implantology

内植学
  • 文章类型: Journal Article
    以深度学习为代表的人工智能在种植牙修复领域备受关注。它广泛应用于手术图像分析,种植计划设计,假体形状设计,和预后判断。本文主要介绍了深度学习在口腔种植修复全过程中的研究进展。分析了当前研究的局限性,并展望了未来的发展方向。
    Artificial intelligence represented by deep learning has attracted attention in the field of dental implant restoration. It is widely used in surgical image analysis, implant plan design, prosthesis shape design, and prognosis judgment. This article mainly describes the research progress of deep learning in the whole process of dental implant prosthodontics. It analyzes the limitations of current research, and looks forward to the future development direction.
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  • 文章类型: Journal Article
    在世界范围内,牙周和种植体周围疾病的患病率一直在增加,并受到了广泛的关注。作为具有类酶活性的多功能纳米材料,纳米酶在生物医学领域赢得了一席之地。在牙周病和种植学中,nanozyme还为维持牙周健康和提高种植成功率的研究做出了巨大贡献。为了突出进展,我们回顾了用于抗菌治疗的纳米酶,抗炎治疗,促进组织再生,以及在牙周和种植体周围疾病中的协同作用。还讨论了纳米酶在牙周学和种植学中的未来前景以及挑战。
    The prevalence of periodontal and peri-implant diseases has been increasing worldwide and has gained a lot of attention. As multifunctional nanomaterials with enzyme-like activity, nanozymes have earned a place in the biomedical field. In periodontics and implantology, nanozymes have contributed greatly to research on maintaining periodontal health and improving implant success rates. To highlight this progress, we review nanozymes for antimicrobial therapy, anti-inflammatory therapy, tissue regeneration promotion, and synergistic effects in periodontal and peri-implant diseases. The future prospects of nanozymes in periodontology and implantology are also discussed along with challenges.
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  • 文章类型: Journal Article
    已证明通过牙槽突入路抬起鼻窦可完美解决上颌骨后部区域的牙槽骨高度不足。然而,无法直接观察手术区域,成像方法是必要的,以揭示手术是否达到了预期的效果。通常在手术前和最终修复前骨整合完成时拍摄锥形束计算机断层扫描(CBCT)图像,并通过测量植骨区域的牙槽骨高度来评估上颌窦提升的效果。然而,在上颌窦抬起前后,没有统一和公认的方法来准确测量植骨区的牙槽骨高度。因此,作者提出了一个简单的,准确,CBCT上颌窦隆起牙槽骨高度测量的可重复性方法,这将是一个创新。
    本研究包括30例植入物病例(30例患者)。作者在CBCT轴向界面中创建了统一的测量表面,以确保完成最终修复前骨整合和手术前的一致性。然后在CBCT冠状和足弓平面上测量鼻窦抬起前后植骨区牙槽骨高度的变化。最后,为了验证可重复性,随机选择我科的3名牙医在3个不同时间点测量并记录上述CBCT数据.
    数据显示,在三位牙医的CBCT测量中,冠状平面和拱形平面均无统计学意义。(P>0.05)。
    这种测量方法简单,准确和可重复。可应用于上颌窦提升前后植骨区牙槽骨高度的测量。
    Sinus lift via the alveolar crest approach has been proven to solve inadequate alveolar bone height perfectly in the posterior region of the maxilla. Nevertheless, the surgical area cannot be directly observed, imaging methods are necessary to reveal whether the surgery has achieved the expected results. Cone-Beam Computed Tomography (CBCT) images are usually taken before surgery and at the completion of final pre-repair osseointegration and evaluate the effect of maxillary sinus lift by measuring the alveolar bone height in the bone graft area. However, there is no uniform and recognized method to accurately measure the alveolar bone height in the bone grafting area before and after maxillary sinus lift. Therefore, the authors propose a simple, accurate, and reproducible method for the measurement of alveolar bone height in maxillary sinus lift on CBCT, which will be an innovation.
    30 implant cases (30 patients) were included in this study. The authors create a uniformed measurement surface in the CBCT axial interface to ensure consistency at the completion of final prerepair osseointegration and before surgery. Then changes in alveolar bone height in the bone grafting area before and after sinus lift were measured on CBCT coronal and arch planes. Finally, for the purpose of verification of repeatability, three dentists from our department were randomly selected to measure and record the above CBCT data at three different time points.
    The data showed that in the CBCT measurements of the three dentists, neither the coronal plane nor the arch plane was statistically significant. (P > 0.05).
