Interfacial gaps of resin cemented ceramic inlays

A method was developed for measuring presence, location and extent of interfacial contraction gaps of resin-cemented ceramic inlays in dentin cavities. Cylindrical ceramic inlays were cemented using one of 12 commercially available resin composite cements to make film thickness of 200-μm. Cross-sections revealed absence of marginal gaps but contraction gaps occurred at all dentin-cement interfaces at the cavity floors and ranged from 1.6 to 7.1 μm. This was equivalent to 0.8-3.5% of the cement film thickness and was 3-10 times greater than the wall-to-wall contraction in percent observed when resin composites are used as filling materials in 3-5 mm butt-joint dentin cavities. The results support the theory that contraction gaps developing adjacent to thin films of resin cements reach size equivalent to the cement film thickness multiplied by the volumetric polymerization shrinkage of the cement.     

可切削复合瓷修复对青少年恒磨牙萌出及建牙合过程影响研究

目的    研究可切削复合瓷修复对青少年恒磨牙萌出、建牙合过程的影响。方法    选择2017年10—12月在大连市口腔医院牙体牙髓病科及儿童口腔科就诊的14 ~ 17岁单侧第一磨牙大面积龋坏并累及牙髓且其他3颗第一磨牙无龋坏的患者60例,完成根管治疗后随机分为3组,分别行复合树脂充填修复术（树脂充填组）、聚合瓷嵌体或高嵌体修复术（聚合瓷组）及可切削复合瓷嵌体或高嵌体修复术（CAD/CAM组）。完成修复即刻及1年后分别制取数字化印模,复查并测量患牙、对颌牙及对侧同名牙牙尖至龈缘顶点高度变化。结果　与同名对照牙相比,树脂充填组牙尖高度变化最大,聚合瓷组次之,CAD/CAM组变化最小,差异具有统计学意义（P < 0.01）。结论    采用可切削复合瓷修复青少年恒磨牙大面积牙体缺损,对牙齿萌出及建牙合过程的影响小于传统的修复方式。     

CEREC 3D全瓷嵌体与复合树脂嵌体修复后牙Ⅱ类洞的疗效比较

目的:探讨陶瓷重建修复(CEREC)3D全瓷嵌体与复合树脂嵌体修复后牙Ⅱ类洞的疗效差异.方法:按照随机数字表法将84例(108颗)后牙Ⅱ类洞患者分成研究组(56颗)和对照组(52颗)各42例.研究组予以CEREC 3D全瓷嵌体修复,对照组则予以复合树脂嵌体修复.比较两组治疗后1年时嵌体修复效果[以改良美国公共卫生署(USPHS)标准为评估依据]差异,记录其治疗6个月、12个月、18个月时预后效果(磨耗情况、邻接关系、嵌体颜色、继发龋齿、嵌体折裂、嵌体脱落等)评估结果差异.结果:治疗后1年时,两组USPHS评估结果显示:研究组边缘密合性、嵌体外形、牙体完整性及牙龈健康情况A级率均明显高于对照组,差异均有显著性.治疗6个月时,两组嵌体磨耗情况、邻接关系、嵌体颜色、继发龋齿、嵌体折裂、嵌体脱落等预后指标A级率比较,差异均无显著性;治疗12个月、18个月时,研究组上述预后指标A级率均明显高于对照组,差异均有显著性.结论:CEREC 3D全瓷嵌体对后牙Ⅱ类洞的修复效果及预后效果均较复合树脂嵌体突出,临床可将其作为一种可行性治疗途径为患者获得更理想的治疗效果提供条件.     

Vertical ridge augmentation of the atrophic posterior mandible with interpositional bloc grafts: bone from the iliac crest vs. bovine anorganic bone. Clinical and histological results up to one year after loading from a randomized-controlled clinical trial

Objectives: To compare two different techniques for vertical bone augmentation of the posterior mandible: bone blocs from the iliac crest vs. anorganic bovine bone blocs used as inlays.
Materials and methods: Ten partially edentulous patients having 5–7 mm of residual crestal height above the mandibular canal had their posterior mandibles randomly allocated to both interventions. After 4 months implants were inserted, and after 4 months, provisional prostheses were placed. Definitive prostheses were delivered after 4 months. Histomorphometry of samples trephined at implant placement, prosthesis and implant failures, any complication after loading and peri-implant marginal bone-level changes were assessed by masked assessors. All patients were followed up to 1 year after loading.
Results: Four months after bone augmentation, there was statistically significant more residual graft (between 10% and 13%) in the Bio-Oss group. There were no statistically significant differences in failures and complications. Two implants could not be placed in one patient augmented with autogenous bone because the graft failed whereas one implant and its prosthesis of the Bio-Oss group failed after loading. After implant loading only one complication (peri-implantitis) occurred at one implant of the autogenous bone group. In 16 months (from implant placement to 1 year after loading), both groups lost statistically significant amounts of peri-implant marginal bone: 0.82 mm in the autogenous bone group and 0.59 mm in the Bio-Oss group; however, there were no statistically significant differences between the groups.
Conclusions: Both procedures achieved good results, but the use of bovine blocs was less invasive and may be preferable than harvesting bone from the iliac crest.     

Synthetic corneal inlays

This review is based on the activities of the Vision Cooperative Research Centre (previously Cooperative Research Centre for Eye Research and Technology) Corneal Implant team from 1991 to 2007. The development of a synthetic polymer of perfluoropolyether (PFPE), meeting essential physical and biological requirements, for use as a corneal inlay is presented. Each inlay was placed in a corneal flap created with a microkeratome and monitored over a two‐year period in a rabbit model. The results indicate that the PFPE implant shows excellent biocompatibility and biostability. As a result, a Phase 1 clinical trial is being conducted. Three years post‐implantation, the PFPE inlays are exhibiting continued excellent biocompatibility. Corneal inlays made from PFPE are biocompatible with corneal tissue in the long term and offer a safe and biologically‐acceptable alternative to other forms of refractive surgery.     

