全口即刻负重种植固定义齿2例

对2例全口多数牙缺失、残留少量重度牙周炎患牙的患者拔除全口余牙,即刻于上下颌分别植入10颗和8颗Straumann种植体,36颗种植体经共振频率分析,种植体稳定指数（ISQ）值大于60的34颗种植体即刻接入临时基台行复合树脂临时固定桥修复,3个月左右种植体形成骨整合后完成永久性修复。修复后追踪18～26个月,无1颗种植体失败,平均累积骨丧失为0.41 mm。     

ITI种植体在单颗牙即刻种植即刻负重的临床研究

目的：评价ITI种植体在前牙区单颗牙缺失即刻种植即刻负重修复的临床效果。方法：对31例前牙区单个牙缺失患者在拔除残根后行即刻植入ITI种植体，并对其中18枚术中戴入临时义齿，行即刻负重修复（扭矩〉25Ncm，初期稳定性好），六个月后行永久修复。在植入后3、6、12个月对其进行临床及影像学检查。结果：18枚前牙区单个牙缺失即刻植入ITI种植体并行即刻负重修复后无1枚脱落。结论：前牙区单颗牙缺失使用ITI即刻种植及即刻负重修复只要病例选择合适，合理控制咬[牙合]可以达到与常规种植同样的修复效果。     

上颌单颗前牙不翻瓣即刻种植修复的临床效果观察

目的 评价即刻种植即刻修复联合不翻瓣技术在上颌单颗前牙位点的临床应用效果,并探讨其技术要点.方法 选择上颌单颗中切牙无法保留的患者17例,采用不翻瓣技术,拔除患牙后即刻植入种植体,并即刻行种植体支持临时冠修复,术后2个月复诊调整临时冠外形,术后3个月行最终修复.最终修复后1、3、6、12、24个月复诊.最终修复即刻、1...     

重度牙周炎患者种植总义齿修复的临床观察

目的:探讨重度牙周炎患者拔除余留牙后行种植总义齿修复的临床疗效。材料和方法:重度牙周炎患者18位,拔除单颌所有余留牙后即刻或4～6周后植入种植体,采用即刻负重或延期负重的修复方式,并于术后3～8月后完成最终种植总义齿的修复。对所有患者进行临床及X线检查评价修复效果。结果:18位患者共植入144颗种植体,共完成24个种植总义齿的修复,其中上颌14例,下颌10例,12例采用了即刻负重的方式,12例3～8个月后延期负重。最终9例行固定总义齿修复,15例行覆盖义齿修复。永久修复完成后随访10～36个月,平均13个月。观察期内共2颗种植体丧失。修复完成后6个月时与植入时相比,种植体周边缘骨吸收0.56mm。采用覆盖义齿或固定义齿,种植体边缘骨吸收无明显差异。讨论:对于临床预后不佳的重度牙周炎患者,早期拔除余留牙后采用种植总义齿的修复方式,可早日恢复患者的咀嚼功能。严格的适应症选择,合理的治疗设计及正确的手术实施是保证成功率的关键。结论:对重度牙周炎患者采用种植总义齿的修复方式可获得满意的临床效果。     

一段式小直径种植体在小缺牙间隙即刻修复种植的临床研究

目的研究Osstem MS一段式小直径种植体用于5～6 mm的缺牙间隙即刻修复种植的临床效果。方法在36例患者的36个5～6 mm缺牙间隙处植入直径2.5 mm或3.0 mm的Osstem MS一段式小直径种植体36颗,即刻在椅旁或技工室完成树脂冠临时修复,树脂冠避开与对颌牙接触。术后3～5个月,金合金烤瓷冠完成修复。对所有病例进行定期的临床和放射线检查。结果36颗种植体行烤瓷冠修复时无1颗失败,其中1颗种植体植入后导致1颗邻牙牙髓坏死,经根管治疗后天然牙和种植体均成功保留。36例患者从种植体植入开始平均随访21.3个月（12～37个月）,36颗种植体均获得成功,种植义齿龈缘与邻牙龈缘曲线协调,龈乳头充盈,美学效果理想。结论5～6 mm缺牙间隙采用Osstem MS一段式小直径种植体即刻修复种植可以取得良好的临床效果。     

