采用种植固定义齿修复,7例采用杆-卡式种植覆盖义齿修复,11例采用球-帽式种植覆盖义齿修复,1例采用双套筒冠种植覆盖义齿修复,1例采用磁性固位种植覆盖义齿修复。患者种植体植入2-9颗,共植入种植体97枚,种植体采用Frialit-2,Fri-alit-xive系统,观察时间108个月,采用临床检查、X线观察和患者主观评价等来评价种植体与骨组织结合状态,评价其义齿的修复效果。结果:观察期内发现1枚种植体脱(球-帽式固位种植体),1枚种植体未作修复,仍埋入在粘膜下的颌骨内。种植义齿修复后固位稳定作用良好,患者咀嚼有力,对义齿修复效果满意。结论:无牙颌患者种植义齿修复效果良好,患者满意度高。     

磨牙区即刻种植的回顾性研究

目的:回顾性观察磨牙区即刻种植的临床效果。方法:对55例患者的55颗磨牙经微创拔牙后行即刻种植,采用多种外科技术如引导骨再生、骨劈开、骨挤压和经牙槽嵴上颌窦内提升术等进行骨增量,共植入直径为4.8mm的Straumman种植体24枚和5.5mm的Ankylosis种植体31枚。上磨牙区在种植体植入4~6月后进行修复,下磨牙区在种植体植入3~4月后进行修复。结果:55枚种植体,有1枚种植体在植入1个月时松动,其余种植体骨结合良好,成功率98.18%,修复后追踪4-52个月,功能正常。结论:磨牙区即刻种植是一种预后良好的治疗方法。     

前牙区牙种植即刻修复的临床评价

目的:评价前牙区牙种植即刻修复的临床效果,通过随访观察即刻修复技术的近期临床效果,以便对临床提供指导.方法:对33例病人植入48颗种植体(均为Xive及31种植系统)并于术后行即刻临时冠修复.种植体植入后安装临时基台,临时冠为树脂冠、患者原烤瓷牙或原自体牙,3-6个月后行最终烤瓷冠修复,并对其进行定期临床观察和放射学检查.结果:修复后经3-24个月观察,所有病例全部成功,美学效果好,患者均较满意.修复后至最近一次复查未见种植体异常,并且都取得良好的骨结合.结论:选择合适的病例,在前牙区行牙种植即刻修复可以取得良好的临床效果.前牙区即刻修复近期临床效果满意,是临床切实可行的方法.远期效果尚待进一步观察.     

593枚二段非埋置式种植体近期疗效观察

目的:探讨二段非埋置式种植体植入手术的优点、临床操作与可行性。方法:237例牙缺失患者,共植入593枚二段非埋置式种植体,非埋置法植入,即刻修复或3～6个月后延期修复,观察3～36个月。结果:23枚种植体松动,取除,其余种植体骨结合良好,短期留存率96.12%。结论:二段非埋置式种植体种植修复,简化了手术,缩短了疗程,取得良好的近期效果。     

Bio-oss骨胶原在即刻种植中的临床应用研究

目的:探讨Bio-oss骨胶原在即刻种植中的临床应用。方法:拔除患牙,采用Xive种植系统的操作方法,将Xive种植体即刻植入拔牙区,骨量不足处植入Bio-oss骨胶原。3-6个月后进行Ⅱ期手术,10天后进行固定修复。结果:22枚即刻种植的Xive种植体中,上颌16枚,下颌6枚,观察最长24个月,最短12个月,种植体存留率为100%。结论:Bio-oss骨胶原在Xive即刻种植的临床应用结果满意,其长期效果有待进一步观察。     

