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1 Only a 10% of the implant manufacturers can show scientific evidence about their products Osseointegration and Dental Implants: Chapter 1. Implant Dentistry: A technology assessment. How many Implant System do we have and are they documented? Dr. Asbjørn Jokstad Professor and Head Discipline of Prosthodontics Department of Clinical Sciences Faculty of Dentistry, Toronto, Ontario, Canada 只有 10% 的种植体生产商能展示他们产品的科学依据 骨整合和牙种植体第一章牙科植体学 : 技术评估 我们拥有多少种植系统, 它们是如何记录信息的? Asbjørn Jokstad 博士加拿大安大略省多伦多市牙科临床科学学院口腔修复系主任和教授 From 6th February, Mozo Grau dental implants are to be known as Ticare, consequently all the references to Mozo-Grau brand name correspond to the new trade name Ticare, without any other modification except the market name. 自 2 月 6 日起,Mozo Grau 牙种植体即更名为 Ticare, 因此所有参考文献引用 Mozo-Grau 品牌名称都相当于新的品牌名 Ticare, 除了市场名称其他没有任何改动

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3 Scientific Summary 科学总结

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5 Valladolid, May 2016 Dear Doctor: It is a pleasure to introduce our new Scientific Summary 2015, in which you will find a selection of scientific articles where Mozo-Grau dental implants have been used, showing the strong interest in science the company has. With over 18 years of experience in the Oral Surgery and Dental Implantology fields, Mozo-Grau is one of the leading companies, a position achieved thanks to three basic pillars: Quality, Training and Research. The Scientific Summary 2015 you have in your hands is the result of over a decade of commitment to scientific activity embodied in this summary of over 30 scientific articles on experimental and clinical studies, and a collection of selected clinical cases. The trust in our products by the research teams is the best guarantee of the quality and constant improvement Mozo-Grau can offer its thousands of customers around the world. From Mozo-Grau we hope that this material will be of interest and we appreciate your trust, thanks to which Mozo-Grau has managed to become a respected company within the Implantology market. 巴利亚多里德,2016 年 5 月 亲爱的博士先生 : 十分高兴能够向大家介绍我们公司最新的 2014 年科学总结, 在其中您能读到一些精选的科学文章, 且在文章中已使用 Mozo-Grau 公司的牙种植体产品, 这显示了该公司对科学的强烈兴趣 Mozo- Grau 公司在口腔外科和牙种植体技术领域已拥有超过 17 年的经验, 是行业领先公司之一, 取得这样的地位得益于三大基本支柱 : 品质 培训和研究 在您手中的 2016 年科学总结是公司十多年来致力于科学活动的成果, 其成果体现在该总结中精选的 30 多篇实验和临床研究的科学文章中, 同时它也是一部精选的临床案例汇编 研究团队对我们产品的信任是产品品质和 Mozo-Grau 公司为世界各地数以千计的客户持续改进的最佳保证 就 Mozo-Grau 公司来说, 我们相信您会对该报告感兴趣, 感谢您的信任, 这都得益于 Mozo-Grau 公司一直努力在种植技术市场中成为一家受人尊敬的企业

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7 GENERAL INDEX 总索引 Scientific Summary: 科学总结 : 研究列表案例报告列表研究病例报告

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9 科学总结索引 : 第一部分 List of Studies 研究列表 9

10 科学总结第一部分 List of Studies 研究列表 23 MICROLEAKAGE OF THE PROSTHETIC ABUTMENT/IMPLANT INTERFACE WITH INTERNAL AND EXTERNAL CONNECTION: IN VITRO STUDY Larrucea Verdugo, Carlos; Jaramillo Núñez, Guido; Acevedo Avila, Ariel; Larrucea San Martín, Carlo Clinical Oral Implant Research. Vol. 25, Issue 9, 2014: INFLUENCE OF IMPLANT NECK DESIGN AND IMPLANT ABUTMENT CONNECTION TYPE ON PERI-IMPLANT HEALTH. RADIOLOGICAL STUDY Peñarrocha Diago, Miguel Ángel; Flichy-Fernández, Antonio Juan; Alonso González, Rocío; Peñarrocha Oltra, David; Balaguer Martínez, José Francisco; Peñarrocha Diago, María Clinical Oral Implant Research. 2013; Vol. 24, Issue 11: INFLUENCE ON EARLY OSSEOINTEGRATION OF DENTAL IMPLANTS INSTALLED WITH TWO DIFFERENT DRILLING PROTOCOLS: A HISTOMORPHOMETRIC STUDY IN RABBIT Blanco, Juan; Álvarez, Elena; Muñoz, Fernando; Linares, Antonio; Cantalapiedra, Antonio Clinical Oral Implant Research. 2011; 22: REHABILITATION OF EDENTULOUS POSTERIOR ATROPHIC MANDIBLE: INFERIOR ALVEOLAR NERVE LATERALIZATION BY PIEZOTOME AND INMMEDIATE IMPLANT PLACEMENT Fernández Díaz, Juan Óscar; Naval Gías, Luis International Journal of Oral & Maxillofacial Surgery. 2013; Volume 42, Issue 4: ORAL REHABILITATION WITH OSSEOINTEGRATED IMPLANTS IN ONCOLOGIC PATIENTS Cuesta-Gil, Matías; Ochandiano Caicoya, Santiago; Riba García, Francisco; Duarte Ruiz, Blanca; Navarro Cuéllar, Carlos; Navarro Vila, Carlos International Journal of Oral and Maxillofac Surgery. 2009; 67: CHANGES IN GENERAL AND ORAL HEALTH-RELATED QUALITY OF LIFE IN IMMEDIATE OR CONVENTIONALLY LOADED DENTAL IMPLANTS: A NONRANDOMIZED CLINICAL TRIAL Dolz, Javier; Silvestre, Francisco J.; Montero, Javier International Journal for Oral and Maxillofacial Implants. 2014; Vol. 29, Issue 2:

11 29 SENSITIVITY OF RESONANCE FREQUENCY ANALYSIS FOR DETECTING EARLY IMPLANT FAILURE: A CASE-CONTROL STUDY Monje, Alberto; Ortega-Oller, Inmaculada; Galindo-Moreno, Pablo; Catena, Andrés; Monje, Florencio; O Valle, Francisco; Suarez, Fernando; Wang, Hom-Lay International Journal for Oral and Maxillofacial Implants. 2014; Vol. 29, Issue 2: A 12-YEAR RETROSPECTIVE ANALYTIC STUDY OF THE IMPLANT SURVIVAL RATE IN 177 CONSECUTIVE MAXILLARY SINUS AUGMENTATION PROCEDURES Cho-Lee, Gui Youn; Naval Gías, Luis; Castrejón Castrejón, Sergio; Capote Moreno, Ana Laura; González García, Raúl; Sastre Pérez, Jesús ; Muñoz Guerra, Mario Fernando International Journal Oral Maxillofacial Implants. 2010; Vol. 25, Issue 5: Implantologia Stomatologiczna / PSI Implant Dentistry rok III nr 1 (5) 科学总结第一部分 31 Does Length, Diameter, or Bone Quality Affect Primary and Secondary Stability in Self-Tapping Dental Implants? Miguel Gómez-Polo, MDS,Rocío Ortega,, Cristina Gómez-Polo, Cristina Martín, Alicia Celemín,, Jaime del Río Journal of Oral and Maxillofacial Surgery, MANDIBULAR RECONSTRUCTION WITH ILIAC CREST FREE FLAP, NASOLABIAL FLAP, AND OSSEOINTEGRATED IMPLANTS Navarro Cuéllar, Carlos; Ochandiano Caicoya, Santiago José; Acero, Julio Jesús; Navarro Cuéllar, Ignacio; Maza, Cristina; Navarro Vila, Carlos Journal of Oral and Maxillofacial Surgery, Vol. 72, Issue 6, 2014: 1226.e e15 List of Studies 研究列表 ZYGOMATIC DISTRACTION OSTEOGENESIS FOR CORRECTION OF MIDFACIAL SUPPORT AFTER HEMIMAXILLECTOMY: EXPERIENCE AND TECHNICAL CONSIDERATIONS Capote-Moreno, Ana Laura; Naval-Gías, Luis; Muñoz-Guerra, Mario F.; Rodríguez-Campo, Francisco J. Journal of Oral and Maxillofacial Surgery. 2013; Vol. 71, Issue 4: e189-e197 OSSEOINTEGRATED IMPLANT REHABILITATION OF IRRADIATED ORAL CANCER PATIENTS Mancha de la Plata, María; Naval Gías, Luis; Martos Díez, Pedro; Muñoz Guerra, Mario; González García, Raúl; Cho Lee, Gui-Youn; Castrejón Castrejón, Sergio; Rodríguez Campo, Francisco J. Journal of Oral Maxillofacial Surgery, Vol. 70, Issue 5,

12 科学总结第一部分 List of Studies 研究列表 CLINICAL STUDY ON INSERTION TORQUE AND RESONANCE FREQUENCY ANALYSIS TO EVALUATE PRIMARY AND SECONDARY STABILITY IN DENTAL IMPLANTS MOZO GRAU INHEX Martín, Goómez -Polo, Celemín, del Río Highsmith Revista Internacional de Prótesis Estomatológica, Volumen 17, Número 2, 2015 Impact of crestal and subcrestal implant placement in peri-implant bone: A prospective comparative study. Hilario Pellicer-Chover, María Peñarrocha-Diago, David Peñarrocha-Oltra,Sonia Gomar-Vercher,Rubén Agustín-Panadero, Miguel Peñarrocha-Diago Medicina Oral, Patologia Oral, Cirugía Bucal Jan 1;21 (1):e PREDICTABILITY OF THE RESONANCE FREQUENCY ANALYSIS IN THE SURVIVAL OF DENTAL IMPLANTS PLACED IN THE ANTERIOR NON-ATROPHIED EDENTULOUS MANDIBLE González García, Raúl; Monje Gil, Florencio; Moreno García, Carlos Medicina Oral, Patologia Oral, Cirugia Bucal. 2011; 1;16 (5): e664-9 SINUS ELEVATION BY IN SITU UTILIZATION OF BONE SCRAPERS: TECHNIQUE AND RESULTS Martos Díaz, Pedro; Naval Gías, Luis; Sastre Pérez, Jesús; González García, Raúl; Bances del Castillo, Fernando; Mancha de la Plata, María; Galindo Moreno, Pablo; Muñoz Guerra, Mario Medicina Oral, Patología Oral, Cirugía Bucal: 2007; 12: In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants Herminio García-Roncero, Jordi Caballé-Serrano, Jordi Cano-Batalla, Josep Cabratosa-Termes, Oscar Figueras-Álvarez The Journal Advanced Prosthodont Apr;7(2): TRANSPORT OSTEOGENESIS IN THE MAXILOFACIAL SKELETON. OUTCOMES OF A VERSATILE RECONSTRUCTION METHOD FOLLOWING TUMOR ABLATION González García, Raúl; Naval Gías, Luis Arch Otolaryngol Head Neck Surgery. 2010; 136 (3):

13 MULTICENTRIC PROSPECTIVE STUDY WITH MG OSSEOUS IMPLANTS. TWO YEARS FOLLOW-UP Martín-Granizo López, Rafael; Serrano Caturla, Eduard REVISTA ESPAÑOLA DE CIRUGÍA ORAL Y MAXILOFACIAL. 2009; VOLUME 31,ISSUE 5: CLINICAL ANALYSIS OF OUR EXPERIENCE IN OVER 100 CASES OF MAXILLARY SINUS LIFT Cho-Lee, Gui Youn; Naval-Gías, Luis; M. Mancha de la Plata, J. Sastre-Pérez, A.L. Capote-Moreno, M.F. Muñoz-Guerra, F.J. Rodríguez-Campo Revista Española de Cirugía Oral y Maxilofacial 2009; Volume 31, Issue 4: Implantologia Stomatologiczna / PSI Implant Dentistry MG OSSEOUS IMPLANTS. A MULTICENTRIC RETROSPECTIVE STUDY Martín-Granizo López, Rafael; Serrano Caturla, Eduard Revista Española de Cirugía Oral y Maxilofacial 2006; Volume 28, Issue 6: Relation between macroscopic damage of abutment screws after chewing loads and the microleakage in the implant-abutment interface. Javier Montero Martín, Beatriz Pardal-Peláez. Labor Dental Clínica, Vol. 17, nº 1 1-3/2016 科学总结第一部分 List of Studies 研究列表 13

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15 Index Scientific Summary: 第二部分 List of Case Reports 案例报告列表 15

