骨诱导术在牙种植骨量不足病例的临床应用

目的:探讨应用诱导骨组织再生技术在种植牙时颌骨骨量不足的临床应用研究。方法:选择35例在种植手术时,种植体周围骨量不足的患者,采用可吸收胶原膜(Bio-Gide)和骨粉(Bio-Oss)行诱导骨组织再生,观察其促进颌骨再生和种植体骨整合的临床效果。结果:经6～18个月的临床观察和放射X线片检查,种植体周围骨缺损区骨组织再生情况良好,种植体稳定。结论:采用可吸收胶原膜(Bio-Gide)和骨粉(Bio-Oss)诱导再生技术用于种植牙术骨量不足的患者,可成功诱导骨组织再生、重建缺损的骨组织,促进种植体与新生骨组织形成良好的骨性结合。     

上颌窦区骨量不足3mm植骨后同期种植临床效果分析

目的:探讨在上颌窦区骨量不足3 mm的情况下,进行上颌窦底提升术并植骨同期将种植体植入的临床效果.方法:选择复旦大学附属中山医院和静安区牙病防治所2012年4月1日-2015年12月31日上颌后牙缺失患者56例,剩余牙槽骨高度均小于3 mm,术中行上颌窦底提升术并植骨,同期将种植体植入.术后3、6、12个月定期随访,分析及评估术后愈合效果及骨结合情况.结果:56例患者共植入72颗种植体,随访期间,种植体与周围骨组织结合良好,种植体稳定.术后6个月行种植修复,均能正常行使咀嚼功能,牙龈无形态、色泽异常,无并发症发生,手术成功率为100％.结论:对于上颌窦底骨量不足3 mm的患者,术中行上颌窦底提升术并植骨同期将种植体植入,也能取得良好的治疗效果.     

倍骼生用于牙槽骨量不足的同期牙种植修复的临床观察

目的:评估倍骼生用于骨量不足的牙种植术的临床效果。方法:对22例存在骨量不足的种植牙患者,在植入36颗种植体的同时,采用倍骼生恢复种植体周围的骨缺损。结果:22例中无一例出现手术切口感染及种植体脱落,6～8个月后X线检查提示种植体周围的骨结合好,修复效果好。结论:倍骼生可以较好的修复种植体周围的骨缺损,不但可以扩大种植牙的适应证,而且可以使种植体获得较好的轴向和位置。     

前牙即刻种植2年临床观察

目的 评价前牙区即刻种植义齿2年的临床效果。方法 2005年8月—2008年11月,行前牙区即刻种植治疗患者18例,共植入种植体24颗。完整随访24个月,通过临床检查、X线检查及患者满意度调查,统计分析在种植体植入后周围龈沟深度、牙龈指数、种植体松动度及种植体周牙槽骨的吸收情况并调查患者对种植牙临床效果的满意度。结果 通过2年的临床观察,种植体周围龈沟深度及牙龈无异常,种植体无松动,X线检查种植体周围无透射影区,种植体植入第1年骨吸收量<2.0 mm,第2年骨吸收量<0.2 mm,临床2年存留率达100%,患者对种植牙临床效果总体满意度为91.7%。结论 前牙即刻种植的近期临床效果满意,远期效果有待观察。     

短种植体在骨量不足时种植的临床效果

目的 观察短种植体在骨量不足时种植的成功率及临床效果。方法 选择2005年1月—2010年10月在银川市口腔医院就诊患者中因骨量不足而采用短种植体植入术的65例患者,骨高度在6～9 mm之间,共植入105颗种植体。经过3～6个月的愈合期后行二期修复。结果 经过1～6年的随访,65例患者105颗种植牙全部获得很好的骨结合并完成修复。在随访期间未发生种植体的松动、脱落,未发生种植体周围组织炎。所有患者对修复效果满意。结论 短种植体植入术是颌骨骨量不足时的一种很好的选择,可以简化手术,减轻患者术后反应,缩短治疗时间。     

骨劈开、骨挤压联合GBR技术同期植入种植体的临床疗效评价

目的:采用CBCT及临床检查的方法评价骨劈开、骨挤压联合GBR技术同期植入种植体的的临床疗效。方法:采用CBCT检查术前牙槽骨的形态和骨量,唇舌向牙槽骨厚度介于2.5-4mm的病例适用这种技术。方法如下:使用1.0mm细钻针作为引导钻沿种植体拟植入方向钻入所需深度,然后使用骨劈开器沿钻孔方向劈开牙槽嵴,使用BICON手用扩孔器械逐级备洞,并挤压劈开的唇侧骨板,收集自体骨骨屑,同时撑开牙槽骨增加宽度,植入种植体。在骨质缺损区暴露的种植体表面和较薄的唇侧骨板表面先铺放获得的自体骨屑,然后再铺放人工骨粉,最后以胶原膜覆盖植骨区。6个月后,CBCT复查,完成修复。随访2年。结果:40例患者接受了这种骨增量技术治疗,共植入56颗种植体,均获得成功,平均增加牙槽骨宽度3.5mm。讨论:牙缺失后常常造成骨量不足,单一技术的运用不能获得良好的骨增量效果。骨劈开、骨挤压联合GBR技术是一种综合性的微创骨增量技术,获得了肯定的临床效果。结论:骨劈开、骨挤压联合GBR技术并同期植入种植体是一种有效的骨增量种植方式。     