12例重度慢性牙周炎患者全颌种植义齿修复的临床观察

目的探讨对经牙周治疗的重度慢性牙周炎患者拔除剩余牙齿后同期植入种植体并采用全颌种植义齿修复的可行性。方法对12例重度慢性牙周炎患者行牙周治疗，控制病情后，拔除剩余牙齿并同期植入种植体，5～6个月后行全颌种植义齿修复。根据临床、X线检查和患者主诉评价修复效果。结果共计108枚种植体植入20个牙弓，其中37枚种植体即刻植入拔牙窝内。种植体平均承载3年，所有种植体均无松动。2枚种植体发生种植体周围炎，有进行性骨吸收，其中1枚为即刻植入拔牙窝内的种植体。除2枚有进行性骨吸收的种植体外，其余种植体周围的骨吸收高度平均为（1．33±0．10）mm。108枚种植体的存留率为98．1％，37枚即刻种植体的存留率为97．3％。结论对重度慢性牙周炎患者行牙周治疗后拔除剩余牙齿并同期植入种植体，采用全颌种植义齿修复，可减少牙槽骨的吸收、缩短种植修复疗程，在定期的口腔卫生维护下获得理想的修复效果。     

Risk factors for failure of glass fiber-reinforced composite post restorations: a prospective observational clinical study

Glass fiber-reinforced endodontic posts are considered to have favorable mechanical properties for the reconstruction of endodontically treated teeth. The aim of the present investigation was to evaluate the survival of two tapered and one parallel-sided glass fiber-reinforced endodontic post systems in teeth with different stages of hard tissue loss and to identify risk factors for restoration failure. One-hundred and forty-nine glass fiber-reinforced endodontic posts in 122 patients were followed-up for 5-56 months [mean +/- standard deviation (SD): 39 +/- 11 months]. Glass fiber-reinforced endodontic posts were adhesively luted and the core was built with a composite resin. Cox proportional hazards models were used to evaluate the association of clinical variables and failure rate. Higher failure rates were found for restorations of anterior teeth compared with posterior teeth [Hazard-Ratios (HR): 3.1; 95% confidence interval (CI): 1.3-7.4], for restorations in teeth with no proximal contacts compared with at least one proximal contact (HR: 3.0; 95% CI: 1.0-9.0), and for teeth restored with single crowns compared with fixed bridges (HR: 4.3; 95% CI: 1.1-16.2). Tooth type, type of final restoration and the presence of adjacent teeth were found to be significant predictors of failure rates in endodontically treated teeth restored with glass fiber-reinforced endodontic posts.     

太极扣附着体修复游离端缺失伴牙周病患者的临床效果研究

目的:研究太极扣(ERA)附着体义齿修复肯氏Ⅰ、Ⅱ类牙列缺损伴牙周病患者的临床应用效果.方法:对82例肯氏Ⅰ、Ⅱ类牙列缺失伴牙周病的患者,随机分为实验组和对照组,实验组46例,用太极扣附着体义齿修复;对照组36例,采用卡环式义齿修复,修复后3、6、12、36个月临床复查,通过患者问卷调查,临床检查,及X线片观察其修复效果,并比较2组的临床成功率.结果:通过3、6、12、36个月的系统观察,随访,评价,2组比较有显著性差异(P＜0.01).结论:太极扣附着体义齿修复肯氏Ⅰ、Ⅱ类牙列缺损伴牙周病患者效果明显优于卡环式义齿修复,值得推广.     

Association between root resorption incident to orthodontic treatment and treatment factors

The purpose of this study was to clarify the prevalence and degree of root resorption induced by orthodontic treatment in association with treatment factors. The files of 243 patients (72 males and 171 females) aged 9-51 years were randomly selected from subjects treated with multi-bracket appliances. The severity of root resorption was classified into five categories on radiographs taken before and after treatment. The subjects were divided into extraction (n = 113 patients, 2805 teeth) and non-extraction (n = 130 patients, 3616 teeth) groups and surgical (n = 56 patients, 1503 teeth) and non-surgical treatment (n = 187 patients, 4918 teeth) groups. These subjects were also divided into two or three groups based on the duration of multiloop edgewise archwire (MEAW) treatment, elastic use, and total treatment time: 0 month (T1; n = 184 patients, 4831 teeth), range 1-6 months (T2; n = 37 patients, 994 teeth), more than 6 months (T3; n = 22 patients, 596 teeth); range 0-6 months (n = 114 patients, 3016 teeth) more than 6 months (n = 129 patients, 3405 teeth); range 1-30 months (n = 148 patients, 3913 teeth) and more than 30 months (n = 95 patients, 2508 teeth). The prevalence of overall and severe root resorption evaluated by the number of subjects and teeth was compared with a chi-square test. A Student's t-test for unpaired data was used to determine any statistically significant differences. The prevalence of severe root resorption based on the number of teeth was significantly higher in the group with extractions (P < 0.01). Longer use of a MEAW appliance and elastics also produced a significantly higher prevalence of root resorption (P < 0.05). On the other hand, the prevalence of severe root resorption was not significantly different between the subjects treated with or without surgery, but there was a significant increase when treatment time was prolonged (P < 0.05). A significant difference was found in the amount of root movement of the upper central incisors and the distance from their root apices to the cortical bone surface (P < 0.05). These are regarded as essential factors in the onset of root resorption. These results indicate that orthodontic treatment with extractions, long-term use of a MEAW appliance and elastics, treatment time, and distance of tooth movement are risk factors for severe root resorption.     