16 科学总结第二部分 List of Case Reports 案例报告列表 47 Stabilization of peri-implant tissues by immediate screwed provisionalization of concave subgingival contour: a technical proposal Alberto González-García, Pablo Domínguez-Cardoso Revista Internacional de Prótesis Estomatológica, Volumen 17, Número 2, Stereophotogrammetry for Recording the Position of Multiple Implants: Technical Description. Rubén Agustín-Panadero, David Peñarrocha-Oltra, Sonia Gomar-Vercher, Miguel Peñarrocha-Diago, The International Journal of Prosthodontics Volume 28, Number 6, Maxillary Full-Arch Immediately Loaded Implant-Supported Fixed Prosthesis Designed and Produced by Photogrammetry and Digital Printing: A Clinical Report David Peñarrocha-Oltra, Ruben Agust ın-panadero, Guillermo Pradíes, Sonia Gomar-Vercher, Miguel Peñarrocha-Diago. Journal of Prosthodontics 00 (2015) by the American College of Prosthodontists 50 ALVEOLAR DISTRACTION OSTEOGENESIS IN POSTERIOR ATROPHIC MANDIBLE: A CASE REPORT ON A NEW TECHNICAL APPROACH Felice, Pietro; Lizio, Giuseppe; Checchi, Luigi Implant Dentistry. 2013; Volume 22, Issue 4: THE TORONTO PROSTHESIS, AN APPEALING METHOD FOR RESTORING PATIENTS Montero, Javier; Macedo de Paula, Carla; Albaladejo, Alberto Medicina Oral, Patología Bucal y Cirugía Bucal. J Clin Exp Dent. 2012; 4(5): e RESTORATION OF EDENTULOUS MAXILLAE IMPLANT SUPPORTED PROSTHETIC RESTORATION Zawadzki, Paweł Quintessence Periodontologia-Implanty 3/2013, Poland 53 NEW SYNTHETIC BIOMATERIAL IN SINUS AUGMENTATION: A CASE REPORT González, Alberto; Ríos, Vicente; Herrero, Mariano; Bullón, Pedro Periodoncia y Osteointegración. 2011; Volume 21, Issue 4 54 REPLACING TWO CENTRAL INCISORS: PARAMETERS FOR AESTHETIC SUCCESS González García, Alberto Periodoncia y Osteointegración, Volume 20 - Issue 2 55 CONVENTIONAL ULTRASONIC OSTEOTOMY IN OPEN MAXILLARY SINUS AUGMENTATION González García, Alberto; Diniz, Márcio; Somoza, Manuel; García, Abel Implantologia Stomatologiczna PSI Implant Dentistry. 2011; Issue 03 Periodoncia y Osteointegración. 2010; Volume 20 16

17 56 NEUROGENOUS OROFACIAL PAIN OF TRAUMATIC ETIOLOGY Navarro Cuéllar, Carlos ; Cebrián Carretero, José Luis Chirurgia Czaszkowo-Szczekowo-Twarzowa i Ortopedia Szczekowa. 2009; Volume 4 57 ALVEOLAR BONE RECONSTRUCTION OF ATROPHIC MAXILLA WITH CALVARIAL BONE GRAFT. TWO CASE REPORTS Modelo Pérez, Antonio; Rendón Infante, Juan Ignacio; Budiño Carbonero, Silvia Avances en Periodoncia e Implantología Oral. 2009; Volume 21, Issue 3: MANDIBULAR RECONSTRUCTION WITH A MICROSURGICAL FIBULA FREE FLAP AND IMPLANT-SUPPORTED PROSTHESIS IN A PATIENT UNDERGONE RADIOTHERAPY Maniegas Lozano,Mª Lourdes; Martín-Granizo López, Rafael Revista Consejo de Odontólogos y Estomatólogos. 2008; Volume 13, Issue 1: COMPUTER-BASED APPLICATIONS IN IMPLANTOLOGY (Conference Summary) Salmerón Escobar, José Ignacio Revista del Colegio Oficial de Odontólogos de Madrid 60 Bone regeneration with root level overcontouring in implantsupported restorations of the aesthetic area Dr. Alberto González García y Dra. Carolina Pérez García Maxilaris, Junio Immediate aesthetic in implants post extraction and connective tissue graft: Step-by-step protocol Dr. Herminio García Roncero Maxilaris, Junio Implant supported rehabilitation with guided surgery in upper front sector affected by radicular cysts Dr. Pedro C. Peguero Moreira, Dra. Arantzazu Fernández Larrañaga, D. Juan Manuel Cuevas Maxilaris, Enero MAXIMUM ACCURACY WITH MINIMAL RESOURCES IN IMPRESSIONS FOR IMPLANTS Fernández Encinas, José Raúl; Navarro Camacho, Manuel; Fernández Mileti, Silvina Maxillaris COMPLETE RESTORATION OF THE MAXILLA WITH PROSTHESIS CEMENTED ON SIX IMPLANTS González García, Alberto Maxillaris Sztuka Implantologii DEFINITION AND MAINTENANCE OF THE EMERGENCE PROFILE Núñez, Juan Maxillaris As Stomatologii 科学总结第二部分 List of Case Reports 案例报告列表 17

18 科学总结第二部分 List of Case Reports 案例报告列表 66 BIMAXILLARY IMPLANT-SUPPORTED RESTORATION AND PROVISIONAL IMMEDIATE LOADING Fernández de Peñaranda, Antonio; González Martín, Maribel Stuka Implantologii Gaceta Dental Maxillaris BIMAXILLARY DENTAL RESTORATION WITH POST-EXTRACTION IMPLANTS AND 67 MANDIBULAR IMMEDIATE LOADING Caubet Biayna, Jorge; Sánchez Mayoral, Jacobo; Iriarte Ortabe, José Ignacio; Morey Más, Miguel Vich Calafell, Bartolomé; Tomás Galmés, Alberto Sztuka Implantologii Maxillaris ORAL RESTORATION WITH PROSTHESIS ON IMPLANTS PLACED IN FIBULA MICROSURGICAL AUTOGRAFT Martín-Granizo López, Rafael; Domínguez Cuadrado, Lara; Berguer, Alberto Maxillaris The implantological treatment of severely atrophic alveolar part of the mandible Damian Dudek, Oliwia Segiet, Edyta Reichman-Warmusz, Michał Matusek, Karolina Wałach i Krzysztof Helewski Implants. International Magazine of Oral Implantology, 2014 The application of methodology for bone splitting and bone condensation Michał Fidecki, Izabela Strużycka Implants. International Magazine of Oral Implantology, 2014 Rehabilitation with dental implants in the posterior maxilla Dr. Alfonso Mogedas Vegara, Dr. Juan Antonio Hueto Madrid, Dr. Javier González Lagunas. Gaceta Dental, Febrero Immediate post extraction bone regeneration without flap by means of an implant of a superior central incisor Dr. Carlos Bonilla Mejías, Dra. Begoña Faus Mascarell, Dra. Regina María Mosquera Pérez, Dr. Daniel Torres Lagares, Dr. José Luis Gutiérrez Pérez Gaceta Dental, GUIDED BONE REGENERATION STUDY Castillo Dalí, Gabriel; Batista Cruzado, Antonio; González Martín, Maribel ; Torres Lagares, Daniel; Gutiérrez Pérez, José Luis Gaceta Dental IMMEDIATE LOADING AND AESTHETICS IN THE ANTERIOR SECTOR. A CASE REPORT Núñez Fernández, Juan Implantologia Stomatologiczna Gaceta Dental FIXED IMPLANT-SUPPORTED SUPERIOR FULL RESTORATION WITH GUIDED SURGERY Bowen Antolín,Antonio; Nasimi, Abdul; Pascua Gómez, Maite; Arnáiz González, Francisco Javier Gaceta Dental

