非炎性骨内埋伏牙根与种植义齿

非炎性骨内埋伏牙根是指被牙龈和牙槽骨覆盖的局部无炎症的残根,通常是拔牙后或外伤后残留于牙槽骨内,这类残根不能用于桩核冠修复.在该埋伏牙根处要进行种植义齿修复,笔者认为应根据残根的位置和来考虑是否拔除.若残根近牙槽骨顶且拔除后不会使骨组织丢失太多而影响种植效果,可考虑拔除,若残根离牙槽骨顶较远且小,通过巧妙设计不影响种植体的植入方向.如果对非炎性骨内埋伏牙根都采用拔除后在进行种植,可能会导致牙槽骨大量丢失,影响种植效果或需要植骨,后者会延长患者的治疗时间、就诊次数和费用.对于此类非炎性埋伏牙根可考虑保留并仍埋伏在牙槽骨内,根据具体缺牙状况进行种植设计.一是在埋伏牙根牙位处巧妙设计植入种植体,二是不在埋伏牙根牙位处植入种植体,而是采用种植体支持或种植体与天然牙联合支持修复缺牙.笔者对这类非炎性埋伏牙根予以保留,进行种植义齿修复12例病例,观察1～15年,未发现由于非炎性埋伏牙根保留所引起的不良后果,临床效果良好.保留非炎性埋伏牙根可防止牙槽骨的丢失,缩短修复时间,减少患者的痛苦和费用.     

非埋植型骨内牙种植体的临床应用

目的：分析在口腔内植入非埋殖的骨内种植体后,上部即刻修复与否的临床结果。方法：在口腔前牙区和后牙区分别植入CDIC纯钛骨内种植体,前后牙区各分成两组,一组不做即刻上部修复体,另一组制做无咬He关系的即刻上部修复体。结果：经过36个月后观察,前牙区两组无差异,后牙区两组有显著差异。结论：在前牙区种植后可即刻行无咬He状态的上部结构修复,在后牙区则相反。     

Rational use of endosteal implants

Criteria for the application and design of implants have been discussed. Various applications of endosteal implantscan be useful in selected patients.     

Mandibular fractures associated with endosteal implants

Purpose

The purpose of this study is to report four cases of mandibular fractures associated with endosteal implants and to discuss prevention and treatment of these types of fractures.

Discussion

To evaluate whether the patient's anatomy allows insertion of implants, radiological exams that demonstrate the height and the labial–lingual width are needed. To reduce the potential fracture problem, the mandible can be restrengthened with bone grafting techniques. The treatment of a fracture in an atrophic mandible is always a challenge because of the diminished central blood supply, the depressed vitality of the bone, and the dependence on the periosteal blood supply. The basic principles in fracture treatment are reduction and immobilization of the fractured site for restoration of form and function.

Conclusions

If implants are placed in severe atrophic mandible, iatrogenic fracture of the mandible may occur during or after implant surgery because implant placement weakens the already-compromised mandible. A few millimeters of cortical bone should remain on both the labial and the lingual sites after the hole for insertion of an implant has been drilled. A 3-D surgical planning should be recommended at least in severe atrophic mandibles in order to prevent a severe reduction of bone tissue.     

Immediate-loading dental endosteal implants and the elderly patient

The concept of immediately loading dental implants has the potential of being a viable addition to treatment modalities. The major decision-making challenge in managing depleted dentitions and complete edentulism in an aging society lies in differentiating the treatment outcomes, especially patient-mediated assessments (including economic analyses) of the various prosthodontic options available for older adults. The ability to chew properly is of great importance to maintain a healthy nutrition and improve oral comfort and quality of life, particularly in the elderly years.     

ITI endosteal hollow cylinder implant systems

The endosteal hollow cylinder implant systems have been in clinical use for over 10 years. These systems incorporate advanced sophisticated biomaterials and bioengineering design concepts such as the titanium plasma spray (TPS) surface coating as well as the cylindric shape. This shape has now introduced the third dimension to dental implantology. In previous systems, such as the blade-vent, only height and width were present. Therefore, these previous systems could not be used as single-tooth replacements; also, they were not able to withstand lateral forces or torquing. In a series of cases reported from Switzerland, Sweden, Germany, and the United States, 580 hollow cylinder implants were placed for up to 10 years with an overall rate of success of 95.3 per cent.     

Ridge-lapping restorative crowns over endosteal and subperiosteal implant abutments

Crowns on countless dental implant abutments have been successfully ridge lapped for over 25 years. When properly fabricated, ease of cleansing and maintenance of health at the pergingival site is routine. The advantages of this technique are significant. It promotes pleasing aesthetic results almost regardless of the vestibulo-lingual and mesio-distal location of the abutment relative to the required position of the crown. The technique-sensitive procedures associated with the creation and maintenance of acceptable emergent profiles are rendered unnecessary. Ridge lapping is compatible with abutment heads of any diameter and configuration and with cementable or screw-retained fixed prostheses. This article discusses current opinion and controversy regarding ridge lapping of crowns over implant abutments and offers step-by-step procedures in the diagnosis, design, fabrication, and professional and home care maintenance of highly aesthetic ridge-lapped crowns over abutments of the common dental implant modalities.     

A technique for using endosteal blade implants

A technique for insertion of an endosteal blade implant and its use as a retainer for a fixed partial denture have been described. Careful planning for the location of the implant, good surgical procedures, and attention to proper detail in fixed partial denture construction are essential to success of blade implants.