implantology

内植学
  • 文章类型: Journal Article
    这项研究旨在从组织学上评估XPEED®和SLA表面对放置在人体骨骼中的钛牙植入物在3周和5周时的矿物质附着率(MAR)的影响。总的来说,本研究包括17个钛牙科植入物,其具有XPEED®表面(n=9)用作测试,SLA表面(n=8)用作对照。每个患者在活检前2周以12小时间隔接受四剂四环素500mg。进行了植入物取回,并在落射荧光显微镜下仔细处理并进行组织形态学评估。在3周和5周,新形成的骨出现与两种类型的测试表面直接接触。在3周,MAR值为,分别,XPEED®植入物为2.0(±0.18)μm/天,SLA植入物为1.5(±0.10)μm/天(p=0.017)。在5周,注意到XPEED®和SLA植入物的MAR值较低,1.2(±0.10)μm/天和1.1(±0.10)μm/天,分别(p=0.046)。通过线性回归分析对时间和植入物表面的总体评估显示,与3周相比,5周时的成骨细胞活性降低(p<0.005)。本研究的结果表明,在3周和5周愈合时,在具有XPEED®表面的植入物周围,骨并置速率发生得更快。MAR值可以支持在早期加载方案中使用具有XPEED®表面的植入物。
    This study aimed to histologically evaluate the effects of XPEED® and SLA surface on the mineral apposition rate (MAR) at 3 and 5 weeks in titanium dental implants placed in human bone. In total, 17 titanium dental implants with XPEED® surface (n = 9) used as test and SLA surface (n = 8) used as control were included in this study. Each patient received four doses of tetracycline 500 mg at 12 h intervals 2 weeks prior to biopsy retrieval. Implant retrieval was performed, and retrieved biopsies were carefully treated for histomorphometric evaluation under epifluorescence microscopy. At 3 and 5 weeks, newly formed bone appeared in direct contact with both types of tested surfaces. At 3 weeks, the MAR value was, respectively, 2.0 (±0.18) μm/day for XPEED® implants and 1.5 (±0.10) μm/day for SLA implants (p = 0.017). At 5 weeks, lower MAR values for both XPEED® and SLA implants were noted, with 1.2 (±0.10) μm/day and 1.1 (±0.10) μm/day, respectively (p = 0.046). The overall evaluation by linear regression analysis for both time and implant surfaces showed a decreased osteoblast activity at 5 weeks compared to 3 weeks (p < 0.005). The results of the present study show that the bone apposition rate occurs faster around implants with XPEED® surface at 3 weeks and 5 weeks of healing. MAR values may support the use of implants with XPEED® surfaces in early loading protocols.
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  • 文章类型: Journal Article
    目的:本研究的目的是评估使用四种不同制造商工作流程打印的手术指南的准确性。
    方法:48个手术指南(BlueSky计划,BlueSkyBio)是使用四种不同的打印机生产的,严格遵守每个制造商的说明。使用的打印机是三台DLP打印机(SolFlex170(VC),Nextdent5100(ND),D30+Rapidshape(RS))和一台SLA打印机(Formlabs3B+(FL))。该研究评估了整个表面的真实性和准确性,感兴趣区域(RoI)(咬合和引导区),在几个批次的重复性,和导向孔的直径和xyz轴。将印刷指南数字化,并与CAD设计对照样品(对照X,Geomagic)。进行描述性统计和Kruskal-Wallis检验以及事后Mann-Whitney检验(α=0.05)。
    结果:统计学分析显示,在整体区域和RoI中,各组之间的真实性和准确性存在差异(p=0.00)。ND组表现出最高的可重复性。只有RS组表现出与主样本相当的导孔直径(5.27±2.12mm;p=0.104)。在x轴和z轴的组间没有观察到统计学差异。然而,在y轴上,VC组差异有统计学意义(p=0.01)。
    结论:结果表明,DLP组具有更好的总体准确性,而SLA组在RoI中取得了最好的成绩。制造商的工作流程证明了RoI中批次之间的高再现性。RS组的值与主试样的导孔直径最相似,在导向孔方向偏差最小。
    结论:种植位置是长期成功的关键因素,它可能会受到3D打印手术指南的准确性的影响。因此,使用可用的印刷技术分析导向孔的最终尺寸和方向是至关重要的。
    OBJECTIVE: The aim of this study was to assess the accuracy of surgical guides manufactured with four different 3D printers..
