不同种植方法对即刻负载正畸种植体骨结合的影响

目的 通过比较助攻法和自攻法植入的即刻负载正畸种植体的骨结合情况,评价不同种植方法对种植体及周围组织的影响. 方法 以3只犬的最后一颗前磨牙与第一磨牙根间区、第一磨牙近远中根根分歧的颊侧为植入点,植入24枚正畸种植体;每只犬植入8枚,自攻法(自攻组)植入4枚,助攻法(助攻组)植入4枚.镍钛弹簧即刻提供1.47～1.96 N水平力,持续9周.光学显微镜和荧光显微镜评价种植体周围骨组织的变化和骨结合率. 结果 两组种植体均与骨组织形成骨结合,其间未见结缔组织.自攻组可见较多的陈旧骨,助攻组的骨生长和再生更活跃.自攻组种植体的骨结合率[(41.7±10.7)%]高于助攻组[(25.9±8.0)%],差异有统计学意义(P<0.01). 结论 即刻负载不影响正畸种植体的骨结合.自攻法对骨组织损伤小,且骨结合率高于助攻组.     

Hard tissue implant interface

The osseointegrated interface demonstrates, on an average, some 60–70 per cent bone bordering the implant at the light microscopical level of resolution whereas ultrastructural studies have revealed that only partly calcified proteoglycan layers build up the actual interface. Interfacial bone reactions are dependent on the precise nature of the implant material, its design and surface characteristics supposing that clinical factors such as host reactions and surgical and prosthodontic techniques are being controlled. The most commonly used, although not the only useful, material in oral implantology is cp titanium, a most biocompatible material. The most commonly used oral implant design is the threaded screw whereas cylindrical implants without retention elements have been largely abandoned. The nature of the implant surface is of clear relevance for interfacial reactions; micron-sized irregularities are necessary for osseointegration or biomechanical bonding. Currently, there is evidence of bone ingrowth dependent on nanometer sized irregularities, even if the clinical relevance of this finding remains uncertain. The discussion about an alternative type of implant anchorage (biochemical bonding), started decades ago, however so far without any undisputable evidence of its importance for the oral implant anchorage. Lately, the long-term stability of the oral implant interface has been questioned by some investigators, allegedly it would be threatened by an increasing occurrence of peri-implantitis, however in reality demonstrated for only about 2 per cent of implants over a 10–20 year follow-up.     

支抗种植体直径对骨界面应力分布的影响

目的 :研究不同直径支抗种植体对骨界面应力分布的影响 ,以供临床筛选合适的种植体。方法 :用三维有限元方法给种植体施加 1.47N(150 g)近远中方向的载荷 ,分别对直径为 3 .0、3 .75、5.0mm的支抗种植体 骨界面进行应力分析。结果 :3种直径种植体颈部的Von Mises应力值分别为 0 .80 7、0 .53 3、1.0 80 ;位移值分别为 0 .2 3 2、0 .163、0 .111μm。结论 :在选择正畸支抗种植体时 ,直径为 3 .75mm的种植体较适宜作正畸支抗体     

非埋植型与埋植型牙种植体骨界面改建的X线观察

目的 比较非埋植型与埋植型两种不同种植方式种植体－骨界面组织变化的异同。方法 选用成年杂种犬8只,在其下颌分别植入埋植型与非埋植型种植体,分不同时期处死动物,采用X线对非埋植型与埋植型种植体－骨界面愈合过程进行动态观察,比较两者者界面改建的异同。结果 X线观察1、2、4周非埋植型和埋植型种植体－骨界面新骨形成的速度与骨性结合的程度均无明显差异。12周时,非埋植型和埋植型种植体与骨组织均紧密接触,但非埋植型种植体颈部观察到牙槽骨轻微吸收现象。结论 非埋植型种植体尽管植入后基桩在整个愈合过程中承受了一定的咬合力,但它能与埋植型种植体一样获得良好的骨结合。     

