贵金属合金和低温水热陶瓷在人工种植牙中的临床应用

目的：讨论贵金属合金和低温水热陶瓷在种植义齿的上部修复体的技术特点，说明在临床应用的有效性。方法：以几十例CDIC种植义齿贵金属低温水热陶瓷修复的临床经验为基础，阐述烤瓷熔附冠桥修复体边缘，金属基底制作等方面的技术特点以及生物学问题。结果：在大多数情况下，贵金属低温水热陶瓷熔附冠桥墩是种植义齿的上部修复体最佳选择，其功能、美观、生物相溶性都较为理想。结论：贵金属低温水热陶瓷作种植体上部修复是满意的。     

全颌固定式种植义齿

目的：牙列缺失的种植义齿修复多采用覆盖义齿方式，但某些患者仍希望得到固定修复。Branemark的可拆卸固定全颌种植义齿技术复杂，美观清洁卫生等也不理想。本研究要建立一种牙列缺失的固定种植我齿修复模式。方法：11例有条件的无牙颌患者，在CDIC种植体支持基础上，用常规烤瓷溶附冠桥技术完全成颌固定式种植义齿修复。结果：1至5年的观察表明，该修复模式在咀嚼功能，美观性，舒适感及清洁卫生维护均获得满意结果。     

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烤瓷熔附金属全冠(porcelain-fused-to-metal,PFM)也称金属烤瓷全冠,是一种由低熔烤瓷真空条件下熔附到铸造金属基底冠上的金一瓷复合结构的修复体.烤瓷熔附金属全冠兼具有金属全冠的机械强度好和全瓷冠美观的优点[1].     

高原204例烤瓷修复临床体会

我科于１９９５年在海拔３６５８ｍ高原地区成功地为２０４例口腔患者行烤瓷熔附金属全冠及烤瓷固定桥修复。结合高原临床制作特点及修复后并发症，现将体会总结如下：１方法及器材介绍１．１烤瓷熔附金属全冠及烤瓷固定桥设计采用全瓷覆盖。１．２牙体预备要有足够厚度唇...     

口腔修复工艺学问答(九)

九、烤瓷与硬质冠桥树脂修复技术 147、烤瓷修复有几种、各有何工艺特点? (1)烤瓷全冠:是烤瓷修复的最初形式,先用纯的铂金箔作成坯,烧附烤瓷于其上,修复体制成后,再将铂箔剥去,完成烤瓷全冠。 (2)烤瓷—金属熔合全冠:是最广泛、实用的烤瓷复修技术,主要以高强度的金属与低熔烤瓷熔合,形成烤瓷—金属熔合全冠。其工艺特点是先铸造成冠     

烤瓷全冠修复的进展

烤瓷修复技术的年来发展迅速,烤瓷熔附金属工艺(PFM)因其兼有瓷的美观与金属的强度,目前应用广泛.本文简介了烤瓷修复的现状及其发展.     

铸造桩核加金瓷全冠修复龈下牙体缺损

目的 探讨铸造桩核加烤瓷熔附金属全冠修复涉及龈牙牙体缺损的临床疗效。方法 对63例69只涉及龈下缺损的患牙采用铸造桩核加烤瓷熔附金属全冠进行修复。铸造桩核与烤瓷熔附金属全冠先后取模制作完成,结果 患牙经治疗6-12月后检查69只,良好62只,占89.86%,一般6只,占8.70%,失败1只,占1.44%。结论 铸造桩核加烤瓷熔附金属全冠修复龈下的牙体缺损是一种较理想的修复方法。     

瓷修复技术的临床应用Ⅺ.烤瓷熔附金属修复基底冠材料理化性能的比较

烤瓷熔附金属修复体,也称金属烤瓷修复体,是在真空条件下,借助高温的作用将陶瓷粉熔融并结合到经过特殊处理的金属表面而制作的修复体.烤瓷熔附金属修复体是目前较理想的修复方式,其美观性和生物相容性其他修复体无法取代.     

