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.     

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.     

Rehabilitation of a bulimic patient using endosteal implants

This article describes the dental rehabilitation of a bulimic patient using endosteal implants. Although the patient, a 31-year-old woman with a long history of bulimia nervosa, had been receiving medical and psychological treatment, the condition was not completely controlled. Clinical examination revealed multiple crowns with extensive cervical caries. The prognosis for all remaining teeth was poor. After extractions, implant therapy was implemented to provide support for fixed prostheses. After the implants were uncovered and during provisional therapy, the peri-implant tissue exhibited inflammation and lack of keratinized tissue requiring additional periodontal procedures before definitive restorations could be placed. Because of the difficulty in managing the peri-implant tissue during the many phases of implant therapy, treatment was challenging. One year after treatment, the patient's low self-esteem had improved substantially and her restorations provided satisfactory esthetics and function.     

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.     

A statistical evaluation of 952 endosteal implants in humans.

Of the 952 alloplastic endosteal implants studied for up to 108 months, only the endodontic endosteal implant demonstrated long-range success. A success rate of 49% after 72 months was found in all but the endosteal implants. The evaluation of individual implant designs demonstrated that long, straight shaft lengths such as the transosteal impland survived for long periods. Future efforts should be applied to studies on the use of porous metals, polymers, ceramics, and carbons in laboratory animals, to evaluate attachment phenomena and stability of the gingival cuff. In this manner, we may establish reliable standards and procedures that may be used confidently by the practitioner.     

Wound healing of endosteal vitreous carbon implants in dogs.

Endosteal vitreous carbon implants are biocompatible and were well-tolerated by the alveolar process of dogs but were not accepted by the gingival margin and the mucosa. A continuous gingival recession with 2 to 3 mm sulcus depth was not similar to that around adjacent natural teeth. There was no epithelial attachment around the neck of vitreous carbon implants, and there was very little or no resistance to probing. The feasibility of using vitreous carbon as it presently exists for the maintenance and preservation of alveolar bone is unfavorable and should be revised. Endosteal vitreous carbon implants require more intense laboratory and clinical studies. Therefore, the practical value of the vitreous carbon implant is questionable, and further investigations are needed before vitreous carbon can be declared acceptable in clinical dental practice.     

The clinical use of polymer-coated metal pins as endosteal implants

The polymer-coated metal pin, its fabrication, and use for treating patients have been described. It gives promise of being the most effective and safe type of implant that can be used for long-term fixed partial denture support.