19 76 HEMIMANDIBULAR BONE-ALVEOLAR DISTRACTION. TREATMENT FOR A POST- ONCOLOGIC PATIENT. RESTORATION de Benito-Sendín Velasco, Manuel Andrés; García García, Jorge; de Benito-Sendín Velasco, Andrés; de Benito-Sendín Velasco, José Mª; Arroyo Ramos, Candela; Mateos García; Verónica Gaceta Dental OSTEODISTRACTION OF THE ALVEOLAR PROCESS Bowen Antolín, Antonio; Álvarez, Elena; Bances del Castillo, Elena Gaceta Dental 科学总结第二部分 List of Case Reports 案例报告列表 19

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21 Scientific Summary: 科学总结 Part I 第一部分 研究列表 ABSTRACTS 概要 21

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23 科学总结第一部分 MICROLEAKAGE OF THE PROSTHETIC ABUTMENT/IMPLANT INTERFACE WITH INTERNAL AND EXTERNAL CONNECTION: IN VITRO STUDY OBJECTIVE MATERIALS AND METHODS Larrucea Verdugo, Carlos; Jaramillo Núñez, Guido; Acevedo Avila, Ariel; Larrucea San Martín, Carlo Clinical Oral Implant Research. Vol. 25, Issue 9, 2014: This study determined the degree of marginal microleakage of the abutment implant interface on platforms with Morse taper connection and external connection. For this in vitro study, 42 implants, 21 with external connection and 21 with Morse taper connection, were used, immersed in acrylic resin cylinders. Each implant was joined by a prosthetic abutment screw tightened at different degrees, forming the six study groups: (1) External connection, manual tightening (2) External connection, 20 Newton (N) tightening (3) External connection, 30 N tightening (4) Morse taper connection, manual tightening (5) Morse taper connection, 20 N tightening (6)Morse taper connection, 30 N tightening. All samples were subjected to load cycling and thermocycling. Then, they were submerged in a solution of 0.2% methylene blue for 24 h. Finally, the microleakage was measured via 209 optical microscopy in each study group, average was obtained, and Mann Whitney test was applied. RESULTS DISCUSSION CONCLUSION Statistically significant differences (P < 0.001) were found between the levels of microleakage presented in the Morse taper connection implants (1.48) and external connection implants (2.8) in all three types of tightening. Microleakage levels decrease when increasing torque is applied to the screws. However, if only applied torque is analysed, the lower levels of microleakage occur in 30N tightened abutments, where, as shown in the photomicrographs, the gap is virtually nonexistent for Morse taper connections and external connections get an almost perfect seal. This may be due to the strict manufacturing criteria found in the analysed elements. Morse taper connection implants showed lower levels of microleakage than external connection implants; also, it was observed that microleakage decreases in the way torque increases. 目的 本研究旨在探讨基台 - 种植体在平台上与莫氏锥度连接和外部连接接口的边缘微渗漏程度 材料和方法成果讨论总结 对于该体外研究, 一共 42 颗种植体,21 颗使用外部连接,21 颗使用莫氏锥度连接, 浸入丙烯树脂圆柱筒 每个种植体都使用了义齿基台螺钉以不同程度拧紧, 形成了六个研究组 :(1) 外部连接, 手动拧紧 (2) 外部连接, 20 牛顿 (N) 力拧紧 (3) 外部连接, 30 N 力拧紧 (4) 莫氏锥度连接, 手动拧紧 (5) 莫氏锥度连接, 20 N 力拧紧 (6) 莫氏锥度连接, 30 N 力拧紧 所有的样本都采取了负荷循环和冷热循环处理 然后, 将所有样本浸入 0.2% 的亚甲蓝中 24 小时 最后, 各个研究组使用 209 光学显微镜对其微渗漏进行测算, 得出了平均值, 并采用了曼 - 惠特尼检验法 从统计数据上看, 使用三种方法拧紧的莫氏锥度连接的种植体 (1.48) 与外部连接的种植体 (2.8) 的微渗漏级别存在着明显的区别 (P<0.001) 当施加在螺钉上的扭力增加时, 微渗漏的级别就会下降 但是, 如果仅仅对施加的扭力进行分析的话, 以 30N 力拧紧的基台就会使微渗漏的级别更低, 显微照片上表明, 进行绝对密封的莫氏锥度连接事实上不会出现间隙而外部连接几乎能达到绝对密封 其原因也许在于分析元件严格的生产标准 莫氏锥度连接种植体的微渗漏级别比外部连接种植体更低 ; 通过观察发现, 增加螺钉拧紧扭力会降低微渗漏 23