    METHODS: Forty-eight surgical guides (BlueSky Plan, BlueSky Bio) were produced using four different 3D printers, with strict adherence to each manufacturer\'s instructions. The printers used were three digital light processing (DLP) printers (SolFlex170, VC; Nextdent5100, ND, and D30+Rapidshape, RS) and one stereolithographic (SLA) printer (Formlabs3B+, FL). The study evaluated the trueness and precision of the overall surface, the region of interest (RoI) (occlusal and guide zone), the repeatability in several batches, and the guide hole\'s diameter and xyz axes. The printed guides were digitized and compared with the CAD design control specimen (Control X, Geomagic). Descriptive statistics and Kruskal-Wallis tests with post-hoc Mann-Whitney tests were performed (α=0.05).
    RESULTS: Differences in trueness and precision were found between groups in the overall zone and RoI (p = 0.00). The ND group demonstrated the highest repeatability. Only the RS group exhibited a comparable guide hole diameter to the master specimen (5.27±2.12 mm; p = 0.104). No statistical differences were observed between groups in the x and z axes. However, in the y-axis, the VC group displayed statistically significant differences (p = 0.01).
    CONCLUSIONS: The results showed that the DLP groups had better overall accuracy, while the SLA group had the best results in the RoI. The manufacturer\'s workflows demonstrated a high reproducibility between batches in the RoI. The RS group had values most similar values to the guide hole diameter of the master specimen, with minimal deviations in guide hole orientation.
    CONCLUSIONS: Implant position can be affected by the accuracy of the 3D printed surgical guide. Therefore, it is critical to analyze the final dimensions and the direction of the guide hole using available printing technologies.
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  • 文章类型: Journal Article
    钛植入物通过表面碳氢化合物沉积经历老化过程,导致润湿性和生物活性降低。等离子体处理显着减少表面碳氢化合物,从而提高种植体的亲水性和增强骨整合过程。这项研究调查了等离子体表面处理对呈现纳米结构钙掺入表面(XPEED®)的植入物的骨与植入物接触(BIC)的影响。在随机对照试验(RCT)设计之后,在上颌骨后部接受植入物手术的患者接受了额外的等离子治疗(n=7)或未治疗(n=5)3.5×8mm植入物,这些植入物在4周的愈合期后进行组织学检查.组织形态分析显示,经等离子体处理的植入物表现出38.7%的BIC率,而未经处理的植入物为22.4%(p=0.002)。表明骨整合潜力增强。组织学图像还显示,与未处理的标本相比,等离子体处理的植入物周围的骨形成和成骨细胞活性增加。结果表明,等离子体处理提高了表面亲水性和生物响应,促进钛植入物周围的早期骨形成。这项研究强调了表面修饰在优化植入物整合中的重要性,并支持使用等离子体治疗来增强骨整合。从而改善植入物牙科的临床结果,并为即时和早期加载方案提供益处,特别是在软骨条件下。
    Titanium implants undergo an aging process through surface hydrocarbon deposition, resulting in decreased wettability and bioactivity. Plasma treatment was shown to significantly reduce surface hydrocarbons, thus improving implant hydrophilicity and enhancing the osseointegration process. This study investigates the effect of plasma surface treatment on bone-to-implant contact (BIC) of implants presenting a nanostructured calcium-incorporated surface (XPEED®). Following a Randomized Controlled Trial (RCT) design, patients undergoing implant surgery in the posterior maxilla received additional plasma-treated (n = 7) or -untreated (n = 5) 3.5 × 8 mm implants that were retrieved after a 4-week healing period for histological examination. Histomorphometric analysis showed that plasma-treated implants exhibited a 38.7% BIC rate compared to 22.4% of untreated implants (p = 0.002), indicating enhanced osseointegration potential. Histological images also revealed increased bone formation and active osteoblastic activity around plasma-treated implants when compared to untreated specimens. The findings suggest that plasma treatment improves surface hydrophilicity and biological response, facilitating early bone formation around titanium implants. This study underscores the importance of surface modifications in optimizing implant integration and supports the use of plasma treatment to enhance osseointegration, thereby improving clinical outcomes in implant dentistry and offering benefits for immediate and early loading protocols, particularly in soft bone conditions.
