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Objective@#To explore the treatment options for congenitally missing teeth in patients with ectodermal dysplasia and provide a clinical reference.@*Methods@#A patient with ectodermal dysplasia with a concave midface, anterior protrusion of the chin, and underdevelopment of the lower third of the face presented with congenital loss of multiple maxillary teeth, malocclusion of the remaining teeth, congenital loss of mandibular dentition, small dental arches, and upper and lower alveolar bone hypoplasia. The patient was treated by means of a removable partial maxillary prosthesis, implants in the anterior region of the lower mandible designed with the assistance of digital guides, and bar-clamped implant-overlay prostheses. A literature review of the protocol for the treatment of this condition was also conducted.@*Results@#In addition to good retention and stability after denture wear, an excellent occlusal relationship, improvement of the patient's facial appearance, including upper and lower lip fullness, more equal balancing of the lower and middle 1/3 of the face, and improved masticatory function were achieved. The results of the literature review showed that patients with ectodermal dysplasia who are congenitally edentulous usually have a complex intraoral situation that makes restoration difficult, and common restorative modalities for these patients include fixed bridges, removable partial dentures, complete dentures, overdentures, and implant prostheses, which need to be selected according to the actual intraoral situation of each patient. Currently, there is no consensus on the treatment of congenitally missing teeth in patients with ectodermal dysplasia, and some scholars have suggested that fixed restorations be recommended for patients with fewer missing teeth, while the option of removable or implant-covered denture restorations should be given to patients with more missing teeth, with removeable prostheses for underage patients that are replaced with permanent fixed prostheses when the jaws have stabilized.@*Conclusion@#In patients with ectodermal dysplasia with congenital tooth loss, all factors should be taken into account, and an individualized restorative plan should be developed.
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@#Due to advances in digital technology, intraoral impressions have been increasingly used to fabricate implant restorations because of its simplicity, high efficiency, comfortableness and convenience. In clinical practice, the accuracy of intraoral impressions depends on various factors, including scanner technique, status of dentition and implants, auxiliary devices, materials and environment, which might influence its accuracy and limit its application. When applied to patients missing more teeth, its accuracy may be insufficient. It is suggested that intraoral impressions be used cautiously when there are multiple and far apart implants and that the scan body not be tightened excessively and that maintain appropriate environmental conditions. In this article, we have reviewed recent relevant literature and the factors affecting the accuracy of intraoral impressions for implant restoration.
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Objective@# To explore the early failure of narrow-diameter implants (NDIs) and to provide a reference for clinical implant restoration.@*Methods@# From April 2017 to April 2020, data from a total of 725 patients (with 1 001 NDIs) who accepted implant restoration due to dentition defects were collected from the department of dental implantology in a stomatological hospital; 353 males and 372 females were included. The early failure rate of 1 001 NDIs was retrospectively analyzed. Univariate generalized estimated equation (GEE) and multivariate GEE were used to explore risk factors, including age, sex, implant location, materials, surface modification, length, bone augmentation and healing procedure, associated with early failure of NDIs.@*Results@#There were 34 cases of early failure among 725 patients, including 38 NDIs. The early failure rate of NDIs was 4.69% at the patient level and 3.80% at the implant level. There was no significant difference in the early failure rate of NDIs among different age groups, sexes, implant materials, surface modifications, lengths, and healing procedures (P>0.05). Univariate analysis showed that there was a significant difference between the early failure rate of NDIs in the anterior maxilla group (2.16%) and the anterior mandible group (8.64%) at the implant level (P<0.001). However, there was no significant difference in the early failure rate between the anterior maxilla group and the posterior group (3.35%) (P>0.05). In addition, in the anterior region, the early failure rate of NDIs in the group with simultaneous bone augmentation was significantly lower than that of the group without bone augmentation (P<0.05). However, multivariate GEE analysis showed that the early failure rate of NDIs was only significantly positively correlated with implants in the mandibular anterior region (P<0.01). @*Conclusion @#The overall early survival rate of Straumann 3.3 mm NDIs is greater than 95%. The early failure of NDIs in the anterior mandible region is much higher than that in the anterior maxilla region and posterior region.
