亲水性大颗粒喷砂酸蚀表面种植体骨愈合期的共振频率分析及早期负荷临床探讨

目的:应用共振频率分析仪检测Straumann亲水性大颗粒喷砂酸蚀表面(SLActive)种植体骨愈合期内稳定性变化及种植体早期负荷临床探讨。方法:49例患者共计植入68颗Straumann SLActive种植体,分别在植入即刻、术后1、3、6、10、12周测量种植体稳定性,种植体稳定商值(ISQ)>65的种植体于术后6周早期负荷。结果:术后1周ISQ呈小幅增长,术后3周下降至最低,之后逐渐上升。经方差分析在术后12周时ISQ的增长具有显著性差异,其余时点无显著性差异。放射片显示种植体周围边缘骨吸收小于1 mm,术后12周时种植体留存率达100%。种植体颌位对ISQ有显著影响(P<0.05),种植体直径、长度对ISQ无显著影响。结论:Straumann SLAc-tive种植体早期负荷具有较高的临床可预期性,临床中可以显著缩短治疗周期,共振频率分析是监测种植体稳定性变化的有效手段。     

上下颌后牙区单颗SLA和SLActive种植体共振频率分析比较

目的    应用共振频率分析法使用共振频率分析仪Osstell ISQ对比大颗粒喷砂酸蚀（SLA）和亲水性大颗粒喷砂酸蚀（SLActive）2种表面种植体的种植体稳定系数（ISQ）变化趋势,评价SLActive种植体临床预期性。方法    2011年1—9月就诊于广东省佛山市第二人民医院口腔修复中心的上下颌后牙区部分牙缺失患者55例,后牙区被植入33颗SLA种植体（SLA组）和34颗SLActive种植体（SLActive组）,对比测量术后即刻、2周、4周、6周、12周种植体稳定性。结果    2组对比ISQ在术后2、4、6及12周的变化差异均有统计学意义（均P＜0.05）,而术后即刻差异无统计学意义（P＞0.05）。结论      SLActive能促进骨结合,缩短愈合时间,增加临床预期性。     

临床平台转移设计用于下颌后牙种植修复的五年效果观察

目的:通过下颌后牙区种植修复的五年随访观察,评价临床平台转移设计临床应用的效果.方法:选择下颌后牙区种植一期术后患者90例,随机分实验组对照组;实验组使用较常规小一号的愈合基台和修复基台,临床平台转移与重建种植体周围龈袖口,62例.对照组使用常规愈合基台和修复基台,转移与重建种植体周围龈袖口28例.术后当天和功能负重后1、3、5年后分别拍摄X线根尖片,测量种植体周围边缘骨高度丧失量并评价软组织情况.结果:实验组边缘骨丧失量明显低于对照组(P＜0.01);实验组的软组织的稳定性也明显优于对照组(P＜0.01).结论:临床平台转移设计可以明显地减少种植体周围颈部边缘骨的吸收和保持周围软组织稳定,对种植修复的长期成功率具有重要的意义.     

下颌后牙区Straumann短种植体的临床效果观察

目的 评价Straumann短种植体应用于下颌后牙区单牙种植的临床效果.方法 收集下颌后牙缺失单冠修复的患者共6例,剩余骨量最适合植入长度6 mm、直径4.1 mm的标准种植体,共植入8颗种植体.结果 临床追踪12～38个月种植体没有明显的边缘骨丧失,没有种植体失败.结论 非早期负重种植时,在能够获得足够初期稳定性的情况下,长种植体不一定是必须的选择.下颌后牙缺失剩余牙槽骨高度较低时,采用Straumann短种植体的单牙种植修复是一种可供选择的治疗方案.     