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  • 文章类型: Journal Article
    引言当前的研究着手评估植入物的早期存活率并确定相关参数。方法这项研究跨越了2021年和2022年,包括所有种植牙的人。各种标准,比如年龄,性别,上颌骨/下颌骨,植入位置,立即植入,植入物直径,植入物长度,和其他人,用于确定研究中的植入物存活率。使用多元逻辑回归模型来显示植入物早期生存率的风险变量,在采用卡方检验过滤后,进一步包括p<0.05的成分。结果目前的研究包括128例患者的单一植入程序,包括70名男性和58名女性。早期生存率为91.40%,植入后保留了117个植入物。显示与早期生存率相关的风险变量为30-60岁的患者(OR:2.542),立即植入(OR:3.742),和植入物长度小于10毫米(OR:3.972)。结论年龄,牙齿位置,植入物长度,和即刻植入是导致我们受试者的植入物早期存活率超过91%的风险变量。
    Introduction The current research sets out to assess implant early survival rates and identify relevant parameters. Methods The research spanned the years 2021 and 2022 and included all individuals who had dental implants. Various criteria, such as age, sex, maxilla/mandible, implant location, immediate implant, implant diameter, implant length, and others, were used to determine the implant survival rate in the research. A multiple logistic regression model was used to show the risk variables for early survival rates of implants, and components with p < 0.05 were further included after the Chi-square test was employed to filter them. Results The current research included 128 patients who had a single implant procedure, including 70 males and 58 females. The early survival rate was 91.40%, and 117 implants were retained after implantation. Risk variables that were shown to be associated with early survival rates were patients aged 30-60 years (OR: 2.542), immediate implant placement (OR: 3.742), and implant length less than 10 mm (OR: 3.972). Conclusions Age, tooth location, implant length, and immediate implantation were risk variables that contributed to our subjects\' above 91% early survival rate of implants.
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  • 文章类型: Journal Article
    背景:植入物的有效放置关键取决于植入物与牙槽骨的骨结合水平。为了在植入过程中增加骨整合,研究集中在植入物的表面改性上,和形态学分析研究了与骨骼表面紧密相互作用的螺纹图案。
    目的:本研究旨在评估和比较不同表面修饰技术下口腔种植体骨整合的程度。
    方法:在本研究中,使用12只年龄为18-24个月的健康成年犬。在下颌骨的两侧进行拔牙,伤口用缝线缝合。两个月后,每只狗的右下颌骨接受局部麻醉和全身麻醉。根据其表面处理放置了四种不同的植入物类型:可吸收爆炸介质(RBM)处理的植入物,具有超薄HA膜的羟基磷灰石(HA)植入物,用HA涂覆的水热处理的HA植入物,用等离子喷涂和酸蚀刻处理的喷砂联合酸蚀刻(SLA)植入物。总共48个植入物被分为两周和四周组,具有相同的尺寸。每只狗接受两组植入物,每只狗总共植入八个植入物。将植入物以大于35-N的扭矩牢固地放置在上牙槽骨中,直到深度为1mm。PeriotestM(MedizintechnikGuldene.K.,Modautal,Germany)用于在放置和处死后立即计算每个植入物的颊侧的典型值,以测试植入物的主要固定和稳定性。OsstellMentor(OsstellAB,哥德堡,瑞典)同时评估内侧的植入物稳定性商(ISQ),远端,颊,和植入物的舌侧。使用MGT50(ELECTROMATICEquipmentCo.,Inc.,纽约,美国)扭矩分析仪。使用光学显微镜(OlympusCorporation,东京,日本)。上半部的骨-种植体接触(BIC),这对植入物的稳定性更重要,研究了新骨形成面积(NBFA)与完整植入物的比率。
    结果:在第四周,在HA处理的植入物中观察到最大的稳定性。在第四周在水热处理的HA植入物中观察到最小的稳定性。与两周评估相比,在四周评估中每组的稳定性更大。在两周和三周的评价中,几乎所有植入物的稳定性都是令人满意的。在HA处理的植入物中观察到在两周和四周评估时新形成的骨的百分比面积的最大值。分别在SLA和RBM处理的植入物中观察到在两周和四周评估时新形成的骨的面积百分比的最小值。差异有统计学意义(p≤0.05)。
    结论:所有植入物表面改性,总的来说,产生令人满意的骨整合。在具有水热处理的HA的植入物的上部观察到优异的骨整合。
    BACKGROUND: Effective implant placement depends critically on the implant\'s level of osseointegration with the alveolar bone. To increase osseointegration during implant placement, research has concentrated on the surface modification of implants, and morphological analyses have looked at the thread pattern in close interaction with the bone\'s surface.
