上颌中切牙倒置阻生的正畸治疗

上颌中切牙倒置阻生，可在颌面外科的配合下，给予正畸治疗。术前正畸以开拓间隙，术中注意保持牙乳头、牙囊，术后正畸力应微弱。年龄愈小，效果愈好。     

同期植骨的即刻与延期种植在上颌中切牙区的骨量对比研究

目的:分析比较上颌中切牙即刻种植与延期种植同期唇侧植骨术的疗效。方法:选择2018年度行上颌中切牙区单颗牙种植的患者57例,根据治疗方式分为即刻组(28例)和延期组(29例),2组均同期行唇侧引导骨再生技术(guided bone regeneration,GBR)。所有患者于术前(T0)、术后即刻(T1)、术后6个月(T2)进行锥形束CT(CBCT)检查,并通过影像分析软件测量种植体肩台下2 mm和10 mm处的唇侧水平骨量。结果:在观察期内,2组种植体存留率均为100%。在T1~T2时间段内,即刻组患者2个位点处的唇侧骨板吸收量小于延期组(P<0.05),即刻组2个位点处唇侧剩余骨厚度>2 mm的患者多于延期组,且即刻组获得更好的美学效果与更高的满意度评分。结论:与延期种植相比,即刻种植同期唇侧植骨更有利于减缓牙槽骨吸收,能维持种植体周围软硬组织稳定。     

上颌前牙种植美学修复46颗的临床评价

目的 评价上颌前牙区种植体的临床应用效果。方法 38例上颌前牙缺失的患者,植入ITI种植体46颗,植入后2～4个月完成上部结构修复。术后随访6～12个月。结果 种植修复后临床效果满意率达95%。但有2例出现颈缘金属外露,1例1年后唇侧牙龈退缩。结论 上前牙缺失在种植外科手术时,需注意种植体植入的三维方向,大多数需采用引导骨再生技术恢复牙槽骨的骨量及丰满度,以达到理想的美学效果。     

上颌中切牙间多生牙8颗1例

我科诊治1例上颌中切牙之间8颗多生牙病例,4颗埋伏,4颗萌出,现报告如下.患者男,14岁.因上颌中切牙间多生畸形牙齿来我科就诊.专科检查：颌面部发育正常.上颌两中切牙间见4颗多生牙,呈圆锥状,牙冠短小.     

上颌中切牙埋伏阻生的病因与诊断

上颌中切牙在生理功能、心理健康方面均起着特殊重要的作用 ,中切牙埋伏阻生一直是口腔科临床研究的重点和难点之一[1,2 ] 。研究中切牙埋伏阻生的病因与诊断对开展预防和治疗具有重要意义。本文从临床角度对上颌中切牙阻生的病因及诊断进行初步探讨。材料与方法1 病例收集　收集近几年在我院正畸科及儿童牙科就诊 ,经病史询问、临床检查、Ｘ线片检查确诊为上颌中切牙埋伏阻生的病例 40例 ,年龄 7～ 13岁 ,男 2 2例 ,女 18例。2 诊断标准　健侧中切牙已萌出并与下切牙建立覆牙合、覆盖关系 ,或者Ｘ线片显示上颌恒中切牙牙根已发育完成但牙…     

前牙美学区牙槽嵴保存延期种植的临床研究

目的 探讨前牙美学区即刻拔牙后采用牙槽嵴保存技术对延期种植的美学修复影响.方法 收集选取2016—2018年于南京医科大学附属口腔医院就诊的患者20例,其中男8例、女12例,所有患者美学区无法保留患牙且骨质缺损较严重,需行前牙美学修复,行前牙微创拔牙,拔牙后即刻行植骨术和胶原膜隔离,引导拔牙窝骨再生,实现位点保存.6个...     

牙种植术中几种骨量不足的处理

本文应用冻干骨粉、羟基磷灰石、可吸收骨诱导膜等植骨材料，和磁固位附着种植体处理牙种植术中牙槽骨骨量不足。通过对临床２７例患者的治疗，结果：１３例使用植骨材料，诱导骨组织再生，增加了牙槽骨宽度和高度，种植体植入后稳定，均健康存在。１４例患者采用磁性固位附着种植体，制作全口覆盖义齿。种植体生长良好，义齿的支持，固体，咀嚼功能恢复较好，取得了满意的效果。     

Management of maxillary alveolar bone fracture and severely intruded maxillary central incisor: report of a case