对105名实施即刻种植伴即刻跨弓长桥修复患者的回顾性队列研究

目的：1评价即刻种植伴即刻跨弓长桥修复患者牙列缺失的治疗疗效;2．比较愈合拔牙位点和新鲜拔牙窝种植体植入成功率的差异性。材料和方法：共有105名患者的下颔经拔牙变成无牙骀（平均每名患者拔除61颗牙）,在每名患者的下颌种植4～6颗种植体（共植入448颗种植体）,这些种植体被植入在愈合（共266颗种植体．占59％）或新鲜（共182颗种植体．占41％）的拔牙窝内。制作即刻临时义齿并即刻负载．所有患者术后随访4个月。治疗成功的标准包括：修复是否成功;单颗种植体的稳定性及术后并发症的评估。结果：没有患者中途退出。105名患者在治疗4个月后均接受了永久固定义齿修复。术后4个月．种植体的植入成功率为98.2％。8名患者的8颗种植体出现治疗失败（8％）。失败的8颗种植体中．有4颗位于新鲜的拔牙窝内（2．2％）,4颗位于愈合的拔牙位点内（1．5％）。在新鲜的拔牙窝和愈合拔牙位点植入的种植体成功率差异无显著性（P=0．4990）。所有患者均无并发症出现。结论：即刻种植和即刻负载均获得了较高的成功率。愈合拔牙位点和新鲜拔牙窝对种植体的植入成功率并无影响。     

口腔种植修复技术在无牙颌患者中的应用

目的:评价口腔种植修复技术在无牙颌患者中的临床应用效果,以促进其在临床上的广泛应用.方法:对49例全口无牙颌患者,根据患者的条件,在植入种植体后3-6个月,进行种植覆盖全口义齿或种植固定全口义齿修复,所有患者均于术后1、3、6、12个月.之后每12个月复查1次,根据临床观察,X线检查和患者主诉,评价其效果.结果:种植覆盖全口义齿修复26例,82颗种植体(上颌11例,下颌15例);种植固定全口义齿修复23例.213颗种植体(上颌18例,下颌5例),经过12个月～108个月的临床观察(平均42.32月),其中种植覆盖全口义齿1例2颗种植体发生脱落,其余种植体均获得良好的临床效果,累计存活率为97.56%;种植固定全口义齿除2例6颗种植体松动外,其余种植体临床效果良好,累计存活率为97.18%,两种修复方式均能获得良好的临床效果,义齿功能优良,患者对修复效果满意.结论:对全口无牙颌患者,采用种植义齿进行修复,通过精心的设计和完善的手术,能有效地恢复功能,达到美观效果,并能使种植体长期稳固于口腔内行使功能.     

即刻种植修复的临床研究

目的评价种植术后即刻修复的临床效果。方法单颗牙缺失,牙槽嵴高度及宽度足够的患者12例,植入种植体,要求种植体植入扭力大于40Ncm,即刻取模,术后3d戴入临时冠,3～6个月后改为烤瓷冠永久修复,定期进行临床及X线片观察,观察种植体的动度、种植体周骨结合情况及边缘骨吸收量。结果12颗种植体均已完成金属烤瓷冠修复,经15～26个月的追踪观察,种植体无一松动或脱落,X线显示种植体骨结合良好,种植体植入后1年种植体周骨高度丧失(0.75±0.22)mm。结论若缺失区骨质情况良好,单牙种植即刻修复可获得满意的近期临床效果。     

拔牙后植入4颗（all-0n-4）种植体并即刻负重进行下颌无牙耠跨牙弓固定义齿修复的疗效：一项随访18个月的多中心前瞻性队列研究

目的：通过拔牙后植入4颗（all-oR-4）种植体并即刻负重18个月．评价拔牙后进行下颌无牙耠跨牙弓固定义齿修复的疗效。材料和方法：平均年龄623岁的47位患者（52～78岁）．拔牙后植入4颗种植体并进行即刻跨牙弓固定义齿修复。共植入188颗种植体。术后48h内．采用含有金属支架的临时固定义齿修复,6个月后进行永久性修复。植入时以及植入后第6、12、18个月的随访检查中,对患者进行临床和影像学评估。结果：在植入后第18个月的随访检查中．未发现种植体失败．且所有修复体都保持稳定。植入后第6、12、18个月时种植体周围骨水平量分别为031±0．12mm、0．58±0112mm、07±0107mm。研究发现在轴向和倾斜植入的种植体之间．在植入后第6个月（0.6mm．P=0115）、第12个月（012mmjP=O062）和第18个月（0．08mm;P=O146）期间骨丧失量并无显著性差异。在整个研究期间,有3位患者出现临时修复体折断．但所有患者的永久性修复体都保持稳定．并未发现任何并发症。结论：本研究认为．拔牙后植入4颗种植体并即刻负重进行跨牙弓固定义齿修复是可行的,但此结论仍需更大样本量及更长随访期的研究来加以论证。     