    OBJECTIVE: This study aimed to assess and compare the extent of oral implant osseointegration in different surface modification techniques.
    METHODS: In this study, 12 healthy adult dogs aged 18-24 months were used. Tooth extractions were performed on both sides of the mandible, and wounds were closed with sutures. Two months later, the right mandible of each dog underwent local anesthesia and general anesthesia. Four different implant types were placed based on their surface treatments: resorbable blast media (RBM)-treated implants, hydroxyapatite (HA) implants with an ultra-thin HA film, hydrothermal-treated HA implants coated with HA, and sandblasting combined acid etching (SLA) implants treated with plasma spray and acid etching. A total of 48 implants were divided into two- and four-week groups, with identical dimensions. Each dog received two implants from each group, for a total of eight implants per dog. The implants were securely placed into the superior alveolar bone with a torque greater than 35-N up to a depth of 1 mm. Periotest M (Medizintechnik Gulden e.K., Modautal, Germany) was used to calculate the periotest value (PTV) as a typical value on the buccal side of each implant immediately following placement and sacrifice to test the main fixation and stability of the implants. Resonance frequency analysis (RFA) was utilised by Osstell Mentor (Osstell AB, Gothenburg, Sweden) to simultaneously assess the implant stability quotient (ISQ) on the medial, distal, buccal, and lingual sides of the implant. The rotational torque in one of the sacrificed dogs was calculated using the MGT 50 (ELECTROMATIC Equipment Co., Inc., New York, USA) torque analyzer. The histomorphometric evaluation was performed using an optical microscope (Olympus Corporation, Tokyo, Japan). The upper half\'s bone-implant contact (BIC), which was found to be more important for implant stability, was studied together with the ratio of the new bone formation area (NBFA) to the complete implant.
    RESULTS: The maximum stability was observed in HA-treated implants in the fourth week. The minimum stability was observed in hydrothermal-treated HA implants in the fourth week. The stability in each group was greater in the four-week evaluation as compared to the two-week evaluation. The stability was satisfactory in almost all implants at two- and three-week evaluations. The maximum value of the percentage area of newly formed bone at the two- and four-week evaluations was observed in HA-treated implants. The minimum value of the percentage of the area of newly formed bone at two- and four-week evaluations was observed in SLA and RBM-treated implants respectively. The difference was significant statistically (p ≤ 0.05).
    CONCLUSIONS: All implant surface modifications, in general, produced satisfactory osseointegration. Excellent osseointegration was seen in the upper portion of the implant with hydrothermally treated HA.
