implants

植入物
  • 文章类型: Case Reports
    美学是恢复性护理的主要目标之一。上颌骨前部受创伤的牙齿通常会撕脱或因骨折而需要拔除。康复在这种治疗状态下具有挑战性,因为它存在一些解剖学和美学问题。存在传统植入物放置成问题的情况。必须有足够的骨骼来放置植入物才能顺利和成功。除了某些手术的植入物放置之外,其他手术治疗可能是必要的。比如广泛的嫁接,直接或间接的鼻窦抬高,和神经偏侧化。这些操作需要某些程序,但并不总是可以实现的。因为单件基底植入物提供即时的时间和负荷,同时从基底皮质骨获得足够的锚定,它们已被广泛用于修复被吸收的山脊。此病例报告显示了基底植入物在前区的放置。
    Aesthetics are one of the primary goals of restorative care. Teeth that are traumatized in the anterior maxilla usually avulse or require extraction due to fractures. Rehabilitation is challenging in such a therapeutic state since it presents several anatomical and aesthetic issues. There are circumstances in which traditional implant placement is problematic. There must be enough bone for implant placement to be uneventful and successful. Other surgical therapies may be necessary in addition to implant placement for certain operations, such as extensive grafting, direct or indirect sinus lifts, and nerve lateralization. Certain procedures are required for these operations but are not always achievable. Because single-piece basal implants provide immediate temporization and loading while receiving adequate anchoring from the basal cortical bone, they have been extensively used to rehabilitate resorbed ridges. This case report demonstrates the placement of the basal implant in the anterior zone.
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  • 文章类型: Case Reports
    最佳的美学效果对于前区的植入物支持修复至关重要。在审美区,在植入手术后提供即时临时修复已被提出作为可靠和理想的治疗方法。植入物放置后轮廓良好的临时修复体可最大程度地减少植入物周围区域的硬组织和软组织变化。这反过来又有可能增强审美结果,因此,患者满意度。需要仔细计划和执行多个假体和手术方面以实现预期的最终结果。这是一份报告,描述了在将单个植入物立即加载到美学区后,重新勾画牙龈轮廓以达到最佳出现轮廓的步骤。
    An optimal esthetic result is essential for an implant-supported restoration in the anterior zone. In the esthetic zone, providing immediate interim restorations following implant surgery has been proposed as a reliable and desirable treatment approach. A well-contoured interim restoration following implant placement minimizes hard and soft tissue changes in the peri-implant zone. This in turn has the potential to enhance the esthetic outcome and, therefore, patient satisfaction. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the intended final result. This is a report describing the steps involved in recontouring the gingiva to achieve an optimal emergence profile following the immediate loading of a single implant in the esthetic zone.
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  • 文章类型: Case Reports
    由于支撑组织的损失,通过牙科植入物修复在美学区域中恢复牙周受损的牙齿提出了重大挑战。此病例报告描述了为患有美学区晚期慢性牙周炎的48岁女性设计的分阶段治疗策略。这种方法结合了各种先进技术,包括牙周再生,唇根扭矩的正畸种植部位发展,引导骨再生,和软组织增强。采用唇根扭矩技术进行创新的正畸种植部位开发,通过在水平唇腭方向上战略性地施加唇根扭矩来利用健康的腭牙周膜细胞。这项技术使用健康的腭牙周膜细胞,这有利于整体牙周健康。该程序涉及使用镍钛丝以每月2毫米的速度逐渐移动无望的牙齿,从而在提取前保持两个月的过度校正。在使用唇根扭矩成功进行正畸种植部位发育后,下一阶段涉及使用蜂窝状结构的钛膜引导骨再生。这为六个月后植入奠定了基础,确保后续假肢干预的稳定基础。然后使用注入成纤维细胞生长因子-2的人造胶原蛋白真皮精心进行软组织增强,从而有助于整体美学结果。最终的假体整合显示出与相邻牙齿和牙龈的和谐融合,强调了这种多学科方法的成功。此病例报告为美学领域的严重牙周炎提供了宝贵的见解。我们的发现强调了不断研究和改进程序以实现最佳患者护理的重要性。
    Restoring periodontally compromised teeth in esthetic zones through dental implant rehabilitation poses significant challenges due to the loss of supporting tissues. This case report describes a staged treatment strategy designed for a 48-year-old woman with advanced chronic periodontitis of the esthetic zone. This approach combined various advanced techniques, including periodontal regeneration, orthodontic implant site development with labial root torque, guided bone regeneration, and soft tissue augmentation. The innovative orthodontic implant site development with labial root torque technique was employed to harness healthy palatal periodontal ligament cells by strategically applying labial root torque in the horizontal labial-palatal direction. This technique uses healthy palatal periodontal ligament cells, which benefits overall periodontal health. The procedure involved gradually shifting hopeless teeth at a rate of 2 mm per month using nickel-titanium wires, thereby maintaining overcorrection for 2 months before extraction. Following successful orthodontic implant site development with labial root torque, the next phase involved guided bone regeneration using a honeycomb-structured titanium membrane. This set the stage for implant placement 6 months later, ensuring a stable foundation for subsequent prosthetic intervention. Soft tissue augmentation was then meticulously performed using an artificial collagen dermis infused with fibroblast growth factor-2, contributing to the overall esthetic outcome. Final prosthesis integration revealed a harmonious blend with the adjacent teeth and gums, underscoring the success of this multidisciplinary approach. This case report provides valuable insights into severe periodontitis in the esthetic field. Our findings highlight the importance of continuously researching and improving procedures for optimal patient care.