上颌窦内提升植骨同期植入Endopore种植体临床评价

目的 评价上颌窦内提升植骨同期植入Endopore种植体临床效果。方法 20例上颌后牙缺失，因牙槽骨高度不足，采用上颌窦内提升植骨，同期植入Endopore种植体28枚。术后6-9个月行种植义齿修复。结果 28枚种植体植入后伤口一期愈合，无上颌窦炎发生，义齿修复后行使咀嚼功能6-36个月，种植体稳定。X线检查植骨改建成新骨并与种植体形成紧密结合。结论 对牙槽骨高度不足的上颌后牙缺失，经上颌窦内提升植骨同期植入Endopore种植体，近期成功率高，方法简便。     

Bicon短种植体在上颌后牙区骨量不足病例中的临床应用

目的：评估Bicon短种植体在上颌后牙区骨高度不足病例种植修复的临床效果。方法：选择上颌后牙区骨高度1．7—8ram的病例62例,共植入Bicon短种植体252枚,其中植入长度6ram的种植体192枚,长度8mm的种植体60枚。其中上颌窦区牙槽骨高度不足的患者行经牙槽嵴上颌窦底提升术同期植入种植体,部分植体使用上颌窦基台固位。3—6个月后完成永久修复。结果：62例252枚Bicon短种植体均获得了良好的骨结合,9—26个月的随访观察及X光片和牙科CT检查,临床效果良好,种植体周围骨组织稳定。结论：Bicon短种植体在上颌后牙区骨量不足病例种植修复中临床效果肯定。     

骨挤压联合骨引导再生术在上颌前牙种植中的应用

目的 评价上颌前牙区牙槽骨吸收的患者应用骨挤压联合骨引导再生术行种植体植入的临床效果。方法 16例上前牙单牙缺失伴牙槽骨萎缩的患者，应用骨挤压联合骨引导再生术植入16颗种植体，术后6个月暴露种植体，最终完成烤瓷冠修复。结果 术后无明显并发症发生，修复完成后观察7～26个月，种植体行使功能良好，无种植体丧失。结论 对上颌前牙区牙槽骨吸收的患者，应用骨挤压联合骨引导再生术行种植体植入，可改善牙槽骨质，保存骨量，临床效果良好。     

上颌前牙区骨挤压联合骨引导再生同期种植术的应用

目的：评价上颌前牙区骨挤压联合骨引导再生同期种植术的临床效果.方法：对14例上前牙缺失、牙槽骨厚度为3mm-4mm的患者,联合采用骨挤压、骨引导再生技术,植入Frialit-2种植体17颗,于植入后6个月行二期手术,同时测量牙槽嵴顶增宽的厚度,最终完成烤瓷冠修复.结果：本组共17颗种植体,术后均无明显并发症发生,牙槽嵴顶增宽的厚度平均为2.8mm±0.6 mm,修复完成后观察12-20个月,种植体行使功能良好,无一种植体松动或脱落.结论：对于上颌前牙区牙槽骨吸收的患者,采用骨挤压联合骨引导再生术后行种植体植入,可改善牙槽骨质量,获得满意的近期临床效果.     

Aneurysmal bone cyst of the sphenoid bone

Aneurysmal bone cyst (ABC) is an uncommon benign lesion that rarely presents in the craniofacial region. Aneurysmal bone cysts represent nearly 1.4% of all bone tumors, and among those, only 3% are located in the cranium. In this study, we report on an ABC located in the sphenoid bone with superior nasal cavity and ethmoid extension. The presenting symptom of our patient was headache, followed by diplopia, loss of visual accuracy, and abduction restriction. We successfully resected the lesion by a combined subcranial-midfacial degloving approach without any complications or recurrence.     

Particulated bone grafts--effectiveness of bone cell supply

OBJECTIVE: The objective of this study was to measure the amount of viable bone cells present in different types of bone graft. MATERIAL AND METHODS: Bone chips were harvested from the trabecular or cortical bone of the mandible or the iliac crest and either milled or not. The average size of unmilled bone particles was 5 x 5 x 5 mm and that of milled was 2 x 2 x 2 mm. Drill sludge was obtained using either a ball reamer, a diamond ball or an implant drill (the latter from mandibular bone and of average dimension 1 x 1 x 1 mm). A measure of 0.5 g of each category was cultured in Dulbecco's modified Eagle's medium with additives for four weeks. Cell counts were performed. An analysis of the osteocalcin synthesis, the alkaline phosphatase (ALP) activity, the collagen types and the concentration of bone-specific collagen cross-links in medium supernatants was performed. RESULTS: Cells stained positively for osteocalcin and ALP in all groups. Bone-specific collagen cross-links could be quantified and collagen of types I and V was present with no difference in all groups. Unmilled spongy bone chips revealed greater cell counts than milled (P<0.05). Spongy bone chips revealed greater cell counts than cortical bone chips (P<0.05). Drill sludge obtained by hard alloy ball reamer showed the least amount of viable cells (P<0.05). CONCLUSIONS: Bone milling reduces the quantity of osteoblasts. Bone obtained by the ball reamer supplies a smaller number of cells than bone obtained by other methods. Unmilled spongy bone chips appear to offer the greatest amount of viable osteoblasts.     