24 科学总结第一部分 INFLUENCE OF IMPLANT NECK DESIGN AND IMPLANT ABUTMENT CONNECTION TYPE ON PERI-IMPLANT HEALTH. RADIOLOGICAL STUDY Peñarrocha Diago, Miguel Ángel; Flichy-Fernández, Antonio Juan; Alonso González, Rocío; Peñarrocha Oltra, David; Balaguer Martínez, José Francisco; Peñarrocha Diago, María Clinical Oral Implant Research. 2013; Vol. 24, Issue 11: OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION To carry out a comparative study of two implants with different neck features and prostheses platform connection (machined with external connection and rough-surfaced with switching platform) upon peri-implant marginal bone loss, before and after functional loading. A randomized, prospective radiological study was made. Eighteen totally edentulous patients were selected. Subjects were divided into two groups according to the type of implant neck used: (a) Osseous, with machined surface, without microthreads, external connection, and without platform switching; and (b) Inhex, with treated surface, microthreads, internal connection, and platform switching. Fifteen patients that received 120 dental implants were included: 47% Osseous group and 53% Inhex group. Global mean marginal bone loss with Osseous was 0.27 ± 0.43 mm and 0.38 ± 0.51 mm as determined 6 and 12 months after prosthetic loading, respectively, whereas in the case of Inhex was 0.07 ± 0.13 and 0.12 ± 0.17 mm. These differences were statistically significant (P = 0.047). Difference between Osseous and Inhex in maxilla (P = 0.272) and mandibular (P = 0.462) bone loss were not statistically significant. Bone loss after 6 and 12 months proved statistically significant between two groups, with comparatively greater loss in the case of Osseous implants vs. Inhex implants. Regardless the heerogeneity of the two groups (neck shape, microthreads, surface texture), the implant abutment connection appears to be a significant factor on peri-implant crestal bone levels. Anyway, in both groups, the values obtained were within normal ranges described in the literature. 目的 材料和方法 在功能负载之前和之后, 根据种植体周围边缘骨丢失对两种具有不同颈部特征和义齿平台连接 ( 用交换平台的外部连接和粗糙表面加工 ) 的种植体对比研究 进行随机性和前瞻性的影像学研究 一共挑选了 18 名无齿患者 根据种植体颈部的种类, 将患者分为两组 :(a)osseous, 采用机械界面, 不采用微丝 外部连接和交换平台 ;(b)inhex, 采用处理表面 微丝 内部连接和平台交换 成果 15 名接受 120 颗牙种植体植入的患者包括 :47% 的 Osseous 组和 53% 的 Inhex 组 经过 6 个月和 12 个月的义齿负载后,Osseous 的整体平均边缘骨丢失分别为为 0.27 ±0.43 mm 和 0.38 ±0.51 mm, 但是 Inhex 的相关数据则为 0.07 ± 0.13 和 0.12 ± 0.17 mm 其差异具有统计学意义 (P = 0.047) Osseous 与 Inhex 两组的上颌骨 (P = 0.272) 和下颌骨 (P = 0.462) 骨丢失差异并不显著 总结 两组的 6 个月和 12 个月后骨丢失数据对比差异显著,Osseous 组的种植体骨丢失比 Inhex 组要更多 除了两组 ( 颈部形状 微丝 表面纹理 ) 的异质性, 其种植体基台连接也是影响种植体周围骨脊水平的重要因素 总之, 两组所得值都是在文献中描述的正常范围内 24

25 科学总结第一部分 INFLUENCE ON EARLY OSSEOINTEGRATION OF DENTAL IMPLANTS INSTALLED WITH TWO DIFFERENT DRILLING PROTOCOLS: A HISTOMORPHOMETRIC STUDY IN RABBIT Blanco, Juan; Álvarez, Elena; Muñoz, Fernando; Linares, Antonio; Cantalapiedra, Antonio Clinical Oral Implant Research. 22, 2011; OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION To evaluate early osseointegration of dental implants installed with two different drilling protocols. Thirty-six cylindrical shape Mozo Grau implants, with a diameter of 3.75 and 11mm long, were placed into the distal condyle (submerged) of each femur of 18 New Zealand rabbits. In the control group, a 3.3mm diameter drill was used as the last one prior implant installation (standard protocol). In the test group, the same procedure was carried out but an additional 3.5mm drill was used as the final one (oversized protocol) Thus, we could obtain different primary stability at day 0 between groups. Sacrifice of the animals was after 2, 4 and 8 weeks. The ISQ values were statistically significant different between groups at day 0 (control: 69.65; test: 64.81); and after 2 weeks (control: 77.93; test: 74). However, after 4 and 8 weeks the results were similar. BIC% showed a similar tendency, with 58.69% for the control group and 40.94% for the test group after 2 weeks, this difference being statistically significant. At 4- and 8-week interval, BIC% was similar. At 2-week interval (early healing), osseointegration had been influenced by different primary stability at implant installation, being slower in the oversized protocol (lower primary stability), which could be especially risky in challenging clinical situations, such as soft bone (class 3 and 4) and early/ immediate loading. However, from 4 week on, these differences disappeared. Nevertheless, we have to consider that a direct transfer of the results of this animal study (time bone repair mechanisms) into clinic has to be done with caution. 目的材料和方法成果总结 评估用两种不同钻孔方案的牙种植体植入的早期骨性结合 将 36 颗直径为 3.75 mm, 长度为 11mm 的圆柱形 Mozo Grau 种植体植入到 18 只新西兰兔股骨的远端髁 ( 深层 ) 中 在对照组中, 植入种植体之前, 最后应钻取直径为 3.3mm 的孔 ( 标准方案 ) 在试验组中, 采取相同的步骤, 但最后要额外钻取 3.5mm 的孔 ( 扩大方案 ), 因此, 我们可以获得各组间当天不同的初期稳定度 2 4 和 8 周后, 杀死动物 各组间当天的 ISQ 值差异很显著 ( 对照组 :69.65; 试验组 :64.81);2 周后同样显著 ( 对照组 :77.93; 试验组 :74) 但是,4 和 8 周后, 两结果相似 BIC 百分比有相同的趋势,2 周后, 对照组为 58.69%, 试验组为 40.94%, 其差异具有统计学意义 间隔 4 和 8 周后, 两组的 BIC 百分比较为相似 在间隔 2 周时 ( 早期恢复 ), 骨性结合受种植体植入不同的初期稳定度的影响, 在扩大方案中速度更慢 ( 较低的初期稳定性 ), 在严重的临床表现中, 这可能颇具风险, 例如软骨 (3 和 4 级 ) 和早期 / 即刻负重 但是, 从第 4 周开始, 这些差异消失了 然而, 我们要考虑到, 将该动物研究的成果 ( 时间骨修复机制 ) 直接应用到临床中需要格外谨慎 25

26 科学总结第一部分 REHABILITATION OF EDENTULOUS POSTERIOR ATROPHIC MANDIBLE: INFERIOR ALVEOLAR NERVE LATERALIZATION BY PIEZOTOME AND INMMEDIATE IMPLANT PLACEMENT Fernández Díaz, Juan Óscar; Dr. Naval Gías, Luis International Journal of Oral & Maxillofacial Surgery 2013; Volume 42, Issue 4: ABSTRACT The height and consistency of the bone tissue located above the inferior alveolar nerve (IAN) represents an important challenge when a patient s atrophied posterior mandible is rehabilitated with an osseointegrated implant. Usually, the surgical reconstruction of atrophic ridges is performed using several different techniques. The purpose of this study is to demonstrate the effectiveness and safety of the inferior alveolar nerve lateralization (IANL) technique performed with ultrasonic cutting technology (piezotome). To demonstrate this, 38 osseointegrated implants (11 15 mm in length) were performed during 19 procedures on 15 different patients. After 8 weeks, 14 of those 15 patients (18 of 19 sites: 94.73%) showed normal IAN function. The implant success rate was 97.36%. 摘要 使用骨性结合种植体对患者已萎缩的后方下颌骨进行修复时, 下牙槽神经 (IAN) 下部的骨组织高度和一致性是一大亟待解决的难题 通常, 萎缩嵴的手术重建都会使用一些不同的技术 本研究的目的旨在说明采用超声切割术实现的下牙槽神经偏侧化 (IANL) 技术的有效性和安全性 为了说明该点, 在 15 名患者上植入 38 颗骨性结合的种植体 ( 长度为 mm), 并经过 19 道程序 8 周后,15 名患者中 14 名 (19 处的 18 处 :94.73%) 的 IAN 功能正常 种植体成功率为 97.36% 26