下颌即刻负荷种植覆盖义齿3～5年临床观察

目的 探讨种植体支持的覆盖义齿即刻负荷后种植体的长期稳定性.方法 对北京大学口腔医学院·口腔医院第一门诊部就诊的10例牙列缺失患者采用Ankylos SynCone种植系统支持的即刻负荷覆盖义齿修复,均为下颌全颌覆盖义齿.10例均在下颌颏孔之间植入4枚种植体,共植入40枚,修复后平均随访3～5年,以共振频率分析和影像学检查评价种植体稳定性和边缘骨丢失情况.结果 所有种植体无松动脱落,均获得良好的骨结合,存留率为100％;种植体稳定性指数值均＞ 65,与临床检查种植体稳定性良好一致.种植体周软组织健康,未见X线连续透射影,边缘骨吸收＜1 mm.结论 下颌即刻负荷种植覆盖义齿修复3～5年随访临床效果满意.     

常规种植术与骨挤压种植术对上颌后牙区Ⅲ类骨种植5年成功率及边缘骨吸收量的影响比较研究

目的　比较常规种植术与骨挤压种植术对上颌后牙区Ⅲ类骨种植5年成功率及边缘骨吸收量的影响。方法　选择2010年1月至2011年12月在中国医科大学附属口腔医院种植中心行上颌后牙区种植修复并且骨质分类为Ⅲ类骨的患者82例（共使用111颗种植体）。以种植体为研究单位,根据是否行骨挤压术,将纳入的病例分为常规种植术组（53颗种植体）和骨挤压种植术组（58颗种植体）。术后随访5年,计算两组种植体5年成功率,并测量种植体植入后半年和1、2、3年时的种植体边缘骨吸收量。比较上颌后牙区Ⅲ类骨行常规种植术与骨挤压种植术对种植体5年成功率及种植体边缘骨吸收量的影响。结果　常规种植术组和骨挤压种植术组种植体5年成功率分别为96.23%和98.28%,两组比较差异无统计学意义（P＞0.05）。种植体植入后半年时,骨挤压种植术组的种植体边缘骨吸收量明显小于常规种植术组,差异有统计学意义（P＜0.05）,而植入后1、2、3年时两组的种植体边缘骨吸收量差异无统计学意义（P＞0.05）。结论　常规种植术和骨挤压种植术对种植体的5年成功率及远期边缘骨吸收量的影响无明显差异。因此,临床中对于上颌后牙区Ⅲ类骨种植病例,术者可根据种植体初期稳定性的需要决定是否行骨挤压术。     

下颌后牙区软组织水平种植体边缘骨吸收相关因素的临床研究

目的研究下颌后牙软组织水平种植体边缘骨吸收的影响因素,为减少种植体边缘骨吸收量,提高种植体存留率提供理论依据。方法 选择76例患者行下颌后牙区软组织水平种植,共植入种植体116枚。记录患者的一般情况、种植体特征、种植体植入部位特征及修复体特征,在术后即刻、种植后3个月、修复后3个月、修复后12个月行锥形束CT检查,利用One Vlume Viewer软件测量并计算边缘骨吸收量,采用SPSS 20.0软件进行统计学分析。结果 吸烟、骨密质厚度、种植体长轴与牙冠长轴夹角、种植体局部卫生情况在各组间的差异有统计学意义（P<0.05）,患者性别、年龄、种植体长度、种植体直径、种植体系统、种植体边缘骨高度和修复体类型在各组间的差异无统计学意义（P>0.05）。结论 吸烟、骨密质较厚、种植体长轴与牙冠长轴夹角较大、种植体局部卫生差是引起种植体边缘骨吸收的危险因素,其中,局部卫生差与种植体边缘骨吸收的相关性较强。     

短种植体后牙区种植的初步研究

目的 探讨短种植体在上下颌后牙区种植修复中的临床疗效及冠-种植体比(crownimplant ratio,C/I)对种植义齿修复效果的影响.方法 65例上、下颌后牙缺失患者,共植入98枚长度≤8.0 mm的短种植体,并进行常规修复.通过临床观测、X线检查和测量修复后修复体高度,计算C/I.结果 98枚种植体均获得良好的骨结合并完成种植修复,其中92枚(94%)C/I≥1.通过3～18个月的随访观察,无种植体脱落.结论 短种植体应用于骨量不足后牙区种植短期临床效果明显,可简化术式、缩短治疗时间、减轻患者术后反应、扩大种植义齿适应证.未发现C/I≥1的种植修复体对其短期成功有明显影响.     