愈合期微型种植体-骨界面的组织形态学研究

目的研究微型种植体-骨界面在不同愈合时间下的组织形态学变化。方法应用种植钉30枚,新西兰大白兔10只。采用HE染色方法,骨磨片方法对种植体-骨界面的横纵断面进行观察。结果种植体-骨界面在愈合1、2周时界面机化,以胶原纤维包绕为主;界面在4周时表现为复合骨;愈合8周时层状骨为主,出现二次改建。结论在家兔胫骨内纯钛微种植体骨钉骨整合可在8周内完成。     

微型支抗种植钉愈合期骨结合状态的组织学观察

目的对纯钛微型种植钉支抗在不同愈合时间下种植体-骨界面的组织形态学变化进行研究.方法采用纯钛种植钉30枚,SPF级新西兰大白兔10只.应用扫描电镜技术及HE染色方法对不同愈合时间下的种植体-骨界面进行观察.结果种植体-骨界面在愈合1周时界面机化为主,出现胶原纤维包绕及局部吸收;无负载愈合2周时,大量胶原纤维包绕,纤细的骨小梁生长明显;4周时,表现为复合骨;愈合8周时层状骨为主,出现二次改建.结论愈合4周是纯钛微型种植钉骨整合组织形态学的一个转折点.     

Clinical evaluation of implant survival based on size and site of placement: A retrospective study of immediate implants at single rooted teeth sites

Objectives

This retrospective clinical study sought to evaluate the survival of immediate implants placed at maxillary and mandibular single-rooted tooth extraction sites and to determine the relationship among implant size, placement site, and implant survival.

Methods

Between January 2010 and June 2011, 85 patients (33 males, 52 females; mean age: 45 years) underwent immediate implant placement after extraction of single-rooted teeth. All implants were restored between 12 and 14 weeks after implant placement. The implant survival and its relationship with implant size and implantation site were evaluated by odds ratios (ORs).

Results

Implants were placed at the following sites: upper central incisor (UCI, n = 35), upper lateral incisor (ULI, n = 27), upper second premolar (U2ndP, n = 36), lower incisor (LI, n = 53), and lower premolar (LP, n = 22). Implants of the following sizes were used: 5 × 10 mm (n = 24), 5 × 8 mm (n = 21), 4.3 × 10 mm (n = 77), 4.3 × 8 mm (n = 36), 3.5 × 10 mm (n = 12), and 3.5 × 8 mm (n = 3). After a mean follow-up time of 47 months, the overall implant survival rate was 96%. Survival rate was highest at the LI site (98.1%) and lowest at the ULI site (92.6%). All of the 5-mm implants survived (100%), as did most of the 4.3 × 10 mm implants (96.1%). Implants of 4.3 × 8 mm and 3.5 × 10 mm were the least successful (91.7%). Mandibular implants had a better survival rate (97.3%) than maxillary implants (94.9%). There was no significant OR of increased survival for any particular implant size or site.

Conclusions

Immediate implant placement in fresh extraction sockets can give predictable clinical outcomes, regardless of the implant size and site of placement.     

腭部专用正畸支抗种植体Straumann Orthosystem Implant

腭部专用正畸支抗种植体Straumann Orthosystem Implant是专门设计植入腭正中区的一种骨内牙种植体,为口腔正畸移动牙齿提供临时固定支抗功能。本文详细综述了该种植体的基本结构、植入方法、实验研究、临床应用以及其优缺点,旨在为正畸医生提供参考与帮助。     

皮质骨厚度对支抗种植体-骨界面应力分布的影响

目的：研究皮质骨厚度改变对支抗种植体-骨界面应力分布的影响，供临床参考。方法：用三维有限元方法，对分别种植于皮质骨厚度为0．5mm、1．0mm、2．0mm颌骨模型中的种植体施加150g近远中方向的载荷，分析支抗种植体-骨界面应力分布情况：结果：三者种植体颈部的Von-Mises应力值分别为0．6040MPa、0．5330MPa、0．5380MPa；位移值分别为0．2110μm、0．1630μm、0．1250μm：结论：皮质骨在一定厚度内，植入体颈部皮质骨越薄，骨界面应力值就越大：但皮质骨超过一定厚度后，骨界面应力并不随其厚度的增加而做相应递减。皮质骨的厚度与界面骨的位移成反比.     

