设置缓冲间隙对下颌种植覆盖总义齿应力分布的影响

目的 分析设置缓冲间隙对下颌种植覆盖总义齿应力分布的影响。方法 应用三维有限元方法模拟正中开闭口运动中下颌种植覆盖总义齿的受力状态,分析冲击载荷下缓冲间隙的设置对义齿应力分布的影响。结果 缓冲间隙的设置可以降低种植体内部、种植体软硬组织界面和义齿基托内应力的峰值,最易引起种植体侧方界面骨吸收的压应力峰值降低了约５２％。结论 设置缓冲间隙有利于保护种植体界面软硬组织的健康,防止义齿基托折裂,提高种植     

冲击载荷下骨外段种植基桩不同高度对下颌覆盖总义齿应力分布的影响

目的 分析骨外段种植基桩高度不同对下颌种植覆盖总义齿应力分布的影响。方法 应用ＣＴ扫描法建立下颌种植覆盖总义齿三维有限元模型,分析冲击载荷下骨外段种植基桩高度不同对下颌种植覆盖总义齿应力分布的影响。结果 随种植基桩高度的降低,种植体内部及种植体软硬组织界面应力分布更为均匀。结论 在保证义齿固位稳定的前提下,在一定范围内降低种植体骨外段基桩高度有利于保护种植体及其周围软硬组织健康。     

种植磁性覆盖义齿的临床效果观察

目的探讨种植磁附着体全口义齿对下颌牙槽嵴重度吸收的无牙颌患者的修复效果。方法采用C D I C牙种植体及配套磁性附着体,为15例下颌牙槽嵴重度吸收的无牙颌患者在下颌两侧第一前磨牙区各植入1枚种植体,4～6个月后制作下颌全口义齿并在组织面粘固磁体。进行咀嚼效率和患者满意度测定。结果种植磁附着体全口义齿在粘固磁体后及粘固后2周的固位力和咀嚼效率均较放置磁体前明显提高,且患者满意度提高。结论磁性固位种植体覆盖义齿用于牙槽骨严重吸收的无牙颌患者修复治疗的临床效果好。     

种植体支持球帽附着体固位下颌覆盖全口义齿的临床应用

目的:评价种植体支持球帽附着体固位的下颌覆盖全口义齿临床应用效果.方法:随机选择15例下颌无牙颌患者,每例植入2枚种植体,共植入30枚,随访观察1-12个月,从患者满意度、临床检查及种植体X线片观察修复效果.结果:种植体支持覆盖全口义齿修复下颌无牙颌,义齿固位和咀嚼功能满意率分别为100％和93.3％,义齿稳固,咀嚼功...     

窄径植体下颌种植覆盖义齿的优化设计

目的：利用有限元法,分析不同种植体数目及附着体类型,对下颌窄径种植覆盖义齿颌骨内应力分布的影响。方法：采集患者下颌骨及其所佩戴覆盖义齿的CT数据,利用逆向工程技术构建包含下颌皮质骨、松质骨、附着体（杆卡附着体B;球帽附着体R;磁性附着体M）及覆盖义齿的完整下颌窄径种植覆盖义齿的三维有限元模型,通过对上述不同部件接触关系的定义,模拟右侧后牙垂直咬合作用下,不同植体数目及附着体类型对下颌窄径种植覆盖义齿颌骨内应力分布的影响。结果：偶数枚植体设计,植体周围应力峰值明显低于奇数枚植体设计;杆卡附着体植体周围应力峰值较低,球帽附着体其次,磁性附着体最高;杆卡附着体随着植体数目的增多,植体周围应力峰值降低;磁性附着体随着植体数目的增多,植体周围应力峰值反而增高。结论：植体数目和附着体类型对于颌骨内的应力分布均有显著影响;建议临床优先选用偶数枚植体的杆卡附着体设计;其次建议使用两植体球帽附着体设计。     