应用髓室固位的金属嵌体冠修复磨牙重度牙冠缺损

目的:评价利用髓室同位制作嵌体冠修复磨牙残冠的效果.方法:对61颗磨牙残冠经完善根管治疗后,制作髓室固位的铸造金属嵌体冠,修复完成后,定期进行临床检查,评价修复效果.结果:经过1～5a的随访观察,61颗患牙经过修复治疗后获得满意效果,个别病例出现修复体颈缘密合不良、牙龈炎.或继发龋、食物嵌塞.结论:利用髓室固位的铸造金属嵌体冠治疗磨牙残冠,是一种简单易行、经济实惠、效果良好的修复方法,严格选择适应证以及准确的牙体预备和精确的加工制作,是修复成功的关键.     

Onlay Tibial Implants Appear to Provide Superior Clinical Results in Robotic Unicompartmental Knee Arthroplasty

Background

Unicompartmental knee arthroplasty (UKA) is an increasingly popular option for the treatment of single-compartment knee osteoarthritis (OA) in adults. Two options for tibial resurfacing during UKA are (1) all-polyethylene inlays and (2) metal-backed onlays.

Questions/Purposes

The aim of this study was to determine whether there are any differences in clinical outcomes with inlay versus onlay tibial components.

Patients and Methods

We identified 39 inlays and 45 onlays, with average 2.7- and 2.3-year follow-up, respectively, from a prospective robotic-assisted surgery database. The primary outcome was the Western Ontario and McMaster University Arthritis Index (WOMAC), subcategorized by the pain, stiffness, and function subscores, at 2 years postoperatively. The secondary outcome was the need for secondary or revision surgery.

Results

Postoperative WOMAC pain score was 3.1 for inlays and 1.6 for onlays (p = 0.03). For 25 inlays and 30 onlays with both preoperative and postoperative WOMAC data, pain score improved from 8.3 to 4.0 for inlays versus from 9.2 to 1.7 for onlays (p = 0.01). Function score improved from 27.5 to 12.5 for inlays versus from 32.1 to 7.3 for onlays (p = 0.03). Four inlays and one onlay required a secondary or revision procedure (p = 0.18).

Conclusions

We advise using metal-backed onlays during UKA to improve postoperative clinical outcomes.

Electronic supplementary material

The online version of this article (doi:10.1007/s11420-014-9421-9) contains supplementary material, which is available to authorized users.     

CAD/CAM全瓷嵌体与复合树脂嵌体修复后牙Ⅱ类洞临床疗效对比分析

目的：对比分析CAD/CAM全瓷嵌体与复合树脂嵌体修复后牙Ⅱ类洞的临床疗效。方法：选择在解放军总医院口腔内科就诊的后牙Ⅱ类洞患者193例（共226颗牙）,根据患者意愿,其中101颗采用CAD/CAM全瓷嵌体修复,其余125颗采用复合树脂嵌体修复,分别在术后6个月、12个月、18个月进行随访,观察其修复体磨耗、折裂、脱落、边缘密合性、边缘着色及继发龋等情况。结果：2种嵌体在修复体磨耗及边缘着色的差异有统计学意义（P〈0.05）,在修复体折裂、修复体脱落、继发龋和边缘密合性的差异无统计学意义（P〉0.05）。CAD/CAM全瓷嵌体的成功率为：96.84%,树脂嵌体的成功率为：81.05%,两组之间成功率的差异有统计学意义（P〈0.05）。结论：在后牙Ⅱ类洞缺损的修复治疗中,CAD/CAM全瓷嵌体的效果优于复合树脂嵌体。     

弹性镶嵌技术在后牙游离端缺失修复中的应用

目的:针对后牙游离端缺失,以弹性义齿技术与合金铸造支架技术相结合制作可摘义齿,观察其临床疗效.方法:通过物理镶嵌原理使弹性义齿材料与金属网格支架相结合,前牙区以弹性义齿仿龈卡环代替以往的金属卡环,尽量减少金属基托的体积.结果:经过2年多的临床应用,患者普遍感觉较美观、轻便、舒适,功能良好;客观检查前牙区美观,基牙及义齿稳固,抗摆动性能强于金属卡环.结论:弹性镶嵌技术针对后牙游离端缺失而言,不失为一种适合国情的新技术,完全符合设计目的.     

两种根管修复治疗后牙牙体缺损的疗效比较

 目的 对比两种方法修复根管(全冠修复根管、高嵌体修复根管)用于后牙牙体缺损患者临床治疗的效果及预后状况。方法 选取2017-05至2019-05医院口腔科收治的后牙牙体缺损患者80例,按治疗方法分为两组,每组40例;A组行高嵌体修复根管治疗,B组行全冠修复根管治疗,分析患者缺牙修复效果、满意度、口腔健康状况改善情况等。结果 两组修复效果优良率分别为92.50%、95.00%,差异无统计学意义;B组满意度评分为(96.82±4.37)分,明显高于A组的(80.62±5.35)分,差异有统计学意义(t=14.362,P<0.05); B组治疗后修复体完整、与邻牙吻合、牙齿美观、咀嚼功能恢复患者构成比,治疗后口腔健康影响程度量表(oralhealthim pactprofile,OHIP-14)中各项评分,均明显优于A组,差异有统计学意义(P<0.05)。结论 全冠、高嵌体修复根管均可获得良好修复效果,但高嵌体修复根管对改善口腔健康状况及预后效果更好。