Osseointegration and stability of a modified sand-blasted acid-etched implant: an experimental pilot study in sheep

Objective: The aim of this pilot study was to compare the early‐term osseointegration characteristics of standard (SLA) and modified sand‐blasted and acid‐etched (modSLA) implants in an experimental animal model. Material and methods: A total of 30 SLA and modSLA implants were placed to the tibiae of three sheep and the insertion torque value (ITV) and resonance frequency analysis (RFA) measurements were performed. RFA measurement was repeated on 3 and 6 weeks healed implants after which the animals were sacrificed for histomorphometric analysis. Bone‐to‐implant contact was assessed on the non‐decalcified sections. Six weeks healed implants were also subjected to the reverse torque test (RTT). Results were analyzed by the Friedman test, Kruskal–Wallis test and Spearman rank correlation test. Results: All implants reached to a strong primary stability with a mean 36.13 ± 2.47 and 35.47 ± 2.85 N/cm ITV. In the surgical stage, RFA values for SLA and modSLA implants were found to be 72.27 ± 3.17 and 71.6 ± 2.87, respectively. After 3 weeks of healing, mean BIC% (80.64 ± 13.89%) and RFA value (76.8 ± 1.14) of modSLA implants were significantly higher (P=0.0002) than that of SLA implants (64.39 ± 21.2 BIC% and 74.2 ± 4.76 RFA). However, no statistically significant difference between SLA and modSLA implants was recorded after 6 weeks of healing. Both implants revealed similar results in the RTT test (115.2 ± 4.14 and 117 ± 4.47 N/cm for SLA and modSLA implants, respectively). No correlation was found between RFA and BIC%. Conclusion: Within the limits of this pilot study, it can be concluded that modSLA implants achieve a higher bone contact and stability at earlier time points when compared with SLA implants. To cite this article:
Abdel‐Haq J, Karabuda CZ, Arιsan V, Mutlu Z, Kürkçü M. Osseointegration and stability of a modified sand‐blasted acid‐etched implant: an experimental pilot study in sheep.
Clin. Oral Impl. Res. 22 , 2011; 265–274.
doi: 10.1111/j.1600‐0501.2010.01990.x     

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??Bone implant repair for missing teeth has become one of the treatments with plenty of evidence to support. The theoretical basis of planting technology is osseointegration??the direct connection of the implant surface with the surrounding living bone. Surface characteristics of the implant material are an important factor which affects osseointegration. In recent years??researchers have modified surface properties of the implant by various methods??such as the change of the surface morphology??structure??chemical properties and/or hydrophilicity??to promote osseointegration speed. For now??promoting osseointegration by increasing the hydrophilic properties of titanium implant surfaces has become one of the main research focuses. This review focuses on improving the surface properties of titanium implants??especially the hydrophilic properties .     

Rehabilitative Considerations for Dental Implants in the Diabetic Patient

Diabetes is a serious illness that affects many people, and there are many new cases diagnosed every year in all populations around the world. Dental implant is one of the restorative methods to replace missing teeth. As implants are directly anchored into bones, they provide stability, a more natural appearance, and minimize the risk of bone resorption. Thus, today, there is a high demand of dental implants and it is inevitable to meet diabetics who request implant treatment. However, Diabetes mellitus patients may pose contraindications to dental implants because of microvascular complications leading to slower healing process after surgery. Studies have shown that dental implantation failure rate in diabetic patients is much higher than that in non-diabetic patients. This article reviews the effect of diabetes on the osseointegration of implants and the soft tissue healing. It presents the factors used in assessing the severity of diabetes and its complications, as well as considerations for rehabilitation planning in these patients. In addition, the role of antibiotic prophylaxis has been reviewed since its effect on wound healing in diabetics is controversial. Integration of these factors by the dentist can dictate whether, as well as what type of implant supported prosthesis should be given to the diabetic patient.     

Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorphometric study in canine mandibles

PURPOSE: The aim of this study was to evaluate bone apposition to a modified sandblasted and acid-etched (SLA) implant surface (modSLA) in the canine mandible as compared with the standard SLA surface. MATERIAL AND METHODS: In this experimental study, all mandibular premolars and first molars were extracted bilaterally in five foxhounds. After a healing period of 6 months, each side of the mandible received six randomly assigned dental implants alternating between the standard SLA and modSLA surface. The dogs were sacrificed at 2 weeks (n=2) or 4 weeks (n=3) after implant placement. Histologic and histomorphometric analyses were then performed for each implant. RESULTS: The microscopic healing patterns at weeks 2 and 4 for the two implant types with the standard SLA and modSLA surfaces showed similar qualitative findings. New bone tissue had already established direct contact with implant surfaces after 2 weeks of healing. The mean percentage of newly formed bone in contact with the implant (BIC) was significantly greater for modSLA (28.2+/-7.9%) than for SLA (22.2+/-7.3%) (P<0.05). This difference was no longer evident after 4 weeks. An increase in BIC for both implant surface types occurred from weeks 2 to 4. This increase was statistically significant when compared with SLA at 2 weeks (P<0.05), but not when compared with modSLA at 2 weeks. CONCLUSION: The data from the present study demonstrate significantly more bone apposition for the modSLA surface than the standard SLA surface after 2 weeks of healing. This increased bone apposition may allow a further reduction of the healing period following implant placement for patients undergoing early loading procedures.     

增强钛种植体表面亲水性能研究进展

骨内种植体修复缺失牙已成为具有大量证据支持的治疗方法。种植技术的理论基础是骨结合,即种植体表面与周围活骨的直接连接,种植体材料表面特性则是影响种植体骨结合生物学过程的重要影响因素 。近年来,研究者们通过各种方法修饰种植体的表面特性,如改变表面形态、结构、化学性能和亲水性等,以促进骨结合的速度。目前,通过提高钛种植体表面的亲水性能从而促进骨结合已成为研究热点之一。本文就提高钛种植体表面性能,尤其是亲水性能的研究现状进行综述。     

Is zirconia a viable alternative to titanium for oral implant? A critical review

Purpose

Titanium based implant systems, though considered as the gold standard for rehabilitation of edentulous spaces, have been criticized for many inherent flaws. The onset of hypersensitivity reactions, biocompatibility issues, and an unaesthetic gray hue have raised demands for more aesthetic and tissue compatible material for implant fabrication. Zirconia is emerging as a promising alternative to conventional Titanium based implant systems for oral rehabilitation with superior biological, aesthetics, mechanical and optical properties. This review aims to critically analyze and review the credibility of Zirconia implants as an alternative to Titanium for prosthetic rehabilitation.

Beagle犬埋植型与非埋植型种植义齿骨界面改建的超硬切片观察

目的：研究在体情况下埋植型与非埋植型种植体在义齿修复受载后,其周围骨界面改建的异同.方法：选用纯系动物Beagle犬8只,在其下颌分别植入埋植型与非埋植型种植体,采用固定金属全冠行种植义齿修复,分不同程期处死动物.取不同程期骨标本制备不脱钙的超硬切片,采用改良Mallory氏三色染色的方法,在光镜下观察比较埋植型和非埋植型种植义齿受载后种植体-骨界面改建动态变化的异同.结果：受载后种植体-骨界面的改建随加载程期的不同而变化.埋植型和非埋植型种植义齿之间无明显差别.结论：不脱钙的超硬切片采用改良Mallory氏三色染色的方法,研究埋植型和非埋植型种植义齿受载后其界面改建的动态变化具重要价值