Replace种植系统的临床应用及效果评价

目的探讨Replace种植系统的临床修复效果。方法57例患者植入Replace Select Tapered种植体102枚,3～4个月(下颌)或4～6个月(上颌)后行固定义齿修复,评价修复效果。结果植入3年后,1例因反复感染并发种植体周围炎性骨吸收而予以拔除,其余均获成功,成功率为99.02%。结论Replace种植系统行固定义齿种植修复能获得满意的效果,是一种有效的牙列缺损(缺失)修复方法。     

15例上颌前牙种植的美学临床研究

目的：评价ITI种植系统用于上颌前牙列缺损修复的临床应用和短期疗效并总结牙种植治疗中的经验教训。方法：50例患者的缺牙区植入ITI种植体78颗并完成义齿修复,临床观察12～36个月,其中15例为上颌前牙区种植美学修复。6例上颌植入区骨量不足者,用Bio-Oss人工骨粉植入缺损区及Bio-Gide可吸收生物膜覆盖。结果：50例患者总共78颗种植体稳固无松动,种植部位无疼痛或不适,短期种植成功率100%。2颗上颌前牙种植修复后牙龈乳头缺失。患者满意度为92.3%。结论：ITI种植系统在牙列缺损修复中有的成功率很高,但患者对前牙缺损修复美学效果要求也越来越高,软组织的处理对最后的美学效果十分重要。     

锥形束CT结合简易种植导板应用于上颌无牙颌种植修复的探讨

目的探讨锥形束CT（cone beam computed tomography,CBCT）影像结合简易种植导板定位应用于上颌无牙颌种植修复的效果。方法对8例拟行种植修复的上颌无牙颌患者术前拍CBCT,得到上颌骨多层次影像,通过测量分析确定种植修复方式,结合简易种植导板完成种植手术,定期随访。结果8例患者共植入39枚种植体,其中6例为种植覆盖义齿修复,共植入24枚种植体;2例为种植固定义齿修复,共植入15枚种植体。均无术中及术后并发症发生。12个月后CBCT检查未见明显骨吸收,种植体存活率100％。结论通过术中简易种植导板定位结合CBCT影像,手术安全可靠,种植体植入的位置较理想,为顺利完成上部修复创造有利条件。     

下颌无牙颌种植体支持SynCone套筒冠固位覆盖义齿的临床观察

目的：探讨应用Ankylos种植系统SynCone基台行下颌无牙颌种植体支持覆盖义齿修复的临床效果。方法：17例下颌无牙颌患者,在下颌植入4枚Ankylos种植体,2~3个月后行种植体水平转移并采用SynCone基台制作种植覆盖义齿,戴牙后3、6、12、18个月复查,进行临床和放射学检查。结果：17例患者中无种植体脱落现象,种植体周软组织健康,x线检查来见明显骨吸收,义齿固位力好、稳定,患者对修复效果满意。结论：在下颌植入4枚种植体,使用SynCone基台行种植体支持覆盖义齿修复效果明显,操作简单,易于维护,患者满意度高,值得推广。     

Immediate loading of implants with fixed restorations in the completely edentulous mandible: report of 27 patients from a private practice.

Numerous authors have documented clinical success in loading threaded implants at the time of implant placement when carefully controlled surgical and restorative protocols are followed. This clinical series documents the application of immediate loading techniques to fixed mandibular restorations in 27 patients who were edentulous or had non-restorable mandibular dentitions. Eighteen patients had complete conventional maxillary dentures, while 9 had natural or fixed prosthetic maxillary dentitions. Twelve different restorative dentists provided prosthetic support for these patients and used 4 different restoration types: laboratory- or office-processed, with cement or screw retention. Five to 8 threaded implants were placed in each patient. One hundred sixty-one of the 186 implants that were placed by the authors were loaded immediately using fixed provisional restorations of the various designs. More than 99% (160/161) of the immediately loaded implants and 99.5% (185/186) of all implants were clinically integrated and radiographically successful at the time of final evaluation for restoration fabrication. After final implant evaluation, no additional implant losses occurred, indicating an implant survival rate of nearly 100% over a mean of 25.0 months (range 13 to 41 months) following implant placement. While a strong preference for cement-retained restorations was apparent, all prostheses showed similar success. The data and the experience described in this report indicate that immediate loading with fixed restorations using appropriate surgical and restorative techniques can be a predictable technique for rehabilitation of the completely edentulous mandible.     