两种贵金属烤瓷合金的制作技术及临床应用现状

目前含金率80％以上的金合金以及金沉积烤瓷全冠作为高贵金属烤瓷熔附修复体普遍应用于口腔修复中。本文就较常用的两种高含量金修复体的特点作一综述。     

浅析金属烤瓷冠边缘适合性的影响因素

金属烤瓷冠（PFM）是一种由低熔烤瓷在真空条件下熔附到金属基底冠上的金一瓷复合结构的修复体。近年来随着我国口腔修复学和修复工艺学的快速发展及人们对美观的要求日益增高,PFM的临床应用逐渐增多,目前已成为牙体、牙列缺损修复中常用的修复形式,在口腔专科医院中,PFM修复体占据冠桥修复体的60％以上。     

Long-term survival and success of oral implants in the treatment of full and partial arches: a 7-year prospective study with the ITI dental implant system

PURPOSE: This study evaluated the long-term survival and success of different implant-supported prostheses supported by ITI implants. MATERIALS AND METHODS: Two hundred fifty consecutive patients were rehabilitated using implant-supported prostheses. Seven hundred fifty-nine implants were loaded. Single-tooth prostheses (n = 106), cantilever fixed partial prostheses (n = 42), fixed partial prostheses (n = 137), fixed complete prostheses (n = 5), implant/tooth-supported prostheses (n = 13), and overdentures (n = 37) were used. The mean follow-up period was 3.85 years. Life table analyses were performed. Implant survival rates were calculated by means of standard life table principles. Statistical analysis was performed to compare the implant survival and success by implant placement site for each type of prosthesis. RESULTS: The cumulative implant survival rates were calculated for implants supporting single-tooth prostheses (95.6%), cantilever fixed partial prostheses (94.4%), fixed partial prostheses (96.1%), fixed complete prostheses (100%), implant/tooth-connected prostheses (90.6%), and overdentures (95.7%). Similar survival and success rates were documented for implants placed in maxillae and mandibles. Implant size did not influence survival. DISCUSSION: Seven-year survival rates were similar for implants supporting single-tooth prostheses, cantilever fixed partial prostheses, fixed partial prostheses, and implant/tooth-supported prostheses. Medium-long term implant survival and success were not influenced by the site (maxilla or mandible). Implant and prosthetic survival rates for overdentures supported by 2 implants were comparable to those for overdentures supported by 3 or more implants. CONCLUSION: Prostheses supported by ITI implants represent a reliable medium-term treatment. (More than 50 references.)     

种植固定义齿修复下颌磨牙游离端缺失的临床观察

目的:临床观察研究单纯种植体支持和天然牙与种植体联合支持修复下颌游离端缺失的效果。方法:20例患者采用种植体支持修复,共植入86枚种植体,和20例患者采用天然牙与种植体联合支持修复,共植入42枚种植体,完成对下颌游离端缺失的修复。结果:通过12—42个月的临床观察和X线检查。表现两种修复效果都好,种植体周围骨吸收均值为0.71mm/0.72mm。结论:种植体与天然牙可通过合理设计共同支持修复缺失牙。     

牙弓牙槽弓新分区在全牙弓种植修复的初步应用

目的:对牙弓牙槽弓新分区在临床全牙弓种植修复中的初步应用进行总结,分析新分区在全牙弓种植修复中的应用价值.方法:2017年3月-2019年12月,选取拟采用全牙弓种植修复的患者11例,在弓顶区、弓肩区、弓体区牙弓牙槽弓分区指导下,进行种植体植入位置设计,共完成16副全牙弓种植修复体,分析种植体植入数量、植入位点与分区的...     

Implant treatment of patients with edentulous jaws: a 20-year follow-up

Background: Implant‐supported prostheses are today often used in rehabilitation of partially or totally edentulous patients. Both patients and the dental profession often regard implant treatment as successful in a life perspective. Therefore, studies with a long‐term follow‐up are important. Purpose: The aim was to investigate the outcome of implant treatment with fixed prostheses in edentulous jaws after 20 years, with special reference to survival rate of implants and prostheses and frequency of peri‐implantitis. Materials and Methods: The patient material was a group of patients treated in the early 1980s. The original patient group comprised the first 48 consecutive patients treated with implant‐supported prostheses at Umeå University. All patients were edentulous in one or two jaws. The patients had a mean age at the implant insertion of 54.3 years (range 40–74). At the planning of this study 20 years after treatment, 19 of the 48 patients were found to be deceased. Of the 29 patients still alive, 21 patients with altogether 23 implant‐supported prostheses could be examined clinically and radiographically. All patients were treated ad modum Brånemark® (Nobel Biocare AB, Göteborg, Sweden) with a two‐stage surgical procedure. The implants had a turned surface. Abutment connections were performed 3 to 4 months after fixture insertion in the mandible, and after a minimum of 6 months in the maxilla. The prostheses were fabricated with a framework of gold alloy and acrylic artificial teeth. Results: The 21 patients (with 23 implant prostheses) examined had at the time of treatment got 123 implants (27 in the upper jaw and 96 in the lower jaw) inserted. Only one of these implants had been lost (about 2 years after loading) giving a survival rate of 99.2%. Very small changes occurred in the marginal bone level. Between the 1 and 20‐year examinations, the mean bone loss was 0.53 mm and the mean bone level at the final examination was 2.33 mm below the reference point. Conclusions: This follow‐up over two decades of implant‐supported prostheses demonstrates a very good prognosis for the treatment performed. The frequencies of peri‐implantitis, implant failures, or other complications were very small, and the original treatment concept with a two‐stage surgery and a turned surface of the implants will obviously give very good results.     