27 科学总结第一部分 ORAL REHABILITATION WITH OSSEOINTEGRATED IMPLANTS IN ONCOLOGIC PATIENTS Cuesta-Gil, Matías; Ochandiano Caicoya, Santiago; Riba García, Francisco; Duarte Ruiz, Blanca; Navarro Cuéllar, Carlos; Navarro Vila, Carlos International Journal of Oral and Maxillofac Surgery 67: , 2009 OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION The esthetic and functional rehabilitation of oncologic patients subjected to major resection surgery constitutes one of the greatest challenges for the head and neck surgeon. Immediate bone reconstruction with microsurgical free tissue transfer and dental implants has constituted a genuine revolution in the management of such patients. We present a series of 111 oncologic patients, involving a total of 706 implants, who underwent reconstruction with pedicled or free microsurgical flaps. The osseointegration success rate was 92.9%, with a global failure rate (malpositioning or failed osseointegration or loading) of 15%. Failure particularly affected the group of irradiated patients and those subjected to lateral osseomyocutaneous trapezial pedicled flap reconstruction. Excellent results were obtained with the fibular and iliac crest free flaps and osseointegrated dental implants. The difficulties of prosthetic rehabilitation are discussed, along with the individualized solutions applied, the repercussions on the temporomandibular joint, and the management protocol adopted by our service. The authors claim that the Mozo-Grau product were used the clinical stage of this article. 目的 材料和方法 成果 对于接受过较大切除手术的肿瘤患者, 其美容和功能修复对头颈部外科医生来说是最大的挑战之一 用显微手术游离组织移植和牙科种植体技术的即刻骨重建是治疗类似患者的一种理想方案 我们挑选了 111 名肿瘤患者, 包括总共 706 颗种植体, 这些患者都曾使用带蒂皮瓣或游离显微外科皮瓣的重建治疗 骨性结合的成功率达到了 92.9%, 失败率 ( 位置异常或骨性结合失败或负载失败 ) 仅为 15% 失败严重影响了放疗患者和接受过侧方斜形带蒂皮瓣重建的患者 使用腓骨和髂嵴游离皮瓣和骨性结合牙科种植体取得了极好的成果 我们还讨论了义齿修复的难点 定制个人化方案 颞下颌关节的弹回和采用的管理协议 总结 作者强调, 本文中临床阶段所使用的均为 Mozo-Grau 公司的产品 作者强调, 本文中临床阶段所使用的均为 Mozo-Grau 公司的产品 27

28 科学总结第一部分 CHANGES IN GENERAL AND ORAL HEALTH-RELATED QUALITY OF LIFE IN IMMEDIATE OR CONVENTIONALLY LOADED DENTAL IMPLANTS: A NONRANDOMIZED CLINICAL TRIAL Dolz, Javier; Silvestre, Francisco J.; Montero, Javier International Journal for Oral and Maxillofacial Implants. 2014; Vol. 29, Issue 2: OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION To evaluate changes in the general and oral health-related quality of life (using the European Quality of Life indicator and the Oral Health Impact Profile-49 [OHIP-49], respectively) of patients treated with conventionally or immediately loaded implants. This clinical trial consisted of a clinical oral examination and a questionnaire-based interview carried out before and after both surgery and definitive prosthetic rehabilitation in a consecutive sample of patients requiring dental implants. According to the clinical diagnosis and patient prefrence, patients were assigned to the immediate loading group (IL group; n = 29) or the conventional loading group (CL group; n = 75). The change summary scores and effect sizes were calculated in the intemediate stage and at the final follow-up, taking baseline scores as reference. The oral health-related quality of life and oral satisfaction after implant therapy were significantly better than at baseline, with an even greater benefit when the implants were loaded immediately than when prosthetic rehabilitation was delayed. However, there were no significant differences in between-group comparisons in the ratings of general health status. The effect size for the OHIP-49 exceeded the threshold value of 0.8 for the domains functional limitation, pain/discomfort, and psychological discomfort in both groups and also for physical disability and psychological disability in the IL group. A gradual improvement in oral well-being scores, but not in those of general well-being, were observed for both groups from the intermediate stage to the final evaluation. This benefit was markedly greater for the IL group. 目的 评估常规或即刻负重种植体治疗患者的总体变化和口腔健康相关生活质量 ( 分别采用欧洲生活质量指标和口腔健康影响度量表 -49 OHIP-49 ) 材料和方法 该临床试验包括针对需要牙种植体治疗的患者连续样本进行临床口腔检查, 以及在手术和确定性义齿修复术前和术后的问卷式访谈 根据临床诊断和患者意愿, 患者被分配到即刻负重组 (IL 组 ;n=29 ) 或常规负重组 (CL 组 ;n=75) 在中期阶段, 计算出变化总评分和效应值, 并在接下来的最终阶段, 得出基准分数作为参考 成果 经过种植体治疗后的口腔健康相关生活质量和口腔满意度明显高于基准线, 即刻负重种植体比延期义齿修复的治疗效果更好 但是, 经过组间比较, 总体健康状态评分差距并不大 两组中的区域功能性限制 疼痛 / 不适和心理不适的 OHIP-49 效应值均超过了 0.8 的界限值, 同时也包括 IL 组的生理残障和心理障碍的情况 总结 通过对两组从中级阶段到最终评估阶段的观察, 口腔健康评分有了逐步的提升, 但不包括总体健康评分 IL 组的相关评分明显要更高 28