种植体骨结合稳定性测量及相关因素分析

目的:测量种植体骨结合稳定系数(ISQ),分析影响稳定性的相关因素。方法:对39名种植术后3~6个月后要进行修复的患者(男25,女14),102枚ITI种植体骨结合稳定性进行共振频率(RFA)测量。结果:ITI种植体骨结合ISQ为:76.29±5.25;ITI种植体稳定性主要受种植体骨质影响,密质骨(I、II)种植体稳定性(78.73±3.5)要高于松质骨(III、IV)的稳定性(74.27±5.63)(P<0.05);上颌与下颌的种植体稳定性差异不明显(P>0.05),上颌后牙区稳定性(77.57)要高于前牙区(73.65,P<0.05),下颌前后牙区无明显差别(P>0.05);不同长度不同直径种植体之间稳定性无明显差异(P>0.05)。结论:种植体稳定性与种植体周围骨质关系密切,种植体ISQ可以协助判断上部结构的修复时机,缩短种植修复的周期。     

短种植体在骨量不足后牙区种植修复的临床观察

目的:评估短种植体在后牙骨高度不足区行种植修复的5年临床效果。方法:为43名后牙区骨高度不足的患者,植入Bicon系统短种植体共54枚。种植体周围存在骨缺损者,同期植入种植体及行引导骨组织再生术。种植后3~6个月行二期手术,2~4周内完成固定永久修复,测量冠-种植体高度比。术后每年复查,行临床及X线检查,测量种植体边缘骨高度。结果:一期手术时上颌1例1枚种植体进入上颌窦腔;二期手术时上颌1例1枚种植体松动脱落,其余52枚Bicon短种植体均获得了良好的骨结合。二期修复后,经36~60个月(平均46个月)的随访观察,X线片显示种植体周围骨组织稳定。经临床观察,种植成功率为96.3%。种植体的冠-种植体高度比平均值为(1.38±0.32)。种植体周围平均骨吸收约0.54±0.47mm。结论:在骨高度不足的后牙区,通过植入Bicon短种植体,可以简化手术,缩短患者的治疗时间,达到较高的种植成功率。但在骨高度小于3mm的上颌后牙区,应慎用敲击就位的短种植体,以免种植体进入上颌窦。     

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??Objective    The difference of implant stability quotient??ISQ??was compared between SLA and SLActive implants in the posterior mandible and maxilla by resonance frequency analysis??RFA?? in order to evaluate the clinical predictability of Straumann SLActive implants. Methods    Totally 33 SLA and 34 SLActive implants were placed in the posterior mandible and maxilla of 55 patients. Each implant was tested by Osstell ISQ for RFA after being inserted for 0??2??4??6??and 12 weeks. Results    Significant differences of ISQ were observed in the two groups ??SLA and SLActive?? after being implanted for 2??4??6??and 12 weeks. However??there was no significant difference after 0 week. Conclusion    SLActive exhibits the advantages of improving osseointegration??shortening the healing time??and increasing the clinical predictability.     