    This measurement method is simple, accurate and repeatable. It can be applied to measure alveolar bone height in the bone grafting area before and after maxillary sinus lift.
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  • 文章类型: Journal Article
    由于综合生理过程的复杂性,用于临床应用的骨移植物或假体植入物设计具有挑战性。纳米技术在生物材料领域的革命性进步加速并认可了功能性骨移植和植入物设计中当前尚未解决的复杂性。稀土(RE)材料因其独特的生物相容性而成为组织工程中新兴的生物材料,荧光上转换,抗菌,抗氧化剂,和抗炎特性。在过去的二十年中,研究人员开发了各种RE智能纳米生物材料,用于骨组织工程和植入学应用。此外,研究人员已经探索了RE材料介导的组织再生的分子机制。微米或纳米级稀土材料在生物医学应用中的最新进展为开发新型稀土材料奠定了基础,具有成本效益的骨组织工程策略。本文综述了RE纳米材料在骨组织工程和种植方面的技术创新,血管生成,免疫调节,抗氧化剂,体内骨组织成像,各种稀土纳米材料的抗菌性能,以及参与这些生物事件的分子机制。Further,我们进一步讨论了RE智能纳米生物材料在骨组织工程和种植学领域的挑战和前景。
    Bone grafts or prosthetic implant designing for clinical application is challenging due to the complexity of integrated physiological processes. The revolutionary advances of nanotechnology in the biomaterial field expedite and endorse the current unresolved complexity in functional bone graft and implant design. Rare earth (RE) materials are emerging biomaterials in tissue engineering due to their unique biocompatibility, fluorescence upconversion, antimicrobial, antioxidants, and anti-inflammatory properties. Researchers have developed various RE smart nano-biomaterials for bone tissue engineering and implantology applications in the past two decades. Furthermore, researchers have explored the molecular mechanisms of RE material-mediated tissue regeneration. Recent advances in biomedical applications of micro or nano-scale RE materials have provided a foundation for developing novel, cost-effective bone tissue engineering strategies. This review attempted to provide an overview of RE nanomaterials\' technological innovations in bone tissue engineering and implantology and summarized the osteogenic, angiogenic, immunomodulatory, antioxidant, in vivo bone tissue imaging, and antimicrobial properties of various RE nanomaterials, as well as the molecular mechanisms involved in these biological events. Further, we extend to discuss the challenges and prospects of RE smart nano-biomaterials in the field of bone tissue engineering and implantology.
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  • 文章类型: Journal Article
    使用锁定锥形植入物进行修复是一种广泛使用的方法。然而,锥形连接系统,如锁定锥形植入系统很少被检查。这项研究提供了锁定锥度固定修复的回顾性调查,主要关注假肢并发症。
    检查了2008年至2010年接受锥形连接植入物治疗的患者。根据Bicon系统的标准程序进行植入位点的制备。骨愈合需要超过6个月,此后开始了假肢手术。使用了集成的基牙冠或金瓷冠,假体类型为单冠或固定假体。一旦王冠到位,它的闭塞被彻底检查和调整,然后将表冠上釉或精细抛光。使用Kaplan-Meier方法计算5年和10年的累积无并发症率。此外,Cox回归模型用于确定独立影响结果的因素.还研究了植入物的存活和边缘骨丢失。
    从2008年到2010年,共检查了392例患者,这些患者接受了541种植入物和434种基于锁定锥形植入物的修复。总体5年累积无并发症率为83.34%。最常见的假肢并发症是贴面碎裂,频率为67.53%。根据Cox回归模型,整合基牙冠的无并发症率明显高于金瓷冠,磨牙区明显高于前磨牙区,女性明显高于男性。只有三次植入物失败,和1年时的平均边际骨损失值,5年和10年为0.25mm(95%CI±0.12),0.40mm(95%CI±0.03)和0.51mm(95%CI±0.05),分别。
    贴面碎裂是锁定锥形种植体支撑固定修复体最常见的并发症。IAC的并发症发生率明显高于GPCs。年龄,location,和假体类型不是假体并发症的决定因素。此外,锁定锥形种植体的长期临床效果可以满足临床需要。植入物周围的骨组织水平可以保持长期稳定性。
    Restoration with locking-taper implants is a widely used methodology. However, conical connection systems such as locking-taper implant systems have rarely been examined. This study provides a retrospective investigation of locking-taper fixed restorations, mainly focusing on prosthetic complications.