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  • 文章类型: Journal Article
    本研究的目的是分析和比较两者的角度偏差,四个和六个相邻的牙科植入物放置有和没有直的平行销。
    方法:选择了二百四十(240)个牙科植入物,并随机分配到以下研究组中:两个用直平行销放置的牙科植入物(参考文献:144-100,生物地平线,伯明翰,AL,美国)(n=10)(2PP);两个没有平行销的牙科植入物(n=10)(2没有PP);四个带有直平行销的牙科植入物hT(n=10)(4PP);四个没有平行销的牙科植入物(n=10)(4没有PP);六个带有直平行销的牙科植入物(n=10)(6PP)和六个没有平行销的牙科植入物(n=10)。将随机分配到2PP和2withoutPP组的牙种植体置于牙齿位置2.4和2.6的部分无牙上颌的标准化聚氨酯模型中,将随机分配到4PP和4withoutPP组的牙种植体置于牙齿位置1.6、1.4、2.4和2.6的完全无牙上颌的标准化聚氨酯模型中,将随机分配到6PP和6outPP组的牙种植体置于完全无牙位置1.4、2.4和2.6、之后,术后CBCT扫描和数字印模在3D植入物计划软件中对齐,以比较两者的角度偏差(°),使用一般线性模型统计分析,放置有和没有直平行销的四个和六个相邻的牙科植入物。
    结果:在统计学上发现,2个使用直平行销放置的牙种植体的角度偏差(p<0.0001)与4个使用直平行销放置的牙种植体的角度偏差(p=0.0024)之间存在显著差异;然而,6个用直平行针放置的牙种植体的角度偏差无统计学意义(p=0.9967)。
    结论:使用直的平行销导致两个和四个相邻的牙种植体之间的角度偏差较小;但是,对于大量的牙科植入物是无效的。
    The aim of the present study was to analyze and compare the angle deviation of two, four and six adjacent dental implants placed with and without straight parallel pins.
    METHODS: Two hundred and forty (240) dental implants were selected and randomly allocated into the following study groups: Two dental implants placed with straight parallel pins (Ref.: 144-100, BioHorizons, Birmingham, AL, USA) (n = 10) (2PP); Two dental implants placed without parallel pins (n = 10) (2withoutPP); Four dental implants placed with straight parallel pins hT(n = 10) (4PP); Four dental implants placed without parallel pins (n = 10) (4withoutPP); Six dental implants placed with straight parallel pins (n = 10) (6PP) and Six dental implants placed without parallel pins (n = 10) (6withoutPP). The dental implants randomly assigned to groups 2PP and 2withoutPP were placed into standardized polyurethane models of partially edentulous upper jaws in tooth positions 2.4 and 2.6, the dental implants randomly assigned to groups 4PP and 4withoutPP were placed into standardized polyurethane models of fully edentulous upper jaws in tooth positions 1.6, 1.4, 2.4 and 2.6, and the dental implants randomly assigned to groups 6PP and 6withoutPP were placed into standardized polyurethane models of fully edentulous upper jaws in tooth positions 1.6, 1.4, 1.2, 2.2, 2.4 and 2.6. Afterwards, postoperative CBCT scans and digital impressions were aligned in a 3D implant-planning software to compare the angle deviation (°) of two, four and six adjacent dental implants placed with and without straight parallel pins using the General Linear Model statistical analysis.
    RESULTS: Statistically significant differences were found between the angle deviation of 2 dental implants placed with straight parallel pins (p < 0.0001) and between the angle deviation of 4 dental implants placed with straight parallel pins (p = 0.0024); however, no statistically significant differences were found in the angle deviation of 6 dental implants placed with straight parallel pins (p = 0.9967).
    CONCLUSIONS: The use of a straight parallelization pin results in lower angle deviation between two and four adjacent dental implants; however, it is not effective for a larger number of dental implants.