Abstract –  An 11‐year‐old male who injured his maxilla and right maxillary central incisor and lip during a fall was presented to our hospital. His lower lip and upper gingiva were lacerated with swelling and epistaxis, and he had a maxillary alveolar bone fracture and severe intrusion of the right maxillary central incisor, which had penetrated the floor of the nasal cavity with avulsion. Under local anesthesia, we repositioned the incisor and bone segment and fixed them with a titanium micromesh plate and self‐tapping screws and splints. The incisor was also treated by root canal 3 days after the operation and was restored with a crown. We performed root canal filling 1 month later. Five months later, the plate and screws were removed. In prognosis of our case, no symptoms of inflammatory root resorption or ankylosis have observed for more than 1 year and 6 months of follow up based on both clinical and radiographic findings.     

Clinical evaluation of a patient with single maxillary central incisor

Hypodontia in permanent dentition is the most common developmental anomaly and frequently found in the second premolar and maxillary lateral incisor In the primary dentition, however, hypodontia appears to be less frequent, with the exception of cases such as ectodermal dysplasia and cleft lip and palate. We report a child with one primary maxillary central incisor at midline. The presence of a single permanent maxillary central incisor was also confirmed by radiological examination. Other intraoral abnormalities were detected including absence of upper labial frenulum and abnormal palatal structure, but no other facial or brain anomalies. Although the condition is exceedingly rare, a thorough examination for more serious anomalies should be conducted since it is suggested to be the mildest feature of holoprosencephaly.     

Changes of anterior maxillary alveolar bone thickness following incisor proclination and extrusion

Objective:To investigate changes in maxillary alveolar bone thickness after maxillary incisor proclination and extrusion during anterior crossbite correction in a group of growing patients with Class III malocclusion.Materials and Methods:Maxillary incisors of 15 growing patients with anterior crossbite were proclined and extruded with 0.016″ beta-titanium advancing loops and Class III elastics. Lateral cephalograms were recorded before advancement (T₀) and 4 months after a normal overjet and overbite were achieved (T₁). Changes in alveolar bone thickness surrounding the maxillary incisors at the crestal (S1), midroot (S2), and apical (S3) levels were measured using cone-beam computed tomography (CBCT). Paired t-tests were used to determine the significance of the changes. A Spearman rank correlation analysis was performed to explore the relationship between thickness changes and the rate and amount of incisor movements.Results:Although statistically significant decreases were observed in palatal and total bone thickness at the S2 and S3 level (P < .05), the amounts of these changes were clinically insignificant, ranging from 0.34 to 0.59 mm. Changes in labial bone thickness at all levels were not significant. Changes in palatal bone thickness at S3 were negatively correlated with changes in incisor inclination. (r  =  −0.71; P < .05).Conclusion:In a group of growing patients with Class III malocclusion undergoing anterior crossbite correction, controlled tipping mechanics accompanied by extrusive force may produce successful tooth movement with minimal iatrogenic detriment to the alveolar bone.     

上颌中切牙长轴与牙槽骨方向夹角的锥形束CT测量分析

目的:利用锥形束CT(cone-beam CT,CBCT)测量、分析上颌中切牙长轴与牙槽骨方向夹角角度,为前牙种植美学修复的手术指导和风险评估提供参考.方法:随机选取374例成年患者,按照年龄分成青年、中年、老年3组,拍摄CBCT,通过Kavo eXam Vision软件测量上颌中切牙长轴与牙槽骨方向之间的夹角角度.使用SPSS16.0软件包对数据进行t检验.结果:青年组上颌中切牙长轴与牙槽嵴方向夹角角度为13.81°±4.37°,中年组为15.19°±5.23°,老年组为18.51°±6.62°,各组内男、女比较无显著差异(P＞0.05),各组组间比较有显著差异(P＜0.05),且随着年龄增大,其夹角角度逐渐增大.结论:患者性别对上颌中切牙长轴与牙槽骨方向夹角角度影响不大;患者年龄和上颌中切牙长轴与牙槽骨方向夹角角度有一定关系.对于上颌前牙种植患者,要达到美观修复,术前需要充分了解上颌中切牙长轴与牙槽骨方向夹角角度,尤其是老年患者.     