    Patients undergo treatment with conical connected implants from 2008 to 2010 were examined. Preparation of the implant sites was performed according to the standard procedures for the Bicon system. Bone healing took over 6 months, and the prosthetic procedure was initiated thereafter. Integrated abutment crowns or gold porcelain crowns were used, and the prosthesis type was a single crown or a fixed dental prosthesis. Once the crown was in place, its occlusion was thoroughly checked and adjusted, and then the crown was glazed or finely polished. The Kaplan-Meier method was used to calculate the cumulative complication-free rates for 5 and 10 years. Additionally, a Cox regression model was used to identify the factors that independently influenced the results. Implant survival and marginal bone loss were also investigated.
    A total of 392 patients who underwent 541 implants and 434 locking taper implant-based restorations from 2008 to 2010 were examined. The overall 5-year cumulative complication-free rate was 83.34%. The most common prosthetic complication was veneer chipping, with a frequency of 67.53%. According to the Cox regression model, the complication-free rate of integrated abutment crowns was significantly higher than that of gold porcelain crowns, that of molar regions was significantly higher than that of premolar regions, and that of females was significantly higher than that of males. Only three implant failures happened, and the mean marginal bone loss values at 1- year, 5-years and 10- years were 0.25 mm (95% CI ± 0.12), 0.40 mm (95% CI ± 0.03) and 0.51 mm (95% CI ± 0.05), respectively.
    Veneer chipping was the most common complication with locking-taper implant-supported fixed restorations. The incidence of complications for IACs is significantly higher than that for GPCs. Age, location, and prosthesis type are not determinants of prosthetic complications. Besides, the long-term clinical effect of locking-taper implant can meet the clinical needs. The bone tissue level around the implant can maintain long-term stability.
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  • 文章类型: Journal Article
    BACKGROUND: Large antroliths and those located adjacent to the sinus floor can affect clinical interventions and increase the difficulty of implant placement performed simultaneously with osteotome sinus floor elevation surgery.
    OBJECTIVE: This retrospective study investigated the clinical outcomes of implants placed simultaneously with osteotome sinus floor elevation subjacent to maxillary antroliths.
    METHODS: Twenty implants inserted subjacent to or intruding into the antrolith after sinus floor elevation were evaluated in 18 patients. Cone-beam computed tomography (CBCT) was used to measure antrolith size and membrane thickness at sites of osteotome sinus floor elevation. Periapical radiographs were used to assess the height of grafted bone. Generalized estimating equation (GEE) analysis was performed to correlate the occurrence of antroliths with patient background characteristics and dental outcomes, based on a sample population of 239, among whom 33 presented antroliths.
    RESULTS: The 20 implants remained clinically stable over a mean follow-up period of 42.4 months. The mean thickness of the sinus membrane at osteotome sites was 5.4 ± 3.3 mm. None of the cases presented sinus membrane perforation or sinus symptoms following osteotome intervention. The mean gain in the height of grafted sinus bone was 4.0 ± 1.4 mm at the last follow-up. The occurrence of antroliths was higher among females and the elderly (>49 years old). The multivariable GEE analysis showed that the adjusted odds ratio for the occurrence of antroliths with root canal fillings was significantly lower than those without root canal fillings (odds ratio = 0.33; 95% confidence interval = 0.11-0.96).
    CONCLUSIONS: Our findings indicate that osteotome sinus floor elevation is a surgical procedure with a risk <17%. Thorough planning based on CBCT and careful management during surgery can eliminate the negative effects of antroliths on implant performance.
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  • 文章类型: Journal Article
    Bone debris generated during site preparation is generally evacuated with irrigation; here, we evaluated whether retention of this autologous material improved the rate of peri-implant bone formation.
    In 25 rats, a miniature implant system composed of an osseo-shaping tool and a tri-oval-shaped implant was compared against a conventional drill and round implant system. A split-mouth design was used, and fresh extraction sockets served as implant sites. Histology/histomorphometry, immunohistochemistry, and microcomputed tomography (μCT) imaging were performed immediately after implant placement, and on post-surgery days 3, 7, 14, and 28.
    Compared with a conventional drill design, the osseo-shaping tool produced a textured osteotomy surface and viable bone debris that was retained in the peri-implant environment. Proliferating osteoprogenitor cells, identified by PCNA and Runx2 expression, contributed to faster peri-implant bone formation. Although all implants osseointegrated, sites prepared with the osseo-shaping tool showed evidence of new peri-implant bone sooner than controls.
    Bone debris produced by an osseo-shaping tool directly contributed to faster peri-implant bone formation and implant osseointegration.