The survival of vital and non-vital deciduous molar teeth following pulpotomy

BACKGROUND: There is scant evidence supporting the criteria for establishing the suitability of a deciduous molar for a pulpotomy. Although some criteria, such as patient age, are logical the importance of other factors on tooth survival has not been established. METHODS: All pulpotomies performed at 20 school dental clinics over a period of 15 months were reported together with date of birth, gender, tooth treated, presenting signs and symptoms, pulp status and date and method of treatment. Operators performed the treatment according to their usual procedures. Data were analysed statistically using Statview 5.0 (SAS Institute). RESULTS: The outcome of pulpotomy of 465 deciduous teeth in 403 patients was evaluated. The mean age of the patients was 7.4 +/- 0.1 years. Two hundred and seventy-two teeth were vital and 193 were non-vital. One hundred and ninety-six teeth were treated with the one-step formocresol method and 269 with the two-step formocresol method. The age and gender of the patients did not differ between the vital and non-vital groups. There was no influence of mode of treatment on the asymptomatic survival of the teeth in the mouth. The median survival times were significantly longer in vital (32.7 +/- 1.4 months) than non-vital teeth (20.4 +/- 3.0 months; p < 0.0001). The only factors significantly influencing the survival of pulpotomized teeth were the age of the patient (p < 0.0001), the non-vitality of the pulp (p < 0.0001) and the presence of a radiolucency (p = 0.031). CONCLUSION: Both vital and non-vital teeth were able to survive for extended periods following pulpotomy but the presence of an associated radiolucency or a non-vital pulp at the time of treatment is negatively associated with time of survival.     

348例老年人活动义齿修复临床探讨

目的了解老年修复患者口腔情况,探讨老年人牙列缺失缺损后的修复特点.方法分析348例老年人牙列缺损缺失的情况,采取不同方法进行修复,并进行5年随访.结果老年人牙列缺失缺损在注意咬牙合重建、抬高咬合、防止食物嵌塞情况下进行活动义齿修复.结论 活动义齿是老年人修复治疗的主要方法,老年人活动义齿修复应注意咬合重建,防止食物嵌塞.     

牙髓血管再生治疗年轻恒牙根尖周炎的应用

目的:观察牙髓血管再生治疗年轻恒牙根尖周炎的效果。方法:10名患者12颗牙,平均年龄10.8岁,根尖周有暗影,牙根未发育完成。术后每1~2月复查1次,连续观察6~18个月。结果:8颗牙牙根继续发育;从放置MTA至根尖发育完成的平均时间为4.6个月;牙根长度与对侧同名牙无明显差异。结论:牙髓血管再生是治疗年轻恒牙根尖周炎的有效方法。     

下颌前突外科手术前后的正畸治疗

目的 总结、分析口腔正畸－正颌外科联合矫治下颌前突畸形的治疗经验,以指导临床工作。方法 对４０例年龄为１７￣３８岁的下颌前突患者经口腔正畸与正颌外科联合矫治的资料进行分析。结果 ４０例下颌前突患者平均术前正畸治疗时间９个月（２￣２５个月）,术后正畸治疗时间７．６个月（２￣１５个月）。整个治疗过程平均１６个月（４￣２５个月）。术前正畸治疗的目标为排齐上下牙列,完成切牙和磨牙的去代偿治疗,整平牙例,协     