种植套筒冠义齿修复无牙颌的临床效果观察

目的 探讨种植套筒冠义齿修复无牙颌的临床效果.方法 15例无牙颌患者,采用种植套筒冠义齿修复.共完成26件修复体,其中上颌义齿11件,下颌义齿15件.共植入种植体104颗,修复基台研磨后直接作为套筒冠内冠,套筒冠外冠采用失蜡铸造技术加工.修复后平均回访32个月,对所有种植体及上部结构进行临床及影像学检查,并对原总义齿和种植套筒冠义齿满意度进行比较.结果 完成种植体支持修复的26件覆盖义齿,所有上部修复体的外冠与种植体基台间固位较好、义齿稳定,患者对覆盖义齿的舒适度和咀嚼功能满意,在舒适度和咀嚼功能方面,患者的种植套筒冠义齿满意度要高于常规总义齿,差异有统计学意义(P<0.05),而发音方面二者差异无统计学意义(P>0.05).覆盖义齿在观察时间内未发生松动、折断及损坏,种植体无松动或脱落.随访期内,种植体周围牙槽骨平均垂直骨吸收量约1 mm.结论 本研究结果表明,种植套筒冠义齿修复无牙颌是一种可靠的方法,但仍需要进一步长期观察.     

Biomechanical rationale for a single implant-retained mandibular overdenture: an in vitro study

OBJECTIVES: This study aimed to examine the biomechanical rationale of a single implant-retained overdenture (SIO) system using an in vitro model. MATERIAL AND METHODS: Laboratory implant analogs (3.75 x 13 mm) were embedded into the midline and canine regions on both sides of the mandibular phantom model with artificial mucosa. Magnetic attachments (flat, FM; dome, DM) and a ball attachment (Ball) were mounted to the abutment where lateral forces were measured with four miniature strain gauges attached to the surface. A 50 N static load was applied at five different sites of the occlusal surface of the simulated denture base using each counterpart of the attachments. Strain data were compared between SIO and two implant-retained configurations (TIO) with three attachments. Three-dimensional (3D) denture base displacements were also measured. Statistical analysis was performed by multiple comparisons using a post hoc test (P<0.05). RESULTS: Statistically significantly smaller lateral forces to abutments were obtained in SIO than in TIO with the Ball with the molar load, while there were no statistical differences between SIO and TIO with FM. There were no statistical differences in 3D denture base movements between SIO and TIO in the midline and molar regions, while there were larger movements in SIO than in TIO with FM. CONCLUSION: Within the limitations of our in vitro study, we suggested that single-implant overdentures with dome-type magnet or ball attachments had biomechanical effects similar to two-implant overdentures in terms of lateral forces to the abutment and denture base movements under molar functional loads.     

Rehabilitation of the edentulous mandible with implant-supported overdenture using ball attachments and healing abutments: A case report

For many years, osseointegrated implant-supported overdentures have been used in the rehabilitation of the edentulous lower jaw with excellent results. In this report, additional implants with healing abutments were applied posterior to mental foramen on each side was used to achieve additional support to the overdenture.     

Indigenous ball and socket implant supported mandibular overdenture: A case report

Edentulism is a major health concern of old age. Indigenous implant based over dentures offer a cost effective option for severely resorbed dental ridges. Here, we report rehabilitation of a resorbed mandibular arch with indigenous implant supported overdenture and maxillary arch with a conventional denture. Two ball and socket implants were placed bilaterally in the parasymphyseal area. Existing denture was relined to accommodate the ‘ball head’ of the implant in the interim period. Four months later, when patient was taken up for denture fabrication, the ‘socket part’ of the ball and socket implant was incorporated into the new denture base. The socket provided a fitting surface for the implant. Implant supported overdenture significantly increased the retention, support and stability of the lower denture. Further, it worked well with the upper conventional denture. The simple design and efficacy of indigenous implant based overdenture holds promising aspects in the treatment of edentulism.     