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  • 文章类型: Journal Article
    背景:精神孔(MF)的3D位置在牙科种植和下颌手术或局部麻醉中具有重要的临床价值。尽管它很重要,尚不清楚MF的位置在不同的个体中如何改变,因为关于MF位置与垂直生长模式之间的关联的文献不存在,而关于MF位置与骨骼咬合不正之间的联系的文献很少。因此,我们的目标是调查这些,第一次,锥束计算机断层摄影(CBCT)。
    方法:9个子组的存档CBCT(即,3骨骼类I,II,和III×3垂直生长模式,短脸,正常面部)是通过评估患者SNA收集的,SNB,ANB,面部角度,降低面部高度,和FMA(n=9×40=360)。纳入的病例年龄超过17岁,没有任何正畸/正颌治疗史(243名妇女,117人,平均年龄:22.28±2.80岁)。MF和3个固定骨结构之间的垂直距离(下颌联合[S/宽度],下颌支[R/长度],和下颌下皮质[C/高度])在两个半大脑的不同截面上进行了测量。将左侧和右侧测量结果组合。使用3路ANCOVA分析数据,Bonferroni,单向方差分析,Tamhane,皮尔森,和t检验(α=0.05)。
    结果:宽度在II类病例中最小,在III类病例中最大(所有P值<0.000001,Bonferroni)。长面孔最短,短面孔最长(所有P值≤0.00008)。III类的下上身高均大于I类和II类(P值均≤0.003);I类和II类之间的身高没有显着差异(P=0.684)。长面中的高度最大,短面中的高度最小(所有P值<0.000001)。前后长度在III类中最大,在II类中最小(所有P值<0.000001)。与正常或长脸人相比,短脸人的长度更大(P≤0.00003);然而,长面和正常面的长度没有差异(P=0.448).受试者年龄与他们的MF位置无关(P≥0.579,皮尔逊系数)。性别二态仅存在于身高(P=0.009,t检验),而不存在于长度或宽度。
    结论:MF位置在各种水平或垂直生长模式和性别中可能存在很大差异。在下颌骨手术中应注意这一点。
    The 3D position of the mental foramen (MF) is of significant clinical value in dental implantology and mandibular surgeries or in local anesthesia. Despite its importance, it is not clearly known how the position of MF can alter in different individuals, since the literature on the associations between the MF position with vertical growth patterns is non-existent and those on links between the MF position and skeletal malocclusions are scarce. Therefore, we aimed to investigate these, for the first time, on cone-beam computed tomographies (CBCTs).
    Archival CBCTs of 9 sub-groups (i.e., 3 skeletal Classes I, II, and III × 3 vertical growth patterns \'long face, short face, normal face\') were collected by evaluating patients\' SNA, SNB, ANB, facial angle, lower facial height, and FMA (n = 9 × 40 = 360). Included cases were older than 17 years and without any history of orthodontic/orthognathic treatments (243 women, 117 men, mean age: 22.28 ± 2.80 years). Perpendicular distances between the MF and 3 fixed bony structures (the mandibular symphysis [S/width], the mandibular ramus [R/length], and the mandibular lower cortex [C/height]) were measured on different sectional planes on both hemimandibles. Left- and right-side measurements were combined. Data were analyzed using the 3-way ANCOVA, Bonferroni, one-way ANOVA, Tamhane, Pearson, and t-test (α = 0.05).
    Width was the smallest in Class II and greatest in Class III cases (all P values < 0.000001, Bonferroni). It was the shortest in long faces and longest in short faces (all P values ≤ 0.00008). The inferior-superior height was larger in Class III than both Classes I and II (both P values ≤ 0.003); there was no significant difference between Classes I and II in terms of height (P = 0.684). Height was the largest in long faces and smallest in short faces (all P values < 0.000001). The anterior-posterior length was the largest in Class III and smallest in Class II (all P values < 0.000001). Length was larger in short-face people versus normal- or long-face individuals (P ≤ 0.00003); nevertheless, long and normal faces did not differ in terms of length (P = 0.448). Subjects\' age was not correlated with their MF positions (P ≥ 0.579, Pearson coefficient). Sex dimorphism existed only for height (P = 0.009, t-test) but not for length or width.
    The MF position may considerably differ in various horizontal or vertical growth patterns and sexes. This should be noted in mandible surgeries.