上颌前牙单牙种植区采用钛膜引导成骨的效果观察

研究目的:上颌前牙单牙种植区,种植体颈部唇侧裂开性骨缺损或唇侧骨板厚度小于0.5mm时,采取不可吸收性钛膜引导成骨的效果及修复效果的前瞻性研究.材料及方法:2004年6月-2008年12月,在北京大学口腔医学院种植中心,18例上颌前牙单牙缺失患者(男12例,女6例,年龄19-56岁,平均38.6岁),要求采取种植修复,身体健康,不吸烟.种植体植入后唇侧颈缘出现裂开性骨缺损或唇侧骨板厚度小于0.5mm,采用少量自体碎骨和瑞士盖式Bio-Oss骨粉充填骨缺损后,不可吸收性钛膜覆盖植骨区,并用小膜钉固定钛膜,软组织辫充分缓冲无张力后关闭术区.愈合6个月后行二期手术,取出钛膜,测量种植体唇侧骨板的厚度.二期术后2个月进行种植修复,修复效果的观察,采用Furhauser的改良红色美学指数(Defined pink es-thetic score)观察种植体修复后的软组织美学效果.结果:18例病例中,没有一例出现伤口的裂开以及感染.放射学观察18颗种植体均获得骨结合.种植体植入时,唇侧骨板的厚度(平均0.17mm),种植二期手术,即暴露种植体取出钛膜时,测量唇侧骨板的厚度为1.5mm-3.5mm,平均2.14mm,平均增加1.91mm..13例完成永久修复,并观察1年以上,软组织美学效果,采用Furhauser的红色美学指数,PES最高得分14分,最低得分9分,平均12.15分,龈缘水平线位置平均为1.77mm,牙根区的软组织的凸度平均为1.85mm,此两项得分较高,与植骨及成骨效果有密切关系.结论:在上颌前牙区单牙种植时,采取不可吸收性钛膜引导成骨,解决种植体唇侧颈部骨板裂开性骨缺损及厚度不足效果可靠.     

自体块状骨移植重建牙槽骨骨量不足后种植修复的临床观察

目的探讨自体块状骨移植重建牙槽骨骨量不足后种植修复的临床效果。方法 2010年1月至2016年12月完成的自体块状骨移植结合引导骨再生技术(guided bone regeneration,GBR)重建牙槽骨骨量不足的病例共30例,植入种植体共81颗。按照自体块状骨的供区来源分为颌骨组(16例34颗)和髂骨组(14例47颗)两组,通过临床随访及影像学检查,分别计算并比较其种植体存留率。结果 30例自体块状骨移植结合GBR后骨增量明显且愈合良好,术后均无明显供区并发症。同期或延期种植体植入,经平均7.8个月(4~18个月)骨结合期后,除1例种植体因松动拔除,其余29例均完成永久修复。种植体植入后平均随访期为26个月(9~68个月),植入的81颗种植体在随访期内存留率为98.76%。其中颌骨组升支取骨失败1颗,种植体存留率为97.06%;髂骨组失败0颗,种植体存留率为100%,两者统计学上无显著性差异(P>0.05)。结论自体块状骨移植重建牙槽骨骨量不足后种植修复,其种植体存留率,较骨量正常情况下的种植修复无明显差异。颌骨与髂骨两种供区的块状自体骨,其移植重建牙槽骨骨量不足均可取得理想的种植修复临床效果。但颌骨内取骨因避免了第二术区、减少手术时间、术后并发症小等优点,临床上应予以优先选择。     

Immediate implant placement in the maxillary central incisor region: a case report

PATIENT: A 67-year-old female with root fracture of the maxillary central incisor underwent implant placement immediately after extraction, with the goal of shortening the treatment period. The superstructure was placed on the implant after a 4-month healing period. Review 5 years after implant loading revealed no clinical problems. DISCUSSION AND CONCLUSION: The treatment time was shortened effectively by the flapless immediate post-extraction placement procedure. Immediate post-extraction implant placement based on proper examination and diagnosis would reduce the patient burden.     

上颌埋伏中切牙向新生牙槽骨内移动的三维有限元分析

目的　分析拔除多生牙后不同施力时机对埋伏牙矫治效果的影响,为临床矫治上颌唇侧阻生中切牙提供一定的理论依据。方法　建立上颌中切牙唇向阻生的三维有限元模型,于牙槽骨不同愈合时期向埋伏牙施以相同的复位力,分析埋伏牙、牙周膜、牙槽骨的初始应力及位移情况。结果　随着牙槽骨的愈合,牙齿、牙周膜的最大应力与位移、愈合期牙槽骨的最大位移逐渐减小,愈合期牙槽骨的最大应力逐渐增大。结论　阻碍埋伏牙正常萌出的多生牙去除后,可以即刻施力移动埋伏牙。但早期移动时牙齿的倾斜趋势比较明显,建议初期加载力值应适度减小,以利于埋伏牙的整体移动。