Long-term prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture

Objective: The aim of this long‐term study was to compare the need for prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant‐supported overdenture. Materials and methods: Forty‐five consecutive patients were included (130 implants were placed). Treatment was randomly allocated, resulting in 22 patients (group A) to be treated with direct ball attachment incorporation and 23 patients (group B) to be treated with indirect ball attachment incorporation. All patients were treated by experienced oral‐maxillofacial surgeons/periodontists and experienced prosthodontists/residents. From the first day that the patients visited the clinic up to 20 years after the first treatment session, all surgical or prosthetic therapeutic interventions were recorded. The recorded data for the present study included the number of aftercare visits and dental treatment received (pressure sores relieve, liner changes due to loss of retention and attachment replacement due to wear). Results: The mean follow‐up was 93±57 months. No implants were lost. Statistical analysis revealed a statistically significantly (P<0.001) greater need for prosthetic interventions in group B vs. group A. The mean number of visits dedicated to – pressure sores relieve (7.04±1.4 vs. 3.63±0.84); liner exchange due to loss of retention (3.6±1.3 vs. 1.09±1.06) was significantly higher in group B. Attachment replacement due to wear occurred only in group B (11/23 – 47.8%). Conclusion: The direct technique for attachment incorporation in mandibular implant‐supported overdentures using ball attachments is superior to the indirect technique from the aftercare perspective during a long‐term evaluation period. To cite this article:
Nissan J, Oz‐Ari B, Gross O, Ghelfan O, Chaushu G. Long‐term prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant‐supported overdenture.
Clin. Oral Impl. Res. 22 , 2011; 627–630
doi: 10.1111/j.1600‐0501.2010.02026.x     

老年下颌牙列缺失患者种植覆盖义齿治疗的临床评估

无牙颌是一常见的口腔疾病,全球社会人口老化的发展趋势导致牙列缺失患者的人数相继增加。近年来,随着种植技术越发成熟,以种植义齿为导向的修复方式在提高患者的生活质量和改善心理素质方面均获得良好反响。下颌无牙颌种植覆盖义齿主要具有两大优势：相较于传统单颌全口义齿,具有更优良的固位和咀嚼效能;相较于种植固定义齿,所需的植入位点更少,且能恢复更多缺损的软组织,从而有助于恢复美观和发音,价格也更为患者所接受。因此,本文通过系统性的整理、分析和探讨下颌种植覆盖义齿针对老年牙列缺失患者的临床疗效,结合现有相关研究中对于下颌种植覆盖义齿操作过程中种植体数目、植入位点及上部修复体的选择要点,进一步阐释其在下颌无牙颌修复中的优势。     

老年下颌牙列缺失患者种植覆盖义齿治疗的临床评估

无牙颌是一常见的口腔疾病,全球社会人口老化的发展趋势导致牙列缺失患者的人数相继增加。近年来,随着种植技术越发成熟,以种植义齿为导向的修复方式在提高患者的生活质量和改善心理素质方面均获得良好反响。下颌无牙颌种植覆盖义齿主要具有两大优势：相较于传统单颌全口义齿,具有更优良的固位和咀嚼效能;相较于种植固定义齿,所需的植入位点更少,且能恢复更多缺损的软组织,从而有助于恢复美观和发音,价格也更为患者所接受。因此,本文通过系统性的整理、分析和探讨下颌种植覆盖义齿针对老年牙列缺失患者的临床疗效,结合现有相关研究中对于下颌种植覆盖义齿操作过程中种植体数目、植入位点及上部修复体的选择要点,进一步阐释其在下颌无牙颌修复中的优势。     

总义齿、覆盖义齿和种植覆盖义齿修复后咀嚼效率和下颌运动型的比较

目的　比较总义齿 (completedenture ,CD )、覆盖义齿 (completeoverdenture ,COD )和种植覆盖义齿 (implant supportedoverdenture ,IOD)修复后患者的咀嚼效率和下颌运动轨迹的差异。 方法　分别选取CD、COD和IOD修复后患者各 14名 ,在义齿正常戴用半年后测量患者的咀嚼效率和下颌运动轨迹。对下颌运动轨迹从规则程度、末端集中性、额状面的分型和咀嚼运动中的接触滑动4个方面进行评价 ,测试用食物为杏仁和小枣。结果　IOD组患者咀嚼枣和杏仁的效率均显著高于CD组 (P <0 0 1) ;COD组患者咀嚼杏仁的效率显著高于CD组 (P <0 0 1)。COD组患者咀嚼枣的效率高于CD组 ,且IOD组患者咀嚼枣和杏仁的效率高于COD组 ,但其间差异无显著性。IOD组患者下颌运动轨迹的规则程度显著优于CD组 (P <0 0 5 ) ,末端轨迹集中性也显著优于CD组 (P <0 0 1)。结论　IOD和COD修复有利于提高无牙颌患者或口内只保留个别残根患者的咀嚼效率。IOD修复患者较CD修复患者具有更加规则的下颌运动型。     