Early Loading of Nonsubmerged Titanium Implants with a Chemically Modified Sand-Blasted and Acid-Etched Surface: 6-Month Results of a Prospective Case Series Study in the Posterior Mandible Focusing on Peri-Implant Crestal Bone Changes and Implant Stability Quotient (ISQ) Values

Purpose: The aim of this prospective case series study was to evaluate the short-term success rates of titanium screw-type implants with a chemically modified sand-blasted and acid-etched (mod SLA) surface after 3 weeks of healing.
Material and Methods: A total of 56 implants were inserted in the posterior mandible of 40 partially edentulous patients exhibiting bone densities of class I to III. After a healing period of 3 weeks, all implants were functionally loaded with a screw-retained crown or fixed dental prosthesis. The patients were recalled at weeks 4, 7, 12, and 26 for monitoring and assessment of clinical and radiological parameters, including implant stability quotient (ISQ) measurements.
Results: None of the implants failed to integrate. However, two implants were considered "spinners" at day 21 and left unloaded for an extended period. Therefore, 96.4% of the inserted implants were loaded according to the protocol tested. All 56 implants including the "spinners" showed favorable clinical and radiographic findings at the 6-month follow-up examination. The ISQ values increased steadily throughout the follow-up period. At the time of implant placement, the range of ISQ values exhibited a mean of 74.33, and by week 26, a mean value of 83.82 was recorded. Based on strict criteria, all 56 implants were considered successfully integrated, resulting in a 6-month survival and success rate of 100.0%.
Conclusion: This prospective study using an early-loading protocol after 3 weeks of healing demonstrated that titanium implants with the modified SLA surface can achieve and maintain successful tissue integration over a period of at least 6 months. The ISQ method seems feasible to monitor implant stability during the initial wound-healing period.     

Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue integration: II. Implant surface modifications and implant diameter

Objectives: To monitor the development of the stability of Straumann^® tissue‐level implants during the early phases of healing by resonance frequency analysis (RFA) and to determine the influence of implant surface modification and diameter. Material and methods: A total of twenty‐five 10 mm length implants including 12 SLA RN ?4.1 mm implants, eight SLActive RN ?4.1 mm implants and five SLA WN ?4.8 mm implants were placed. Implant stability quotient (ISQ) values were determined with Osstell^?mentor at baseline, 4 days, 1, 2, 3, 4, 6, 8 and 12 weeks post‐surgery. ISQ values were compared between implant types using unpaired t‐tests and longitudinally within implant types using paired t‐tests. Results: During healing, ISQ decreased by 3–4 values after installation and reached the lowest values at 3 weeks. Following this, the ISQ values increased steadily for all implants and up to 12 weeks. No significant differences were noted over time. The longitudinal changes in the ISQ values showed the same patterns for SLA implants, SLActive implants and WB implants. At placement, the mean ISQ values were 72.6, 75.7 and 74.4, respectively. The mean lowest ISQ values, recorded at 3 weeks, were 69.9, 71.4 and 69.8, respectively. At 12 weeks, the mean ISQ values were 76.5, 78.8 and 77.8, respectively. The mean ISQ values at all observation periods did not differ significantly among the various types. Single ISQ values ranged from 55 to 84 during the entire healing period. Pocket probing depths of the implants ranged from 1 to 3 mm and bleeding on probing from 0 to 2 sites/implant post‐surgically. Conclusions: All ISQ values indicated the stability of Straumann^® implants over a 12‐week healing period. All implants showed a slight decrease after installation, with the lowest ISQ values being reached at 3 weeks. ISQ values were restored 8 weeks post‐surgically. It is recommended to monitor implant stability by RFA at 3 and 8 weeks post‐surgically. However, neither implant surface modifications (SLActive) nor implant diameter were revealed by RFA. To cite this article:
Han J, Lulic M, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell^?mentor during implant tissue integration: II. Implant surface modifications and implant diameter.
Clin. Oral Impl. Res. 21 , 2010; 605–611.
doi: 10.1111/j.1600‐0501.2009.01909.x     

Early loading of single crowns supported by 6‐mm‐long implants with a moderately rough surface: a prospective 2‐year follow‐up cohort study