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  • 文章类型: Journal Article
    背景:上颌骨前部的天然牙齿对于确定单植入物假体的美学效果至关重要。
    目的:本研究旨在使用粉红美学评分/白色美学评分(PES/WES)指数探索上颌骨前牙的美学。此外,还考虑了天然牙齿的固有弱点和假体的高风险参数。
    方法:本横断面研究通过照相分析进行。
    结果:总共102名受试者和306颗牙齿(右门牙,包括侧切牙和犬齿)。PES和WES的总平均值分别为12.92和8.75。软组织边缘的评分,软组织轮廓和牙冠轮廓/体积明显低于其他变量。PES和WES随年龄增长呈下降趋势。女性的PES/WES值大多数超过男性。
    结论:PES和WES评估中天然牙齿的平均水平分别约为13和9。软组织边缘,软组织轮廓和牙冠轮廓/体积是植入物重建美学结果的高风险参数。潜在因素,比如年龄和性别,有助于自然牙齿变化的美学。
    BACKGROUND: Natural teeth in the anterior maxilla are critical in determination the esthetic outcome of single implant prosthesis.
    OBJECTIVE: The present study aimed to explore aesthetics of natural teeth in the anterior maxilla using the Pink Esthetic Score/White Esthetic Score (PES/WES) index. Additionally, inherent weak spots of natural teeth and high-risk parameters of prostheses were also considered.
    METHODS: This cross-sectional study was performed by photographic analysis.
    RESULTS: A total of 102 subjects and 306 teeth (the right incisor, lateral incisor and canine) were included. The grand means of the PES and WES were 12.92 and 8.75, respectively. The score of soft tissue margin, soft tissue contour and outline/volume of the crown were significantly lower than other variables. The PES and WES showed a downward trend with age. Most of the PES/WES values of the females exceeded those of the males.
    CONCLUSIONS: The average level of natural teeth in PES and WES assessment were around 13 and 9, respectively. The soft tissue margin, soft tissue contour and outline/volume of the crown were high-risk parameters for the esthetic outcomes of implant reconstructions. Underlying factors, such as age and gender, contributed to the esthetics of natural teeth change.
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  • 文章类型: Journal Article
    Bone condensation is thought to densify interfacial bone and thus improve implant primary stability, but scant data substantiate either claim. We developed a murine oral implant model to test these hypotheses. Osteotomies were created in healed maxillary extraction sites 1) by drilling or 2) by drilling followed by stepwise condensation with tapered osteotomes. Condensation increased interfacial bone density, as measured by a significant change in bone volume/total volume and trabecular spacing, but it simultaneously damaged the bone. On postimplant day 1, the condensed bone interface exhibited microfractures and osteoclast activity. Finite element modeling, mechanical testing, and immunohistochemical analyses at multiple time points throughout the osseointegration period demonstrated that condensation caused very high interfacial strains, marginal bone resorption, and no improvement in implant stability. Collectively, these multiscale analyses demonstrate that condensation does not positively contribute to implant stability.
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  • 文章类型: Journal Article
    BACKGROUND: Implant dentistry is a treatment modality which has mainstream clinical practice of comprehensive care, which however is not adequately represented in the undergraduate dental curricula. A consensus workshop organised by ADEE in 2008, set the benchmarks for the knowledge and competences a modern dental practitioner must possess with regard to implant dentistry, as well as defined undergraduate and postgraduate pathways for the acquisition of these competences. Today, 5 years later, there exist several challenges for the implementation of these benchmarks in both undergraduate curricula but also post-graduation educational pathways.
    METHODS: A consensus workshop was organised by ADEE, bringing together 48 opinion leaders, including academic teachers of all disciplines related to implant dentistry, specialists, representatives of relevant scientific and professional associations, as well as industry delegates. The objectives of the workshop were to evaluate the existing scientific literature, reported experience and best practices in order to identify potential and limitations for the implementation of implant dentistry in the undergraduate curriculum, as well produce recommendations for the optimal educational structures for postgraduate programmes and continuing professional development.
    RESULTS: The scientific committee conducted two European-wide questionnaire surveys to better document the current state of education in implant dentistry. Upon completion of the surveys, reviewers were appointed to produce three scientific review papers, identifying current achievements and future challenges. Finally, during the 3 days of the workshop, all the evidence was reviewed and the main conclusions and recommendations that were adopted by all participants are reported in the present Consensus Paper.
    CONCLUSIONS: Implementation of implant dentistry in the undergraduate curriculum has improved significantly, but still lags behind the benchmarks set in 2008 and the diversity between institutions remains big. At the post-graduation level, there is currently a wide diversity of courses and pathways towards competences related to implant dentistry and there is at present a great need for quality assurance, as well as standardisation and transparency of the learning outcomes.
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