29 科学总结第一部分 SENSITIVITY OF RESONANCE FREQUENCY ANALYSIS FOR DETECTING EARLY IMPLANT FAILURE: A CASE-CONTROL STUDY OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION Monje, Alberto; Ortega-Oller, Inmaculada; Galindo-Moreno, Pablo; Catena, Andrés; Monje, Florencio; O Valle, Francisco; Suarez, Fernando; Wang, Hom-Lay International Journal for Oral and Maxillofacial Implants. 2014; Vol. 29, Issue 2: The aim of this study was to test the sensitivity of the resonance frequency analysis for detecting early implant failure. In all, 3,786 implants placed from June 2007 to January 2013 were retrospectively evaluated. A total of 20 implants (in 20 patients) placed in pristine bone were found to have failed before loading. The implant stability quotient (ISQ) values were extracted from these 20 implants at baseline (immediate) and 4 months after placement (delayed). Simple linear regression, logistic regression, and two-way contingency tables were used to test for the relationships between ISQ values and early implant failure. Immediate ISQ values were significantly related to failure (odds ratio [OR] = 4.27). Furthermore, the results of the second regression showed a significant relationship between ISQ at delayed measurement and implant failure (OR = 9.20). For immediate ISQ, it seems that the 73.7% correct classifications were obtained at the cost of an incorrect classification of 55% of the implant failures. However, for the delayed ISQ, 86.2% correct classifications were obtained at the cost of assuming that all implants will survive. The present study showed that ISQ values are not reliable in predicting early implant failure. In addition, the real cutoff ISQ value to differentiate between success and early implant failure remains to be determined. 目的 材料和方法 E 该研究的目的是测试共振频率分析的灵敏度, 而共振频率分析用于检测早期植体失败 从 2007 年 6 月到 2013 年 1 月总共对 3786 颗种植体做了回顾性评估 发现一共有 20 颗植入于原始骨中的种植体 ( 分属 20 位患者 ) 在负重前植入失败 种植体稳定系数 (ISQ) 值是从这些处于基准线的 20 颗种植体 ( 即刻 ) 和植入后后 4 个月 ( 延期 ) 的种植体的数据中提取 采用了简单线性回归 逻辑回归和双向列联表的方法对 ISQ 值和早期植牙失败之间的关系进行了测试 成果 即刻 ISQ 值与种植失败 ( 比值比 OR =4.27) 的关联性很强 此外, 二次回归的结果显示, 延时测算的 ISQ 与种植失败 (OR=9.20) 有着很重要的关系 就即刻 ISQ 来说,73.7% 的分类正确率是以种植失败的 55% 分类错误率为代价达到的 但是, 对于延时 ISQ,86.2% 的分类正确率则是假想所有种植体都存活的情况下才会达到 总结 当前研究表明,ISQ 值在早期植牙失败预测中并不可靠 另外, 用来区分早期植牙失败与成功地真实截止 ISQ 值尚无法判断 29

30 科学总结第一部分 A 12-YEAR RETROSPECTIVE ANALYTIC STUDY OF THE IMPLANT SURVIVAL RATE IN 177 CONSECUTIVE MAXILLARY SINUS AUGMENTATION PROCEDURES OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION Cho-Lee, Gui Youn; Naval Gías, Luis; Castrejón Castrejón, Sergio; Capote Moreno, Ana Laura; González García, Raúl; Sastre Pérez, Jesús ; Muñoz Guerra, Mario Fernando International Journal Oral Maxillofacial Implants. 2010; Vol. 25, Issue 5: Implantologia Stomatologiczna / PSI Implant Dentistry rok III nr 1 (5) This retrospective study sought to demonstrate the outcome of maxillary sinus elevation surgery in a series of 177 procedures performed over 12 years and to determine the existence of variables that could independently predict implant survival. A retrospective descriptive and analytic study of a series of maxillary sinus elevation procedures performed between 1996 and 2007 was undertaken. The sample was composed of patients with severe atrophy of the posterior maxilla who had been rehabilitated with osseointegrated implants placed in grafted maxillary sinuses. Several features of the patients and of the surgical procedure related to implant survival or failure were monitored during the follow-up period. One hundred seventy-seven sinus augmentation procedures were performed in 119 consecutive patients (mean age years; SD 11.5). Of the 272 implants placed in sinus-augmented regions, 19 were lost. The mean follow-up period was 60.7 months (SD 36.5). The overall cumulative implant survival rate was 93% after 5 years. The multivariate analysis showed that the presence of complications related to the sinus augmentation procedure and peri-implantitis were factors in predicting implant failure. On the basis of this retrospective analysis, it might be concluded that sinus augmentation is a very versatile procedure. Its efficacy and predictability in terms of implant survival rate is extremely high and independent of the graft material, surgical technique, associated comorbidities, smoking habits, and timing of implant placement. Complications such as membrane perforation, sinusitis, and peri-implantitis appeared to influence implant failure. 目的材料和方法成果总结 本回顾性研究的目的是为了说明 12 年来使用的 177 种上颌窦提升手术方法的疗效, 并确定能独立预测种植体存活的变量的存在 一系列上颌窦提升法的回顾性描述和分析研究在 1996 年到 2007 年间进行 其所选病例为后上颌骨神经萎缩患者, 这些患者之前都曾在其移植的上颌窦中植入骨性结合种植体 在随访期中监测患者以及手术过程的若干特征, 其中手术过程与种植体存活和失败相关 177 种上颌窦提升法会在 119 名患者中使用 ( 平均年龄 岁 ;SD 11.5) 在 272 颗植入窦提升区域的种植体中, 损失了 19 颗 平均随访期为 60.7 个月 (SD 36.5) 5 年后, 总体累积种植体存活率为 93% 多元分析显示与窦提升方法和种植体周围炎症相关的并发症发生是预测种植体植入失败的因素 根据本回顾性分析, 可以得出结论, 窦提升术是一种通用的方法 从种植体存活率来看, 该技术的功效和预测能力都很高, 它不受移植材料 手术方法 相关并发症 吸烟习惯和种植体植入时机的制约 诸如鼓膜穿孔 鼻窦炎 种植体周围炎症等并发症会导致种植体植入的失败 30