Aim: To evaluate prospectively the clinical and radiographic outcomes after 2 years of loading of 6 mm long moderately rough implants supporting single crowns in the posterior regions. Material and methods: Forty SLActive Straumann^® short (6 mm) implants were placed in 35 consecutively treated patients. Nineteen implants, 4.1 mm in diameter, and 21 implants, 4.8 mm in diameter, were installed. Implants were loaded after 6 weeks of healing. Implant survival rate, marginal bone loss and resonance frequency analysis (RFA) were evaluated at different intervals. The clinical crown/implant ratio was also calculated. Results: Two out of 40 implants were lost before loading. Hence, the survival rate before loading was 95%. No further technical or biological complications were encountered during the 2‐year follow‐up. The mean marginal bone loss before loading was 0.34±0.38 mm. After loading, the mean marginal bone loss was 0.23±0.33 and 0.21±0.39 mm at the 1‐ and 2‐year follow‐ups. The RFA values increased between insertion (70.2±9) and the 6‐week evaluation (74.8±6.1). The clinical crown/implant ratio increased with time from 1.5 at the delivery of the prosthesis to 1.8 after 2 years of loading. Conclusion: Short implants (6 mm) with a moderately rough surface loaded early (after 6 weeks) during healing yielded high implant survival rates and moderate loss of bone after 2 years of loading. Longer observation periods are needed to draw more definite conclusions on the reliability of short implants supporting single crowns. To cite this article:
Rossi F, Ricci E, Marchetti C, Lang NP, Botticelli D. Early loading of single crowns supported by 6‐mm‐long implants with a moderately rough surface: a prospective 2‐year follow‐up cohort study.
Clin. Oral Impl. Res. 21 , 2010; 937–943.
doi: 10.1111/j.1600‐0501.2010.01942.x     

Early loading of non-submerged titanium implants with a sandblasted and acid-etched surface. 5-year results of a prospective study in partially edentulous patients

OBJECTIVES: The aim of this prospective cohort study was to evaluate the success rate of titanium screw-type implants with the sandblasted and acid-etched (SLA) surface loaded early, after 6 weeks of healing. MATERIAL AND METHODS: A total of 104 implants were inserted into posterior sites of 51 partially edentulous patients exhibiting bone densities of class I-III. After a healing period of 6 weeks, all implants were functionally loaded with cemented crowns or fixed partial dentures. The patients were recalled at 3, 12, 24, 36, 48 and 60 months for clinical and radiographic examination. RESULTS: One implant failed to integrate during healing, and three implants were lost to follow-up and were considered drop-outs. The remaining 100 implants showed favorable clinical and radiographic findings at the 5-year examination. The peri-implant soft tissues were stable over time; the mean probing depths and mean attachment levels did not change during the follow-up period. None of the radiographs exhibited signs of continuous peri-implant radiolucency, which confirmed ankylotic stability for all 100 implants. The measurement of the bone crest levels (DIB values) indicated stability as well. Based on strict success criteria, all 100 implants were considered successfully integrated, resulting in a 5-year success rate of 99%. CONCLUSION: This prospective study using an early loading protocol with 6 weeks of healing demonstrated that titanium implants with the SLA surface can achieve and maintain successful tissue integration with high predictability for at least 5 years of follow-up in selected patients and sites.     

不同愈合期施加载荷对正畸微种植体稳定性影响的研究

目的 探讨微种植体在不同愈合时间施加载荷的生物力学性能和稳定性。方法 将64枚微种植体以（12±1） N·cm扭力植入在8只Beagle犬的下颌牙槽骨上,实验组微种植体于植入后即刻及愈合1、3、8周时施加载荷0.98 N,持续10周,对照组不施加载荷,分别于植入后1、3、8、10周取材。测量两组微种植体的最大旋出扭力,以评价微种植体-骨界面结合强度,旋出微种植体用扫描电子显微镜观察微种植体-骨界面的形态。结果 实验组即刻载荷及愈合1、3、8周载荷的微种植体平均最大旋出扭力分别为4.10、4.25、2.42、4.42 N·cm,其中愈合3周的旋出扭力明显低于其他组（P<0.05）;对照组愈合3周的旋出扭力亦明显低于其他组。实验组愈合3周微种植体的表面为编织骨样结构;而其他愈合时间施加载荷后,其表面多为板层骨样结构。结论 微种植体植入后3周左右为稳定性危险期,此时施加载荷不利于微种植体的稳定。临床应选择微种植体的功能愈合期,即植入后即刻,或愈合1、8周后进行适度加载。     