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无牙颌（edentulous jaw）是指各种原因导致的上颌或（和）下颌牙列缺失后的颌骨,常规使用全口活动义齿修复。然而针对牙弓内仅存个别患牙的情况,如果患牙经过牙髓、牙周的系统治疗后可利用,覆盖义齿修复则是常用修复方式。但由于大多数牙齿缺失、牙槽嵴萎缩,致使义齿的固位力十分有限,患者修复后咀嚼效果仍然不理想。     

下颌球帽覆盖义齿与全口义齿戴用2~3年咬合特征研究

目的研究下颌球帽附着体固位覆盖义齿（COD）及全口义齿（CD）修复后2~3年咬合接触特征及差异。 方法采用T-ScanⅡ咬合分析仪对戴用2~3年CD及COD修复患者（各12例）进行体内咬合分布特征及 力升高时间的测定。记录患者义齿左右侧咬合面积不对称指数、咬合力中心（X,Y）值、咬合力前后向分布比率及 力升高时间。 结果（1）CD组、COD组左右侧咬合面积不对称指数、咬合力中心X值,差异无统计学意义（P > 0.05）;（2）COD组咬合中心前移,差异有统计学意义（P < 0.05）;（3） 力升高时间CD组0.28 s,COD组延长为0.59 s,差异有统计学意义（P < 0.05）。 结论正中咬合时,CD戴用2~3年咬合分布、 力升高时间近似正常 ,COD咬合中心向基牙区偏移, 力升高时间延长。     

种植体植入部位对全下颌种植覆盖义齿应力分布的影响

目的:对不同种植体植入部位的全下颌种植覆盖义齿及支持组织进行力学分析,为优化种植覆盖义齿设计提供依据。方法:应用三维有限元法,对分别采用颏孔前和尖牙、磨牙区植入种植体的全下颌种植覆盖义齿进行应力分析,对比义齿本身和支持组织应力分布的差异。结果:①颏孔前植入的覆盖义齿对斜向载荷的抵抗性差,种植体-骨界面应力峰值为垂直载荷的2.4～9.2倍;垂直及斜向载荷,种植体和基托均有较高的应力集中。②尖牙、磨牙区植入的覆盖义齿,垂直及斜向载荷时均表现了较佳的力学特性,支持组织应力峰值位于骨维持的生理范围内。结论:磨牙区种植体的植入可增强覆盖义齿对侧向力的抵抗能力,降低种植体-骨界面应力峰值,减少机械性并发症的发生。而单纯颏孔前植入设计时,应考虑采用缓冲设计,提高覆盖义齿的远期成功率。     

下颌球帽附着体覆盖义齿应力研究

目的 分析不同球帽附着体下颌覆盖义齿在不同加载力作用下基托及支持组织所受的应力.方法 采用电阻应变测量法测量下颌球帽附着体覆盖义齿的应力,比较使用不同类型球帽附着体时,下颌覆盖义齿的应力变化.结果 使用金属球帽附着体比使用塑料球帽附着体牙根表面、义齿基托舌侧正中的应变值小,但后牙区 牙槽嵴顶粘膜表面应变值较大.义齿基托...     

种植义齿患者中应用健康教育处方的效果评价

目的探究健康教育处方在口腔种植义齿患者健康教育中的应用效果。方法将163例口腔门诊行种植义齿患者随机分为对照组（82例）与实验组（81例）,对照组给予常规健康教育,实验组在常规健康教育的基础上发放健康教育处方,通过宣教前后患者种植知识水平评分和复诊依从性对健康教育处方实施效果进行评价。结果宣教前,对照组和实验组患者口腔种植知识平均分分别为（16.83±13.06）、（18.00±14.04）分,差异无统计学意义（t=-0.551,P＞0.05）;两组患者宣教前后知识水平得分差值分别为（44.83±28.35）、（63.19±19.93）分,差异有统计学意义（t=-4.787,P〈0.05）;复诊平均次数分别为（2.26±0.605）、（3.27±0.707）次,差异有统计学意义（t=-9.856,P＜0.05）。结论应用健康教育处方对种植义齿患者进行个性化宣教,可提高患者的宣教效果和复诊依从性,值得在口腔专科门诊推广。