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@#Implant dentures have become the main method for the treatment of dentition defects or complete edentulism. However, due to the lack of periodontal ligament and periodontal ligament proprioceptors, implant dentures have very limited cushioning and sensing capabilities and are prone to occlusal overload. As a risk factor for peri-implantitis, occlusal overload seriously threatens the stability and success rate of implant dentures. This paper reviews the occlusal overload of implant dentures, the causal relationship between occlusal overload and plaque biofilms in peri-implantitis, the mechanism by which occlusal overload promotes peri-implantitis, and the effect of reasonable clinical occlusal adjustment on healing. This review shows that occlusal overload is closely related to the occurrence of peri-implantitis. Occlusal overload can promote the process of peri-implantitis by increasing the release of inflammatory factors and mechanical transduction mechanisms. The intervention of the patients’ bad bite habits and occlusal adjustment can promote the healing of peri-implantitis. At present, there is no uniform standard ideal experimental model for occlusal overload. The phenomenon and mechanism of bone resorption around the implant caused by overload force still need further observation and research, which will help determine the intensity, direction and timing of occlusal loading to guide clinical occlusal adjustment.
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@#The jaw and femur are commonly used sites in basic research for modeling bone defects or inserting implants. An increasing number of studies have identified that the jaw and femur indeed show great differences in embryonic development and growth, histomorphology and bone metabolism. A literature review showed that, compared with the femur, the main osteogenic pathway of the jaw may have better osteogenic ability, and its stem cells have better proliferation and osteogenic differentiation ability. However, the jaw structure is less regular, the osteogenic differentiation ability of its osteoblasts is mineralization slightly weak, and the immune cells of the jaw are more sensitive to cytokines. These may be the reasons why the osseointegration of the jaw implant is different from that of the femur in animal experiments, but its specific mechanism has not been clarified.
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@#Currently, computer-aided implant surgeries include implant placement surgery under the guidance of a dynamic navigation system. With the use of software inherent in the navigation system, doctors can make a preoperative plan including the ideal position of the implant. Then the plan can be accurately transferred to the surgery, during which the real-time condition of the drill and its relationship with the surgical region will be visualized by the surgeon and the drill can be adjusted in a timely manner. Currently the dynamic navigation system is increasingly widely utilized, especially in cases of esthetic zones or surgical sites with important anatomical structures. However, the clinical workflow of the navigation system is complicated, including CBCT taken after the registration device placement, prosthetic-driven 3D design, calibration, registration, navigated borehole preparation and implant placement surgery. Many details should be considered when the device is applied, including implant position design, fixation of the tracking device, registration, and stable borehole preparation under the guidance of dynamic navigation. Therefore, this article introduces the dynamic navigation system into the clinical workflow and evaluates, the effects of the application and the clinical features. The new progress of the navigation system in the field of implantology is demonstrated at the same time, including navigated surgery in fully edentulous arches and in the zygomatic zone. Further improvements in the navigation system in terms of the accuracy and simplification of the workflow are needed in the future.
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@#With the rapid development of implant technology, implant restoration is a conventional treatment option for adult patients with tooth loss. Severe dental lesions, trauma, tumors, abnormal development and other reasons can cause dental defects and even dentition loss in children and adolescents. There has been hesitation to perform implant therapy for growing children because of the growth period; thus, little is known about the outcomes of the osseointegration procedure in young patients. Therefore, this article reviews the current literature to discuss the use of dental implants in children and adolescents. According to current studies, orthodontic treatment or transitional restoration should be undertaken based on the characteristics of the children and adolescents. Implant surgery should be performed after the end of the peak growth period. For patients with severe dentition defects, relevant criteria should be established before implant surgery to evaluate the effect of implant therapy in children and adolescents. The patients should be treated with a multidisciplinary, staged and long-term treatment approach. Most of the recent literature consists of case reports and short-term studies. There is an urgent need for more studies in this field with long-term follow-up.
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@#Short implants can be used as an alternative in cases of insufficient vertical bone volume after dentition defect or absence of dentition to simplify or avoid bone augmentation procedures. Short implants (≤ 6 mm) are reported to have a mean survival rate of 96% after a period of 1-5 years in function and have been widely used in cases of dentition defects or absence of dentition. Compared with conventional implants (≥ 10 mm) combined with bone augmentation procedures, short implants have fewer surgery-related complications, less marginal bone loss, shortened treatment times and reduced costs, and are preferred by patients. Due to a lack of evidence, a high crown-implant ratio should not be an obstacle for the use of short implants. In addition, most of the current literature has not enough follow-up time, the long-term implant survival data of short implants remain unclear. To improve the clinical outcomes of short implants, attention should be paid to the implant site, bone quality, and occlusal force as well as to the presence of oral health maintenance, periodontal diseases and habits through a careful intraoral and radiographic examination. The choices of wider implant use and splint restoration are recommended, occlusal force should be paid attention during implant maintenance. Inappropriate stress on restorations should be avoided. Future studies should be focused on the long-term clinical outcomes of short implants.