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    文章类型: Journal Article
    此病例报告提出了一个具有挑战性的案例,即固定局部义齿的灾难性故障涉及假体以及支撑植入物和牙齿的骨折。机器人的使用促进了患者牙列的有效和成功的恢复。拔除2颗骨折的牙齿和1颗骨折的植入物后,在机器人的触觉指导下放置了2个新的植入物,这允许稳定的截骨术和高初始植入物稳定性商。由于病人的震颤和沉重的咬合力,修复被推迟以允许手术部位愈合,病人接受了临时的局部义齿.随着最终修复的后续放置,治疗在4.5个月内完全完成,只需要一次手术.在这种情况下,触觉机器人的使用允许准确的计划,间距,并放置具有最佳足弓的螺钉固定植入物,为患者带来最佳的长期结果。
    This case report presents a challenging case of catastrophic failure of a fixed partial denture involving fracture of the prosthesis as well as supporting implants and teeth. The use of robotics facilitated efficient and successful restoration of the patient\'s dentition. After extraction of 2 fractured teeth and 1 fractured implant, 2 new implants were placed with haptic guidance from robotics, which allowed for stable osteotomies and high initial implant stability quotients. Due to the patient\'s tremors and heavy occlusal forces, restoration was delayed to allow the surgical site to heal, and the patient received a provisional partial denture. With subsequent placement of the final restoration, the treatment was fully completed in 4.5 months and required only a single surgical procedure. The use of haptic robotics in this case allowed for accurate planning, spacing, and placement of screw-retained implants with an optimal arch, leading to the best long-term outcome for the patient.
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  • 文章类型: Journal Article
    该病例系列评估了使用唇根扭矩(OISD-LRT)进行正畸种植部位发育作为解决7例患者唇骨缺陷的非手术技术的有效性。该程序涉及策略性地在无望的牙齿上放置2-3毫米的多托架,用Ni-Ti线以每月2mm的速度逐渐移动它们,并在提取前保持过校正2个月。OISD-LRT持续增强组织,用于无翼引导植入手术,平均治疗时间为404µ}311.7天。不同阶段的锥形束计算机断层扫描(CBCT)扫描显示垂直和水平骨骼尺寸均增加,尤其是唇骨完全丢失的插座。尽管骨高度和宽度在拔牙后不可避免地减少,保持足够的尺寸以确保植入物的长期稳定性。本系列案例强调了OISD-LRT作为一种有价值的水平骨增强方法的有效性,尤其是唇骨缺损患者。这种方法为随后的植入物放置提供了坚实的基础。展示了其在解决具有挑战性的解剖学条件方面的成功,并为更广泛的种植牙科领域做出了贡献。
    This case series assessed the efficacy of Orthodontic Implant Site Development with Labial Root Torque (OISD-LRT) as a nonsurgical technique for addressing labial bone deficiencies in seven patients. The procedure involved strategically placing a multi-bracket of 2-3 mm apically on the hopeless teeth, gradually shifting them with Ni-Ti wires at the rate of 2 mm per month and maintaining overcorrection for 2 months before extraction. OISD-LRT consistently augmented tissue for flapless guided implant surgery, with an average treatment duration of 404Å}311.7 days. Cone-beam computed tomography (CBCT) scans at various stages revealed increases in both vertical and horizontal bone dimensions, especially in the sockets with complete labial bone loss. Despite inevitable post-extraction reductions in bone height and width, sufficient dimensions were maintained to ensure long-term implant stability. This case series highlights the effectiveness of OISD-LRT as a valuable method for horizontal bone augmentation, particularly in patients with labial bone deficiency. This approach provides a robust foundation for subsequent implant placement, showcasing its success in addressing challenging anatomical conditions and contributing to the broader field of implant dentistry.