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  • 文章类型: Journal Article
    本研究的目的是测试机器人系统的技术和临床可行性,并研究其在使用离体猪模型手术修复穿孔的施耐德膜中的潜力。八个猪头通过手术环进行常规操作,八个猪头使用手术机器人“Symani®手术系统”(医用微型仪器,Inc.,比萨,意大利)。在每个样本上,将Schneiderian膜切开0.7mm的长度,类似于穿孔。操作时间,最大正弦压力,测量压力和填充体积的过程。此外,通过扫描电子显微镜检测到伤口边缘的适应。最大压力没有显着差异(p=0.528),达到压力最大值的时间(p=0.528),或最大填充量(p=0.674)。通过机器人手术缝合膜所需的时间明显更长(p<0.001)。然而,扫描电子显微镜显示,通过机器人手术更好地适应伤口边缘。首次证实了使用机器人系统进行机器人辅助缝合Schneiderian膜裂伤的技术可行性。考虑到与常规修复相比的耐压性没有差异,但是用电子显微镜可以发现伤口适应的优势。关于材料和培训费用以及有限的适应症,机器人手术系统在日常牙科实践中仍然可能没有财务上可行的选择。
    The aim of the current study was to test the technical and clinical feasibility of a robotic system and investigate its potential in the surgical repair of perforated Schneiderian membranes using an ex-vivo porcine model. Eight pig heads were operated conventionally via a surgical loop and eight pig heads with the surgical robot \"Symani® Surgical System\" (Medical Microinstruments, Inc., Pisa, Italy). On each specimen, the Schneiderian membrane was incised over a length of 0.7 mm resembling a perforation. Operation time, the maximum sinusoidal pressure, the course of the pressure and the filling volume were measured. Additionally, adaptation of the wound edges has been detected via scanning electron microscopy. There were no significant differences for the pressure maximum (p = 0.528), for the time until the pressure maximum was reached (p = 0.528), or for the maximum filling volume (p = 0.674). The time needed for the suturing of the membrane via robotic surgery was significantly longer (p < 0.001). However, the scanning electron microscope revealed a better adaptation of the wound edges with robotic surgery. The technical feasibility of robot-assisted suturing of Schneiderian membrane laceration using the robotic system has been confirmed for the first time. No differences considering the pressure resistance compared to the conventional repair could be observed, but advantages in wound adaptation could be found with an electron microscope. Regarding the material and training costs and limited indications spectrum, robotic surgery systems still might not present financially feasible options in the daily dental practice yet.
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  • 文章类型: Journal Article
    这项研究根据患者的骨质量评估了喷砂和酸蚀的牙科植入物的成功率和存活率。
    2016年至2019年3月在五个临床中心进行了一项多中心回顾性研究。总共407个植入物(KONTACTTM,生物技术牙科,法国)纳入229名患者(61.5±12.9岁)。骨质量,分类为D1至D4型(杂项分类),最大插入扭矩,并测量骨丢失。在一年后评估整个队列和每个骨质量的植入物存活率。四年后的总生存率也用Kaplan-Meier分析来估计。
    一年后(12.8±9.6个月),407个植入物中有8个植入物丢失,总存活率为98%.从D1的100%到D4的89.7%(n=39),D2(n=93)和D3(n=165)的生存率显着提高(98.9%和98.2%,分别)与D4相比。根据Kaplan-Meier分析,四年后总生存率估计为96.5%.测得的平均最大插入扭矩为45±12.6N.cm,骨丢失为0.2±1.2mm。
    总生存率高(98%),平均最大插入扭矩(45N.cm),低边缘骨丢失表明酸蚀刻植入物的临床效果良好。尽管每种骨骼质量的存活率相对较高,D4组的结果显著较低,突出了基于骨质量的植入物和手术方案的预期益处.
    UNASSIGNED: This study evaluated the success and survival rate of sandblasted and acid-etched dental implants according to the patient\'s bone quality.
    UNASSIGNED: A multicenter retrospective study was conducted in five clinical centers between 2016 and March 2019. A total of 407 implants (KONTACTTM S, Biotech Dental, France) placed in 229 patients (61.5±12.9 years old) were included. Bone quality, classified as types D1 to D4 (Misch classification), maximal insertion torque, and bone loss were measured. The implant survival rate was evaluated after one year for the overall cohort and for each bone quality. The overall survival rate after four years was also estimated with a Kaplan-Meier analysis.