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Objective@#To investigate the effect of denture stomatitis of selective laser melting (SLM) titanium alloy for removable partial denture frameworks.@*Methods @#Twenty patients with dentition defects in our hospital were divided into two groups according to the different methods of creating a removable partial denture framework: the SLM group and casting group. The success rate, placement rate, masticatory efficiency and incidence of denture stomatitis were compared. Experimental data were analyzed with SPSS20.0.@*Results @# The success rate of the SLM framework group was 100.00%, which was higher than that of the casting group (90.00%) (P ＜ 0.01). The rate of framework placement in the SLM group was slightly lower than that in the casting group (P ＜ 0.05). The masticatory efficiency of the SLM group was higher than that of the casting group (0.783 ± 0.030 vs. 0.699 ± 0.037, P ＜ 0.001). The incidence of denture stomatitis (10.00%) in the SLM group was significantly lower than that in the casting group (30.00%) (P ＜ 0.001). @*Conclusion @#SLM is superior to the traditional casting method in mastication efficiency and reducing the incidence of denture stomatitis. This method can meet the clinical requirements, but the accuracy of the long-term stent needs to be improved.
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Objective To compare the therapeutic effect of conventional dental prosthesis and implant repair in the treatment of dentition defect.Methods From March 2016 to December 2017,110 patients with dental defects in the First People＇s Hospital of Yongkang were selected and divided into control group and observation group according to different treatment methods,with 55 cases in each group.The control group received oral routine repair,and the observation group was treated with implant repair.The therapeutic effect of the two groups was analyzed.Results The total effective rate of the observation group was 96.36%,which was significantly higher than 81.82% of the control group (χ2＝3.168,P＜0.05).After treatment,the scores of fixation function,chewing function,language function,degree of comfort,degree of aesthetics in the observation group were (18.06 ±1.32)points,(17.97 ±1.12) points,(18.41 ±1.06) points,(18.24 ±1.03) points and (18.37 ±1.21) points,respectively,which in the control group were (12.51 ±2.43) points,(13.19 ±2.55) points,(13.76 ±2.46) points,(11.64 ±2.12) points,(13.16 ± 2.45)points,respectively,the differences between the two groups were statistically significant (t＝8.957,11.235,10.369,11.036,13.554,all P＜0.05).After treatment for 1 week,the denture plaque index,gingival index and gingival bleeding index in the observation group were (0.81 ±0.11) points,(0.92 ±0.14 ) points,(1.33 ± 0.17) points,respectively,which in the control group were (1.58 ±0.49) points,(1.65 ±0.58) points and (2.67 ±0.62) points,respectively,and the differences between the two groups were statistically significant ( t ＝14.512,10.647,11.354,all P＜0.05).Conclusion The effect of implant repair in the treatment of dentition defect better than conventional dental prosthesis,which can improve the repair effect of patients and maintain the healthy periodontal health,it is worthy of clinical application.
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Objective@#To analyze implant survival rate and incidence rate of complications after All-on-4 implantation, and to discuss the technical points and consideration of All-on-4.@*Methods @#According to the criteria of inclusion and exclusion, 23 cases treated with All-on-4 immediate restoration were referred, from January 2007 to December 2015, including 5 cases of edentulous maxillary, 14 cases of edentulous mandibular and 4 cases of both maxillary and mandibular were edentulous. All the patients received immediate function with provisional prostheses at the surgery day. Definitive prostheses were delivered to patients after 3-6 months post operation and follow-up visits were performed up to 9 years (average 3 years) after placement of definitive prostheses.@*Results @# In this study, the rate of implant retention of 108 implants and 27 final restorations was 100% until the last review. Among the 23 patients, 3 patients had complications and the incidence of complications was 13.0%. @*Conclusion@# All-on-4 is an effective and reliable method in the treatment of dentures denture. The incidence of complications is low. All-on-4 is a practical method.