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。     

A preliminary report of patients treated with early loaded implants using computerized tomography-guided surgical stents: flapless versus conventional flapped surgery

The objective of this clinical study was to compare the survival rates of early loaded implants placed using flapless and flapped surgical techniques and to determine the bone density in the implant recipient sites using computerized tomography (CT). The study population consisted of 12 patients who were referred implant placement. One group consisted of five patients referred for the placement of 14 implants and treated with a flapless procedure. The other group consisted of seven patients referred for the placement of 45 implants with a conventional flapped procedure. Patients were selected randomly. CT machine was used for pre-operative evaluation of the jaw bone and the mean bone density value of each implant recipient site was recorded in Hounsfield units (HU). All implants were placed using CT-guided surgical stents. The early loading protocols included 2 months of healing in the mandible and 3 months of healing in the maxilla. Single-implant crowns, implant-supported fixed partial dentures, and implant-retained over dentures were delivered to the patients. Of 59 implants placed, one was lost in the conventional flapped group within the first month of healing, meaning overall implant survival rate of 98.3% average 9 months later. The highest average bone density value (801 +/- 239 HU) was found in the anterior mandible, followed by 673 +/- 449 HU for the posterior maxilla, 669 +/-346 HU for the anterior maxilla and 538 +/- 271 HU for the posterior mandible. The results of this study show that the early loading of implants placed utilizing flapless surgical technique with CT-guided surgical stents may be possible.     

Bilateral simultaneous augmentation of the maxillary sinus floor with particulated mandible. Report of a technique and preliminary results

This paper describes a surgical technique that permits the achievement of bilateral simultaneous augmentation of the maxillary sinus floor with the use of autologous bone harvested from the mandibular symphysis alone. Out of a group of 26 partially edentulous patients consecutively treated for sinus augmentation in an 18-month period, eight needed a bilateral procedure and were treated with the same surgical protocol. None of the patients had residual molar teeth, crestal bone height was reduced to 4 mm or less. Bone was harvested from the chin in blocks with a trephine bur, 11 or 9 mm in diameter, it was then particulated with a bone mill. Sinus augmentation and implant placement were done simultaneously in both sides of the maxilla. Implant-supported fixed partial dentures were inserted 6 months after the procedure. 44 ITI solid screw implants were placed in the grafted sinuses with a mean of 2.75 implants on each side. Mean follow-up was 19 months. In all patients needing a bilateral sinus lift, the procedure could be successfully completed. All implants were stable at abutment connection. All implants are stable at the latest follow-up, and all prosthesis are still working. In all implants, a clear bone-to-implant contact was visible. No peri-implant radiolucency has been noticed so far. It is concluded that bilateral augmentation of maxillary sinus floor with particulated mandible associated with simultaneous ITI implant insertion is feasible. It is a safe and effective procedure that can be accomplished in an out-patient environment with only minor discomfort for the patient.     

One-Year Prospective Evaluation of the Early Loading of Unsplinted Conical Brånemark Fixtures with Mandibular Overdentures Immediately following Surgery

Background: Prospective evaluation of the early loading of unsplinted Branemark implants with mandibular over‐dentures opposing conventional dentures is not evident in the implant‐related literature. Purpose: To clinically evaluate progressive and early loading of 20 unsplinted conical Brånemark implants in edentulous mandibles with overdentures. Materials and Methods: Ten edentulous patients all had two conical Brånemark implants placed in the anterior mandible with mandatory primary stability with bicortical anchorage. Ball abutment connection was performed simultaneously. Previously constructed conventional mandibular dentures were temporarily relined with tissue conditioner postoperatively and worn with moderation for the first 2 weeks to allow progressive loading. Early loading of the implants followed after 2 weeks, with inclusion of the respective matrices in the mandibular dentures, using a definitive reline procedure. Results: All patients successfully functioned with their mandibular implant overdentures from 2 to 52 weeks postoperatively. Mean marginal bone loss was within established criteria for success:0.22 mm (SD = 0.48 mm) mesially and 0.30 mm (SD = 0.39 mm) distally on the conical implants. Mobility tests using the Periotest instrument became more negative, although not at statistically significant levels. Difficulties in the management of the peri‐implant mucosa between surgery and loading at 2 weeks were observed in 40% of the patients. Conclusions: These preliminary 1‐year results show that successful early loading of unsplinted conical Brånemark implants with mandibular overdentures is possible.     

Replace种植义齿修复的临床观察

目的：评价Replace种植系统的临床修复效果。方法：选择行Replace种植体植入术后，上颌5～6个月，下颌3～4个月，行二次手术，安装愈合基台后3周，行金属熔附烤瓷冠修复的患者68例80枚种植体，并就其种植体成功率、修复体成功率、植体周牙龈状况进行为期3年的随访观察。结果：种植体成功率100％；修复体成功率93.75％；种植体周围龈炎8例(10％)结论：Replace种植牙修复临床效果切实可靠。