Five-year results of fixed implant-supported rehabilitations with distal cantilevers for the edentulous mandible

Objectives: The purpose of this study was to evaluate the survival rate, success rate and primary complications associated with mandibular fixed implant‐supported rehabilitations with distal cantilevers over 5 years of function. Material and methods: In this prospective multi‐center trial, 45 fully edentulous patients were treated with implant‐supported mandibular hybrid prostheses with distal extension cantilevers. Data were collected at numerous time points, including but not limited to: implant placement, abutment placement, final prosthesis delivery, 3 months and 5 years post‐loading. Biological, implant and prosthetic parameters defining survival and success were evaluated for each implant including: sulcus bleeding ndex (SBI) at four sites per implant, width of facial and lingual keratinized gingiva (mm), peri‐implant mucosal level (mid‐facial from the top of the implant collar, measured in mm), modified plaque index (MPI) at four sites per implant, mobility and peri‐implant radiolucency. Survival was defined as implants or prostheses that did not need to be replaced. Success rate was defined as meeting well‐established criteria that were chosen to indicate healthy peri‐implant mucosa osseointegration, prostheses success and complications. Results: A total of 237 implants in 45 completely edentulous patients were included in the study. In each patient, four to six implants were placed to support hybrid prostheses with distal cantilevers. Cantilevers ranged in length from 6 to 21 mm, with an average length of 15.6 mm. The ages of the patients ranged from 34 to 78 with a mean age of 59.5 years. The survival rate of implants was 100% (237/237) and for prostheses 95.5% (43/45). The overall treatment success rate was calculated as 86.7% (39/45). Of the six patients that have not met the criteria for success, two patients required replacement of the entire prosthesis and four patients presented >four complications events. Conclusion: Fixed implant‐supported rehabilitation with distal cantilever resulted in a reliable treatment modality over the 5‐year observation period. Although biological parameters of MPI, SBI, keratinized tissue and peri‐implant mucosal levels showed statistically significant differences over time, the mean values for each patient remained within the normal limits of oral health. Complications were categorized as biological or technical. The majority of complications were technical complications (54/79) and of these most involved fracture of the acrylic teeth and base (20/54). While the survival rate was 100% for implants and 95.5% for prostheses, the application of strict criteria for treatment success resulted in an overall treatment success rate of 86.7%.     

Magnitude and distribution of occlusal forces on oral implants supporting fixed prostheses: an in vivo study

Since loading is increasingly believed to be a determining factor in the treatment outcome with oral implants, there is a need to expand the knowledge related to the biomechanics of oral implants. The aim of this study is to gain insight in the distribution and magnitude of occlusal forces on oral implants carrying fixed prostheses. This is done by in vivo quantification and qualification of these forces, which implies that not only the magnitude of the load but also its type (axial force or bending moment) will be registered. A total of 13 patients with an implant supported fixed full prosthesis were selected. Occlusal forces on the supporting implants were quantified and qualified during controlled load application of 50 N on several positions along the occlusal surface of the prostheses and during maximal biting in maximal occlusion by use of strain gauged abutments. The test was conducted when the prostheses were supported by all (5 or 6) implants and was repeated when the prostheses were supported by 4 and by 3 implants only. Despite considerable inter-individual variation, clear differences in implant loading between these test conditions were seen. Loading of the extension parts of the prostheses caused a hinging effect which induced considerable compressive forces on the implants closest to the place of load application and lower compressive or tensile forces on other implants. On average, higher forces were observed with a decreasing number of supporting implants. Bending moments were highest when 3 implants only were used.     