    UNASSIGNED: After one year (12.8±9.6 months), eight implants were lost out of 407, representing an overall survival rate of 98%. It ranged from 100% for D1 to 89.7% for D4 (n=39), with significantly higher survival rates for D2 (n=93) and D3 (n=165) (98.9% and 98.2%, respectively) compared to D4. According to the Kaplan-Meier analysis, an overall survival rate of 96.5% was estimated after four years. An average maximal insertion torque of 45±12.6 N.cm and bone loss of 0.2±1.2 mm were measured.
    UNASSIGNED: The high overall survival rate (98%), the average maximal insertion torque (45 N.cm), and the low marginal bone loss indicated good clinical results with acid-etched implants. Despite the relatively high survival rate for each bone quality, the significantly lower results in the D4 group highlight the expected benefits of bone quality-based implants and surgical protocols.
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  • 文章类型: Journal Article
    牙科螺钉植入物的放置通常涉及使用旋转技术和钻头来形成骨床。这项研究探讨了将这种方法与Er:YAG激光器相结合的潜在好处。对10只安乐死的家猪(Susscrofadomestica)的下巴进行了截骨术,每个颌骨有12个下颌骨植入物截骨术,分为4组。为了对Er:YAG激光器的效果做出综合评价,组织形态学技术用于测量Er:YAG激光治疗后非晶层厚度的减少,无论是否放置来自不同制造商的牙科螺钉植入物。骨脱钙和染色后,在四组中测量了非晶层的厚度:A组-未进行Er:YAG激光治疗的截骨术-非晶层厚度范围为21.813至222.13µm;B组-使用Er:YAG激光治疗的截骨术-非晶层厚度范围为6.08至64.64µm;C组-未进行激光治疗的放置在骨骼中的植入物-非晶层厚度为5.90至54.52µAG;D使用LEICADM1000LED显微镜(德国)和LASV4.8软件(LeicaApplicationSuiteV4,LeicaMicrosystems,德国)。当比较A组与B组和C组与D组时,差异有统计学意义(p值=0.000,p<0.05)。该研究证明了协同效应和将激光集成到常规植入方案中的可能性。通过应用我们自己的生物修饰方法,使用Er:YAG激光可以减少旋转截骨术中形成的涂抹层。这种减少导致狭窄的种植体周围空间和改善的骨与种植体接触。促进骨融合加速。
    The placement of dental screw implants typically involves the use of rotary techniques and drills to create a bone bed. This study explores the potential benefits of combining this method with an Er:YAG laser. Split osteotomies were performed on 10 jaws of euthanized domestic pigs (Sus scrofa domestica), with 12 mandibular implant osteotomies in each jaw, divided into 4 groups. In order to make a comprehensive assessment of the effect of Er:YAG lasers, histomorphological techniques were used to measure the reduction in amorphous layer thickness after Er:YAG laser treatment, both with and without the placement of dental screw implants from different manufacturers. Following bone decalcification and staining, the thickness of the amorphous layer was measured in four groups: Group A-osteotomy performed without Er:YAG laser treatment-had amorphous layer thicknesses ranging from 21.813 to 222.13 µm; Group B-osteotomy performed with Er:YAG laser treatment-had amorphous layer thicknesses ranging from 6.08 to 64.64 µm; Group C-an implant placed in the bone without laser treatment-had amorphous layer thicknesses of 5.90 to 54.52 µm; and Group D-an implant placed after bone treatment with Er:YAG laser-had amorphous layer thicknesses of 1.29 to 7.98 µm. The examination and photomicrodocumentation was performed using a LEICA DM1000 LED microscope (Germany) and LAS V 4.8 software (Leica Application Suite V4, Leica Microsystems, Germany). When comparing group A to group B and group C to D, statistically significant differences were indicated (p-value = 0.000, p < 0.05). The study demonstrates the synergistic effects and the possibility of integrating lasers into the conventional implantation protocol. By applying our own method of biomodification, the smear layer formed during rotary osteotomy can be reduced using Er:YAG lasers. This reduction leads to a narrower peri-implant space and improved bone-to-implant contact, facilitating accelerated osseointegration.
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