Immediate versus delayed loading of dental implants in the maxillae of minipigs: follow-up of implant stability and implant failures

PURPOSE: To assess the course of the stability and the failure rate of dental implants placed in the partially edentulous maxillae of minipigs. MATERIALS AND METHODS: Three months after tooth removal, implants were placed in 9 minipigs. Six implants (XiVE; Friadent, Mannheim, Germany) were placed on each side of the posterior maxilla after preparation of the implant sites either by an osteotome technique or with spiral drills. Implant stability was assessed by resonance frequency analysis (RFA) at the time of placement, at second-stage surgery (which took place after a healing periods of 1, 2, 3, 4, or 5 months), and after a loading period of 6 months. RESULTS: Implant stability was significantly influenced by the healing period (P = .007). Implant stability decreased after 1 to 3 months of healing for both of the placement techniques and increased after a healing period of 4 months. After implant site preparation by an osteotome technique, 6 of 12 immediately loaded implants, 18 of 24 implants loaded after healing periods of 1 to 3 months, and 1 of 18 implants loaded after a healing period of 4 or 5 months were lost. After implant site preparation using spiral drills, 7 of 12 immediately loaded implants, 12 of 24 implants loaded after healing periods of 1 to 3 months, and 2 of 18 implants loaded after healing periods of 4 or 5 months were lost. Broad overlapping of confidence intervals for the number of implant failures revealed that there was no relevant difference between immediate and early functional loading for either of the 2 techniques. DISCUSSION AND CONCLUSION: Implant loading after healing periods of 1 to 3 months did not improve implant survival compared to immediate loading in the posterior maxillae of minipigs. Not until a healing period of 4 months was reached did implant stability begin to increase. Only when functional loading was started at this point in time was maximal implant survival achieved.     

Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients

Objectives: The aim of this prospective study was to evaluate the 5‐year performance and success rate of titanium screw‐type implants with the titanium plasma spray (TPS) or the sand‐blasted, large grit, acid‐etched (SLA) surface inserted in a two‐stage sinus floor elevation (SFE) procedure in the posterior maxilla. Material and methods: A total of 59 delayed SFEs were performed in 56 patients between January 1997 and December 2001, using a composite graft with autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) or synthetic porous β‐tricalcium phosphate (β‐TCP). After a healing period averaging 7.75 months, 111 dental implants were inserted. After an additional 8–14‐week healing period, all implants were functionally loaded with cemented crowns or fixed partial dentures. The patients were recalled at 12 and 60 months for clinical and radiographic examination. Results: One patient developed an acute infection in the right maxillary sinus after SFE and did not undergo implant therapy. Two of the 111 inserted implants had to be removed because of a developing atypical facial pain, and 11 implants were lost to follow‐up and were considered drop‐outs. The remaining 98 implants showed favorable clinical and radiographic findings at the 5‐year examination. The peri‐implant soft tissues were stable over time; the mean probing depths and mean attachment levels did not change during the follow‐up period. The measurement of the bone crest levels (DIB values) indicated stability as well. Based on strict success criteria, all 98 implants were considered successfully integrated, resulting in a 5‐year success rate of 98% (for TPS implants 89%, for SLA implants 100%). Conclusion: This prospective study assessing the performance of dental implants inserted after SFE demonstrated that titanium implants can achieve and maintain successful tissue integration with high predictability for at least 5 years of follow‐up in carefully selected patients.