Clinical evaluation of small-diameter implants in single-tooth and multiple-implant restorations: a 7-year retrospective study

PURPOSE: Placement of small-diameter implants often provides a solution to space-related problems in implant restoration. This 7-year retrospective study presents results from 192 small-diameter implants placed in 165 patients from 1992 to 1996. MATERIALS AND METHODS: The dental records of each patient were reviewed. The implants, which were either 2.9 mm or 3.25 mm in diameter, were placed by 2 different surgeons. All prosthetic appliances were fabricated by the same prosthodontist. Ninety-four implants supported single-tooth cemented restorations; the remaining 98 implants supported cemented or screw-retained partial prostheses. RESULTS: The total implant survival rate was 95.3%. Four implants were lost at second-stage surgery, and 5 more were lost after loading. DISCUSSION: Small-diameter implants demonstrated a survival rate similar to those reported in previous studies of standard-size implants. CONCLUSIONS: The results suggest that small-diameter implants can be successfully included in implant treatment. They may be preferable in cases where space is limited.     

口腔种植修复临床效果十年回顾研究

目的评估骨结合种植体应用10年的临床效果。方法1994年8月至2004年8月在北京大学口腔医学院·口腔医院口腔种植中心植入的骨结合种植体共5590枚,其中Branemark种植体161枚,Frialit-2种植体1436枚,IMZ种植体1012枚,Ankylos种植体767枚,Camlog种植体2189枚,Komet种植体25枚。全部种植体均在2004年8月前完成上部结构修复,其中固定修复2314例,活动修复315例,共计2629例患者。平均追踪77·2个月(7~121个月)。观察方法为X线检查和临床检查,采用Wheeler存留标准评估,纳入Kaplan-Meier存留曲线统计。结果种植修复体完成时2624例患者对修复效果满意,5例患者对修复体不满意,重作后4例表示满意,1例表示可以接受。随访中有105例患者共178枚种植体确诊为种植体周围炎。有明确记录的共68枚种植体脱落。10年随访累计修复体松动21件,修复体折断4件,烤瓷冠崩瓷51件。据Wheeler存留标准统计10年存留率为96·7%。结论种植修复患者的满意度高,本组种植体的10年存留率达到96·7%。     

无牙颌患者种植修复的体会

目的：探讨无牙颌种植覆盖义齿、种植固定义齿修复的临床疗效。方法：对34例单颌、全颌无牙颌患进行了种植修复。单颌无牙颌26例中10例进行了杆卡修复,5例球帽修复,2例磁性固位体修复,9例种植固定修复。全颌无牙颌8例中3例种植固定修复,3例杆卡修复,2例球帽修复。结果：经6～60个月的临床观察,256枚种植体中,除3枚种植体形成纤维愈合(1．17％)外,其余253枚种植体均形成了良好的骨性结合(98．83％),种植义齿功能较好,收到了满意的临床效果。结论：对于无牙颁的患,通过精心的设计、精巧的外科手术及合理的种植修复类型的选择,完成的种植修复体能有效地恢复咀嚼功能,并能使种植体长期稳固于口腔内行使功能。     

Long-term treatment outcomes in edentulous patients with implant-fixed prostheses: the Toronto study

PURPOSE: The aim of this prospective study was to report long-term treatment outcomes (prosthetic and implant related) of edentulous patients treated with implant-supported fixed prostheses who participated in the first clinical implant study in North America. MATERIALS AND METHODS: Forty-five patients were treated with Br?nemark implants supporting a total of 47 fixed prostheses (42 mandibular and 5 maxillary) between 1979 and 1984. All patients were recalled regularly for comprehensive prospective clinical and radiographic assessments. RESULTS: Thirty-one patients (33 prostheses) attended a final recall visit in 2002; 71% of patients had been followed for 20 years (range 18 to 23 years), with overall prosthetic plan and implant outcome success rates of 84% and 87%, respectively. Mean marginal bone loss around the implants after the first year of loading was small (0.05 mm/year), with high individual variations. Poor oral hygiene, smoking history, and implant position appeared to be predictors of marginal bone loss. Prosthetic maintenance was ongoing and included fractured components and replacement of prostheses; the longevity of a fixed prosthesis for this group of patients was 8.39+/-5.30 years. CONCLUSION: This study confirmed the overall long-term treatment outcome success of patients treated with fixed prostheses supported by Br?nemark implants. Successful osseointegration with a small mean bone loss was maintained as study patients aged, although prosthetic maintenance was required. The latter consideration should be discussed with all patients seeking such treatment.