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  • 文章类型: Case Reports
    本临床报告探讨了牙种植体修复完全缺牙弓的有效性,专注于全对六的治疗方法。种植体支撑的固定修复体,特别是使用六个植入物,作为无牙患者快速修复的预期且具有成本效益的解决方案,避免骨移植的需要。本报告详细介绍了使用全对六位概念成功康复患者的完全无牙牙弓,强调所涉及的细致计划和执行。它的结论是精确的诊断和植入计划,以及对所有功能的全面关注,对于成功的植入物支持的固定假体至关重要,全对六的概念为萎缩的上颌骨提供了改善的临床和放射学结果。
    This clinical report explores the effectiveness of dental implants for rehabilitating fully edentulous arches, with a focus on the all-on-six treatment approach. Implant-supported fixed restorations, particularly using six implants, are presented as an expected and cost-effective solution for the rapid repair of the edentulous patient, avoiding the need for bone grafting. This report details the successful rehabilitation of a patient\'s completely edentulous arches using the all-on-six concept, highlighting the meticulous planning and execution involved. It concludes that precise diagnostic and implant planning, along with thorough attention to all the features, is crucial for successful implant-supported fixed prostheses, with the all-on-six concept offering improved clinical and radiological outcomes for atrophied maxillae.
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  • 文章类型: Journal Article
    背景:牙周组织与固定假体的结合是假体修复的基础。此前瞻性病例系列旨在通过牙周/种植体周围疾病进展与使用固定局部义齿(FPD)之间的关系来评估牙周健康。
    方法:探测深度(PD),临床依恋水平(CAL),牙龈指数(GI),在长达25年的随访中评估牙齿或植入物的菌斑指数(PI),并与基线进行比较。使用Kaplan-Meier检验进行统计学分析(p^0.05)。
    结果:前瞻性评估显示患者保持了足够的牙周健康。12.5%的患者发生失败(严重的牙周阶段)。107颗牙齿/种植体的存活率为80.48%。临床参数的比较显示没有统计学上的显著差异(p^0.05)。在T1,前部和后部区域的测量,分别,PD=2.7mm和3.1mm;CAL=3.3mm和3.6mm;GI=0.5(两个区域);PI=0.79和0.62。牙周/种植体周围疾病的进展与假体的使用无关。
    结论:随访次数较多、GI和PI较低的患者在较长的时间内表现出牙周健康。口腔卫生水平不同的患者呈现不同的牙周病进展。定期的卫生控制和动机是口腔康复成功的重要因素。
    BACKGROUND: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs).
    METHODS: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05).
    RESULTS: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses.
    CONCLUSIONS: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success.
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  • 文章类型: Case Reports
    The insertion of foreign bodies underneath the skin of the penis is commonly referred to as \"pearling.\" Although rare, there are case reports that describe acute complications such as infection and damage to surrounding penile neurovascular structures; however, there is a paucity of data describing long-term complications and surgical management of such cases. A 43-year-old male presented with a penile abscess secondary to \"pearling\" five years after insertion. His abscess was drained and selected foreign objects were subsequently removed during a simultaneous circumcision procedure. This report describes a case in which surgical removal of penile foreign bodies was performed during a circumcision without the need for additional incisions. The case is unique in that it details a complication five years after initial insertion with microbiological data to guide adequate treatment.
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  • 文章类型: Case Reports
    背景:本研究中的病例有中度牙痛,下侧切牙和左下第二磨牙缺失。II类2级关系与上弓严重拥挤以及骨骼I基部上的创伤性深咬伤使咬合变得复杂。
    方法:该计划是提取上第一前磨牙以减轻上弓拥挤,并提取左下第二前磨牙以保持双侧I类磨牙关系。通过下侧切牙区域的空间开口和上前磨牙和下前磨牙区域的空间闭合,实现了I类咬合关系。
    结果:使用正畸螺钉进行咬合开口和前段回缩,结合括号处方中的双度量时隙大小选择,能有效控制切牙倾角和切角。在开始整理阶段之前使用植入物夹具可以减少总治疗时间,并有助于在脱粘病例之前提供最终假体。因此,患者能够在脱粘当天获得令人满意的封堵。
    结论:通过有效地结合空间封闭和空间开放,成功解决了这种中度牙髓不足的情况。为了解决此类II类2例严重拥挤的拱门问题,需要提取。为了完成这个案子,这与侵入性和回缩力学相结合。在缺牙症病例中,植入物是美学和功能恢复的绝佳选择。
    The case in this study had moderate hypodontia, with both lower lateral incisors and the lower-left second premolar missing. A Class II division 2 relationship with severe crowding in the upper arch and a traumatic deep bite over a skeletal I base complicated the occlusion.
    The plan was to extract the upper first premolars to relieve upper arch crowding and the lower-left impacted second premolar to preserve the bilateral class I molar relationship. A class I occlusal relationship was achieved through space opening in the lower lateral incisors region and space closure in the upper and lower premolars regions.