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Objective @#To investigate the short-term efficacy of implant in the treatment of patients with dentition defect caused by chronic periodontitis. @*Methods @#53 patients with mild to moderate chronic periodontitis treated in our hospital from June 2014 to May 2015 were selected as observation group, and 53 patients without periodontal diseases in the same period were selected as control group. The plaque index (PLI), sulcus bleeding index (SBI), periodontal probing depth (PD) and gingival papilla index (PIS) were measured at six months and one year after operation, respectively. Interleukin-6 (IL-6), interleukin-8 (IL-8), high sensitive C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were detected at six months and one year after operation, respectively. At the last follow-up, the survival rate of two groups were calculated.@*Results @#One year after operation, 5 of the 64 implants in the observation group failed compared with 2 of the 71 implants in the control group. There was no statistical difference in the implant survival rate between the two groups (92.19% vs 97.18%, P=0.191). There was no significant difference in SBI (t=0.936, P=0.351)、 PLI (t=0.457, P=0.649)、PIS (t=1.132, P=0.217)、PD (t=0.957, P=0.341) between the two groups at six months after operation. One year after operation, the periodontal index of the observation group was higher than that of the control group SBI (t=5.297, P=0.000)、 PLI (t=2.341, P=0.021)、 PIS (t=8.218, P=0.000) and PD (t=6.492, P=0.000). The levels of IL-6 (t=6.463, P=0.000)、 IL-8 (t=7.202, P=0.000)、 hs-CRP (t=4.237, P=0.000) and TNF-α (t=6.194, P=0.000) in the observation group were higher than those in the control group at six months after operation. One year after operation, the level of inflammatory factors in the observation group was higher than that in the control group IL-6 (t=12.835, P=0.000)、 IL-8 (t=13.207, P=0.000)、 hs-CRP (t=11.319, P=0.000) and TNF-α (t=8.117, P=0.000). @*Conclusion @# Implant as the treatment of patients with dentition defect caused by chronic periodontitis obtained satisfied short-term effect, but its long-term efficacy remains to be further verified.
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<p><b>OBJECTIVE</b>To evaluate the clinical effectiveness of tooth-alveolar bone grafts in repairing dentition defects.</p><p><b>METHODS</b>Forty-five patients with dentition defect were divided into two groups according to different operation methods. In group A (n=24), the tooth-alveolar bone grafts of the transplanted tooth and its surrounding alveolar bone were cut using modified surgical orthodontics and then embedded into the designated planting hole. In group B (n=21), the teeth were extracted through conventional tooth transplantation and then embedded into the prepared planting holes. The transplanted teeth were fixed for about 4-6 weeks using the orthodontic method. During the postoperation, which lasted for 2-12 weeks, root canal treatments were administered selectively. The medical effect was regularly followed up and evaluated.</p><p><b>RESULTS</b>No significant difference was found in the change of color and the periodontal ligament image between the two groups (P>0.05) whereas significant differences were observed in the degree of tooth mobility, the absorption of root and alveolar bone, and the rate of root canal treatment (P<0.05). The curative effect in group A was superior to group B.</p><p><b>CONCLUSIONS</b>Tooth-alveolar bone graft transplantation has overcome some of the limitations of traditional tooth transplantation. Therefore, it is an effective means of repairing dentition defect.</p>
Sujet(s)
Humains , Greffe osseuse alvéolaire , Denture , Desmodonte , Dent , Racine dentaireRÉSUMÉ
Objective To analyze the clinical curative effect and the impact for denture health by using a fixed denture to repair denti-tion defect of the elderly.Methods A total of 90 elderly patients with dentition defect(118 with tooth)were selected in our hospital from January 2012 to September 2013,who were divided into control group and observation group after the relevant examination,45 cases in each group.The patients in control group were treated by removable dentures,and patients in observation group received fixed denture repair.All patients were followed up for 2 years,the health status and the denture bleeding index between two groups were compared and evaluated by patients feedback and chewing ability tests.Results The clinical total effective rate of observation group after treatment was obviously higher than that of control group,the difference was statistically significant(P <0.05).The health effective rate of abutments of the observation group after 2 years was significantly higher than that of the control group,the difference was statistically significant(P <0.05).Bleeding index of two groups after repair were significantly lower than those before,the difference was statistically significant(P <0.05),which reduced more obviously than control group,the difference was statistically significant(P <0.05).Conclusion The fixed denture has high clinical value for elderly patients with dentition defect,which can effectively repair the complex tooth and tooth defect,with good effect and high safety.
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The presented article introduces a new classification based on the definitive condition of “Occlusion”after repair for different dentition defects,edentulous jaws and maxillofacial defects.The new classification contains 2 types and 8 subclasses descriptions.Exquisite pictures are used for the detailed demonstration.It may help dentists to know the final occlusion result even before the treatment and to pre-pare the major clinical operations..