输液管在儿童替牙期含牙囊肿开窗术中的应用

目的:探讨输液管在儿童替牙期含牙囊肿开窗引流术中的作用。方法 :分析2003-12—2011-12我院口腔颌面外科收治的经病理证实为含牙囊肿的替牙期儿童病例22例,平均年龄11岁,所有病例术前均拍摄曲面断层片和局部小牙片,囊肿直径3～5 cm,其中含多生牙9例。术中拔除部分乳牙及多生牙,于拔牙创处开窗,切取部分囊壁,拔牙创口置直径0.4 cm、长约1.0～1.5 cm输液管,并固定于牙龈或邻近牙齿。每日冲洗,术后3个月、6个月、1年随访,同时拍摄曲面断层片检查。结果:所有病例在开窗术后早期局部轻度红肿疼痛,3个月后囊肿明显减小,6～7个月时骨质膨隆消失,10～11个月时X线检查囊肿低密度影像消失。13例恒牙自行正位萌出,4例出现尖牙与侧切牙错位萌出,5例恒牙未自行萌出。在开窗引流期间,无1例患者伤口感染,均引流通畅。结论:输液管在儿童替牙期含牙囊肿开窗引流术中,具有操作简单、患者术后依从性高、创伤痛苦小、复诊次数少、引流通畅、成本低廉、易于推广等特点,是治疗儿童替牙期含牙囊肿的较理想方法。     

根管治疗期间急症的防治

目的:探讨根管治疗期间急症的防治.方法:将患牙髓炎、牙髓坏死、根尖周炎,需接受根管治疗的348例(348颗患牙)随机分成4组,分别在根管内封甲醛甲酚(FC)、奥硝唑、氢氧化钙、地塞米松-氢氧化钙,观察其根管治疗期间急性疼痛发作率.结果:奥硝唑与氢氧化钙组比较,差异无显著性(P>0.05).地塞米松-氢氧化钙组与奥硝唑组、氢氧化钙组比较,各组之间有显著差异(P<0.05),地塞米松-氢氧化钙糊剂同FC组比较具有非常显著差异(P<0.01).结论:根管内封地塞米松-氢氧化钙能较好预防和降低EIAE的发生率,并能减轻疼痛程度.     

Periodontal healing after intentional auto-alloplastic reimplantation of injured immature upper front teeth

BACKGROUND/AIMS: Conventional endodontic treatment results in high complication quota when performed in immature teeth. Intentional reimplantation with extraoral insertion of an endodontic implant (auto-alloplastic reimplantation) is an alternative. METHOD: In a retrospective study, the healing of 40 teeth reimplanted intentionally according to this method in patients aged 7 to 15 years was evaluated. Clinical tests (palpation, percussion sound, periotest values) and radiographical examinations were used to determine the type of periodontal healing (inflammatory resorption/periodontitis apicalis; replacement resorption/ankylosis; normal healing). RESULTS: Mean lifetime of the replanted teeth was 59.2+/-42.5 months, estimated survival time on the basis of the Kaplan-Meier analysis was 99.5 months. 17 teeth (42.5%) were classified as failures, mostly due to inflammatory resorption or periodontitis apicalis. Further investigations demonstrated that success rate and retention period of intentionally replanted teeth depend on the preoperative condition of the pulp. Teeth with preoperative infection suffered frequently from inflammatory resorption or periodontitis apicalis after being replanted (14 of 28 teeth). Estimated survival time according to Kaplan-Meier was 75.5 months. In contrast, inflammations or progressive resorptions were not observed in teeth without preoperative infection of the pulp. All these 12 teeth showed normal periodontal healing and regular tooth mobility. In the absence of any pathology in clinical or radiological findings after an average functional period of 72.3 months, the prognosis can be presumed excellent. Estimated survival time of 148.3 months according to Kaplan-Meier differs significantly from survival time of teeth infected preoperatively. CONCLUSIONS: From the results of this investigation, it may be concluded that an infection of the pulp - due to delay of treatment or attempts at endodontic therapy - should be avoided before intentional replantation of immature front teeth with pulp necrosis. Periodontal healing of the autologous root is not impaired by the insertion of posts made of Al2O3-ceramics or titanium. The inserted posts do not ankylose. Orthodontic movement of auto-alloplastically replanted teeth is possible.