    The use of orthodontic screws for bite opening and anterior segment retraction, in conjunction with bi-metric slot size selection in bracket prescription, was effective in controlling incisor inclination and interincisal angle. The use of an implant fixture before beginning the finishing stage allowed for a reduction in total treatment time and facilitated the provision of the final prosthesis before debonding the case. As a result, the patient was able to receive a satisfactory occlusion on the day of debonding.
    This case of moderate hypodontia was successfully resolved by combining space closure and space opening effectively. To solve the arch problems in such Class II division 2 cases with severe crowding, extractions were required. To complete the case, this was combined with intrusive and retractive mechanics. In hypodontia cases, implants are an excellent choice for both aesthetics and functional restoration.
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  • 文章类型: Journal Article
    背景:随着牙周病发病率的增加,牙周炎引起的下颌骨游离端水肿在临床上较为常见。通过有限元分析和临床病例报告,评估了不同设计对下颌后端自由端无牙种植假体载荷分布的影响。
    方法:建立了下颌骨后端自由端无食性的有限元模型。考虑到种植位置和选择单冠修复或夹板修复,进行了四次设计,包括模型A:3435×37(由三个植入物支撑的四单元固定桥,植入物位置为34、35、37);模型B:34,35×37,(34:单个植入物冠)(35×37:由两个植入物支撑的三单元固定桥,植入物位置为35,37);模型C:34×3637(由三个植入物支撑的四单元固定桥,植入物位置为34、36、37);模型D:34×36,37(37:单个植入物冠)(34×36:由两个植入物支撑的三单元固定桥,植入位置为34,36)。植入物的应力分布和VonMises应力值,在垂直和45°倾斜载荷下分析牙冠和植入物周围的骨骼。
    结果:皮质骨中的应力主要集中在种植体颈部周围,四个模型的最大VonMises应力(MVMS)在垂直载荷下为11.6-16.1MPa,在45°倾斜载荷下为61.74-96.49MPa。松质骨中的应力集中在植入物基部周围,四个模型的MVMS在垂直载荷下为3.075-3.899MPa,在45°倾斜载荷下为5.021-6.165MPa。修复冠的应力主要集中在桥梁的连接件上,四个模型的MVMS在垂直载荷下为23.38-26.28MPa,在45°倾斜载荷下为53.14-56.35MPa。种植体界面的应力主要集中在桥附近较小的种植体表面,四个模型的MVMS在垂直载荷下为21.12-33.25MPa,在45°倾斜载荷下为83.73-138.7MPa。
    结论:在垂直载荷和45°倾斜载荷下,四种模型的应力分布良好。结合部分牙冠的三单元固定桥的设计可能是设计下颌自由端无牙症患者治疗计划的可用选择。
    BACKGROUND: With periodontal disease having an increasing incidence, mandibular free-end edentulism caused by periodontitis is clinically more common. Finite element analysis and clinical case reports were used to evaluate the influence of different designs on the load distribution of implant prosthesis in mandibular posterior free-end edentulism.
    METHODS: A finite element model of a mandible with posterior free-end edentulism was established. Considering the implant position and selection of single crown repair or splint repair, four designs were conducted including model A: 3435 × 37(four-unit fixed bridge supported by three implants, implant positions were 34, 35, 37); model B: 34,35 × 37, (34: a single implant crown) (35 ×37: three-unit fixed bridge supported by two implants, implant positions were 35, 37); model C: 34 × 3637(four-unit fixed bridge supported by three implants, implant positions were 34, 36, 37); and model D: 34 × 36, 37(37: a single implant crown)(34 ×36: three-unit fixed bridge supported by two implants, implant positions were 34, 36). Stress distribution and the Von Mises stress value of the implants, the crown and the bone around the implants were analyzed at vertical and 45° inclined load.
    RESULTS: Stress in the cortical bone was mainly concentrated around the implant neck, and maximum Von Mises stress (MVMS) of the four models was 11.6-16.1 MPa at vertical load and 61.74-96.49 MPa at 45° inclined load. Stress in the cancellous bone was concentrated around the implant base, and MVMS of four models was 3.075-3.899 MPa at vertical load and 5.021-6.165 MPa at 45° inclined load. Stress of the restoration crowns was mainly concentrated in the connector of the bridge, and MVMS of four models was 23.38-26.28 MPa at vertical load and 53.14-56.35 MPa at 45° inclined load. Stress of the implant interface was mainly concentrated on the surface of the smaller implants near the bridge, and MVMS of four models was 21.12-33.25 MPa at vertical load and 83.73-138.7 MPa at 45° inclined load.
    CONCLUSIONS: There was favorable stress distribution of the four models at vertical load and 45° inclined load. Design of a three-unit fixed bridge combined with a partial crown may be an available option for devising patient treatment plans with mandibular free-end edentulism.
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