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38 patients with dentition defect in our hospital for magnetic attachment dental treatment were analyzed. At the same time,34 cases of patients with dentition defects were ,being treated with conventional prosthodontics, selected to compare the stability of overdentures and masticatory function with magnetic attachment. The stability of overdentures and masticatory function after restored with magnetic attachment was significantly higher than before(P< 0. 01),while there was no difference after 4 weeks. Cementation language,comfort and appearance satisfaction after 4 weeks were significantly higher than before(P < 0. 05). The stability of overdentures,masticatory function, cementation language,comfort and appearance satisfaction after restored with magnetic attachment was significantly higher than conventional prosthodontics(P < 0. 05). It finally indicated that magnetic attachment had the advanta-ges of comfort,convenience and good effect. The stability of overdentures,masticatory function and application sat-isfaction was superior to conventional prosthodontics,and it had an application prospect.
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Objective:To evaluate the clinical effects of the key-way attachment in fixed restoration of mandibular first and second molar deletion.Methods:A 1 -5-year follow-up study was conducted on 1 6 patients with the reconstruction of mandibular first and second molar deletion.The key-way attachment was used as a connector in the fixed partial denture,with the third molar and 2 sec-ond premolars as the abutments.Results:During 5-year follow-up,1 3 of the fixed partial denture were good-looking,stable and functioning.The abutments were stable,without endodontic and periodontal disease.No absorption of alveolar bone was observed by X-ray examination.3 cases were failure.Bleeding on probing of third molar was observed in 1 patient 1 year after restoration.1 re-tainer of a denture on the third molar was loosing 1 .5 years after restoration.1 patient had dental caries on the third molar 5 years af-ter restoration.Conclusion:The key-way attachment as a connector is useful in fixed partial denture in patients with mandibular first and second molar deletion.
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Objective To investigate and analyze if there is association between ischemic cerebral vascular disease (ICVD)and the time factor of dentition defect or not by the way of questionnaire.The investigation and analy-sis will provide the theoretical basis and reference in order to study the relationship between oral disease and brain functional disease as well as ICVD.Methods 159 elderly patients who diagnosed definitely as brain functional dis-ease and dentition defect or oral prosthesis at the same time were selected.The oral condition and cerebral vascular disease history were recorded and analyzed.Results There were only 27 individuals who had teeth missing without ICVD,accounted for 16.98%.The rest of 132 individuals who had both teeth missing and ICVD accounted for 83.02%.The number of individuals who lose back teeth was larger than the number of that who suffered from ICVD (χ2 =32.360,P <0.01).The longer length of time that losing teeth took,the bigger risk that patients suffered from ICVD.Spearman rank correlation analysis result was r =0.437,P <0.01.It meaned that time was another factor. Conclusion There is certain association between the length of lacking teeth and ICVD.Missing back teeth has a bigger effect on ICVD than missing front teeth.Furthermore,the longer time that losing teeth takes,the higher risk that patients suffer from ICVD.However,it is not clear how the length of time effects ICVD.Further study is still needed.
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Objective To evaluate the clinical effects of magnetic attachment on Kennedy Ⅰdentition defect.Methods Totally thirty cases of Kennedy Ⅰ dentition defect were enrolled.Magfit EX 600 magnetic attachments were applied as the extra-coronal retainer on abutment,meanwhile the guide plane and key-key way were applied as the stablizinge apparatus for dentures.The removable partial dentures with magnetic attachment were fabricated in casting framework way.After the clinical examination,X-ray and patients' subjective feeling interview,the satisfaction status to the dentures was evaluated.Results Totally thirty patients were followed up for a period ranging from 1 to 3 years.25 patients were satisfied with the dentures in both function and esthetic results.Additionally,one patient was found to have gingivitis,and 2 patients were found the attachments loosened.These 3patients were considered basically satisfied subjects.The overall satisfaction rate was 93.3％.The rest 2 patients were found alveolar bone absorption,which led to base plate of molar teeth region sinking,and partial plastic base plate of denture cracked or damaged.Therefore the 2 patients were considered as unsatisfied subjects.Conclusions The removable partial dentures with magnetic attachment not only exhibit characteristics as compact,aesthetic and comfort,but also supply reliable retention,stablization,excellent masticatory efficiency and enough protection for abutments in patients bearing Kennedy Ⅰ dentition defect.
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Objective To investigate the effect of clinical application of ERA resilient attachment on Kennedy Ⅰ dentition defect. Methods Twenty-eight Kennedy Ⅰ dentition defect cases were restored by ERA resilient attachment dentures. After the examination of the function of the dentures, oral tissue, X-ray, the satisfaction to the dentures was evaluated. Results After the follow-up of 6 to 32 months, all the patients were satisfied with the dentures in esthetic, retention, normal function and healthy peri-odontium. Conclusion ERA resilient attachment is an esthetieal, economical and reliable approach to Kennedy Ⅰ dentition defect restoration.