Aneurysmal bone cyst of the zygomatic bone

Aneurysmal bone cysts are a rare finding in the facial bones and jaws. Only one previous case of this entity affecting the malar bone could be found in the literature. Ultrasound and isotope scan features of this entity are described.     

Oncological treatment of bone tumours and bone metastases

The majority of patients with a malignant bone lesion will have bone metastases from a distant primary tumour. This could be apparent at diagnosis or develop later in the course of the disease. Some primary tumour types are more likely than others to develop bone secondaries. This common clinical problem requires a multidisciplinary approach in order to reduce patient suffering and maintain quality of life. Almost all patients with metastatic bone disease will have incurable cancer and this needs to be acknowledged when considering treatment options. Conversely primary malignant bone tumours are relatively rare conditions and thus need to be managed by specialist centres. Multimodality, multiprofessional treatment is required which may last for many months and can be associated with considerable toxicity. Patients with localized disease can be cured but there remains a high risk of both local recurrence and metastases.     

可吸收性引导骨再生胶原膜治疗骨缺损的实验研究

本研究是对国产吸收性胶原膜的骨引导再生,在骨缺损上应用的有效性方面进行实验研究。方法在实验动物成年犬的颌骨左右侧形成骨缺损,实验侧的骨缺损上覆盖吸收性胶原膜,对照侧没有覆盖,实验期间分别为２周、６周、１２周的取出下颌骨;     

HA人工骨修复较大颌骨囊肿骨腔的临床探讨

本文对近10年来应用HA修复颌骨囊肿186例，及其中较大颌骨囊肿34例，进行了较系统的临床研究。手术切口一期愈合、外形满意27例（79．5％），较明显颗粒逸漏21例（61.7%），迟发性血清肿4例（2.9％）。并对4例单囊性角化囊肿用液氮冷冻后HA修复，经3年以上随访无复发。     

Relationship between bone mineral density and bone stiffness in bone fracture

Objectives Using cancellous bone blocks of racehorses, the relationship between bone mineral density (BMD), which indicates bone strength, and stiffness in bone fracture occurrences was studied.Methods Two groups of cancellous bone blocks were prepared: a fractured group, using the first phalangeal bones of seven racehorses with sagittal fractures; and a nonfractured group, using the first phalangeal bones of nine autopsied racehorses without any fractures. By a peripheral quantitative computed tomography scan, the BMD values were shown as color images and evaluated. In addition, the BMD values obtained from the fractured and nonfractured groups were compared with the stiffness values obtained from a compression test.Results The difference between the average BMD values of the fractured and nonfractured groups was easily observed on the BMD color-conversion display image. The average BMD of the fractured group (472.1 mg/cm³) was significantly higher than that of the nonfractured group (284.5 mg/cm³, P = 0.005). Moreover, the average stiffness of the fractured group (5564.5 N/cm) was significantly higher than that of the nonfractured group (3808.6 N/cm, P = 0.008).Conclusion These results suggest that the occurrence of a fracture does not depend on the BMD or the bone stiffness value.     

The effcct of eel bone powder on bone mineral density in mouse femoral bone

Improvement in bone mineral density (BMD) in the femur after administration of eel bone powder (EBP) was evaluated in ovariectomized (OVX) mice. Female ICR mice were given ovariectomies or sham operations at 9 weeks of age, then housed for 2 weeks during which they were allowed free access to a normal diet. Subsequently, the mice were divided into 3 groups: sham-operated mice fed a normal diet, OVX mice fed a normal diet, and OVX mice fed a diet containing EBP. After the mice in these 3 groups had been housed for 2 months (during which time they were allowed free access to their respective diets), they were dissected and analyzed. The BMD values in the removed femurs were measured by peripheral quantitative computed tomography (pQCT). Femoral total and femoral cancellous BMD values were higher in the EBP-treated group than in the nontreated group. Total BMD: the value in the EBP-treated group was 573 mg/cm³, and that in the non-treated group was 451 mg/cm³ (p<0.05). Cancellous BMD: the value in the EBP-treated group was 242 mg/cm³, and that in the non-treated group was 143 mg/cm³ (p<0.05). However, cortical BMD values did not significantly differ between the EBP-treated group and the non-treated group. Cortical BMD: The value in the EBP-treated group was 1891 mg/cm³, and that in the non-treated group was 1900 mg/cm³. pQCT was used to measure the cortical and cancellous BMD in the long bones. By use of a color conversion technique to display BMD, regional changes in the long bones can be expressed and easily measured. It has been well documented that EBP is effective for improvement or prevention of BMD reduction associated with OVX.