31 科学总结第一部分 Does Length, Diameter, or Bone Quality Affect Primary and Secondary Stability in Self-Tapping Dental Implants? OBJECTIVE PATIENTS AND METHODS RESULTS CONCLUSION 目标 Miguel Gómez-Polo, MDS,Rocío Ortega,, Cristina Gómez-Polo, Cristina Martín, Alicia Celemín,, Jaime del Río Journal of Oral and Maxillofacial Surgery, 2016 Implant stability is a clinically valuable measurement of the strength of implant anchorage in the bone during placement and in the post-osseointegration period. This study aimed to determine 1) the effect of implant diameter and length and bone quality on measurements of primary and secondary stability (insertion torque [IT] and implant stability quotient [ISQ]), 2) the correlation between IT and primary and secondary ISQ, and 3)differences in ISQ in the post-osseointegration period (secondary stability) compared with immediate post-placement (primary) stability. In this longitudinal clinical study, titanium self-tapping implants were inserted in edentulous patients. The implants were grouped according to 3 independent variables: length (10 and 11.5 mm), diameter (3.75 and 4.25 mm), and bone quality (Lekholm and Zarb classification) to analyze primary and secondary implant stability (outcome variables). Statistical analyses were performed using the Student t test for paired data, 1-way analysis of variance, and the Tukey procedure for multiple pairwise comparisons. Data were collected on 88 self-tapping implants inserted in 63 partially edentulous patients. IT and implant stability were affected by diameter (3.75-mm implants, 26.5-N/cm IT and 74.0 ISQ; 4.25-mm implants, 33.8-N/cm IT and 77.0 ISQ) and bone type (type 1 + 2, N/cm IT and 77.4 ISQ; type 3, N/cm IT and 75.6 ISQ; type 4, N/cm IT and 70.5 ISQ; P <.01 for all comparisons). Secondary ISQ was affected by diameter only (77.41 for vs for 4.25-mm implants). IT correlated with primary ISQ (R = 0.56; P <.01), although no clear correlation with secondary stability was found. IT and primary ISQ in self-tapping implants differed in patients with different bone quality and implant diameter but did not differ between the 2 implant lengths compared in this study. Secondary stability was not substantially affected by any of these factors. Although IT was closely related to primary ISQ, it was unrelated to secondary ISQ. Very high primary ISQ values tended to decrease, whereas intermediate and low values tended to increase, in the transition to secondary stability. 种植体稳定度是在植入和骨性结合后临床上测量骨中种植体固定点强度的重要数值 本研究旨在说明 1) 种植体直径 长度和骨质对测量初期和后期稳定度的影响 ( 种植扭力 [IT] 和种植体稳定度系数 [ISQ]), 2) IT 与初期和后期 ISQ 的关联, 以及 3) 骨性结合后期 ( 后期稳定度 ) 与即刻种植后 ( 初期稳定度 ) 之间的 ISQ 的差异 患者和方法 结果 总结 在本纵向临床研究中, 为牙缺损患者植入了钛合金自攻种植体 种植体根据 3 中独立变量进行了分组 : 长度 (10 和 11.5mm) 直径 (3.75 和 4.25 mm) 和骨质 ((Lekholm 和 Zarb 类 ), 以分析初期和后期种植体稳定度 ( 结果变量 ) 通过配对数据的 Student t test, 差异的单项分析和多个两两对比的 Tukey 法进行了数据分析 收集了 63 位部分牙缺损患者的 88 颗自攻种植体的数据 IT 和种植体稳定度受直径 (3.75-mm 种植体, 26.5-N/cm IT 和 74.0 ISQ; 4.25-mm 种植体, 33.8-N/cm IT 和 77.0 ISQ) 和骨类别影响 ( 类别 1 + 2, N/cm IT 和 77.4 ISQ; 类别 3, N/cm IT 和 75.6 ISQ; 类别 4, N/ cm IT 和 70.5 ISQ; P <.01 用于所有比较 ) 后期 ISQ 只受直径的影响 ( mm 的种植体 ISQ 为 和 4.25-mm 的种植体 ISQ 为 ). 尽管没有发现 IT 与后期稳定度的联系, 但与初期 ISQ 具有关联 (R = 0.56; P <.01) 不同的骨质和种植体直径使患者的自攻种植体的 IT 和初期 ISQ 也不同, 但在本研究中对比的 2 种种植体长度之间不存在差异 这些因素不会对后期稳定度产生较大的影响 尽管 IT 与初期 ISQ 联系很紧密, 但其与后期 ISQ 无关联 在向后期稳定度过渡的过程中, 高初期 ISQ 值会减少, 而中和低值会增加 31

32 科学总结第一部分 MANDIBULAR RECONSTRUCTION WITH ILIAC CREST FREE FLAP, NASOLABIAL FLAP, AND OSSEOINTEGRATED IMPLANTS Navarro Cuéllar, Carlos; Ochandiano Caicoya, Santiago José; Acero, Julio Jesús; Navarro Cuéllar, Ignacio; Maza, Cristina; Navarro Vila, Carlos Journal of Oral and Maxillofacial Surgery, Vol. 72, Issue 6, 2014: 1226.e e15 OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION Oncologic patients undergoing segmental mandibulectomy with soft tissue resection develop several esthetic and functional sequelae; therefore, the defect must be reconstructed immediately. The iliac crest flap is the only flap that allows reconstruction of the previous dimensions of the mandible. However, the excessive soft tissue of this flap prevents optimal reconstruction of intraoral soft tissue defects. This report describes a reconstructive technique used in 12 patients who underwent segmental mandibulectomy because of soft tissue defects resulting from tumor resection. The technique involves reconstruction of the mandible using an iliac crest flap combined with a nasolabial flap to enable subsequent reconstruction of the intraoral soft tissue and immediate placement of osseointegrated implants. The osseointegration success rate was 95.2% with a failure rate of 4.8%. Failure particularly affected the irradiated patients. Excellent functional and aesthetic results were obtained with the iliac crest free flap, nasolabial flap and osseointegrated dental implants. This technique has several advantages. On the one hand, it enables reconstruction of the original dimensions of the mandible, thus allowing immediate placement of implants in an ideal position for subsequent rehabilitation with a dental prosthesis. On the other hand, the nasolabial flap provides a thin layer of tissue that can be used to reconstruct the anatomy of the oromandibular soft tissue. 目的 下颌骨部分骨段和软组织切除会对肿瘤患者的外表美观和功能造成一些后遗症 ; 因此, 其缺损必须立即进行重建 只有髂嵴瓣才能够对下颌骨的先前外形尺寸进行重建 但是, 该皮瓣的过多的软组织会影响对口腔软组织缺损的最佳重建 材料和方法 该报告描述了 12 名因肿瘤切除导致软组织缺损的患者进行下颌骨部分骨段切除所使用的重建技术 该技术就是使用髂嵴瓣和鼻唇沟瓣进行下颌骨重建, 使能够随后重建口腔软组织, 并立即进行种植体骨整合 成果 骨整合的成功率达到了 95.2%, 失败率仅为 4.8% 骨整合的失败尤其会对放疗患者产生影响 通过使用髂嵴游离皮瓣 鼻唇沟瓣和骨性整合牙种植体的治疗, 取得了功能和美容的卓越效果 总结 该技术拥有若干优势 一方面, 它能重建下颌骨的原始外观尺寸, 因此能立即在理想的位置进行植入种植体, 以便随后对义齿进行修复 另一方面, 鼻唇沟瓣会提供一层薄组织, 可用于口下颌肌软组织的解剖重建 32

33 科学总结第一部分 ZYGOMATIC DISTRACTION OSTEOGENESIS FOR CORRECTION OF MIDFACIAL SUPPORT AFTER HEMIMAXILLECTOMY: EXPERIENCE AND TECHNICAL CONSIDERATIONS Capote-Moreno, Ana Laura; Naval-Gías, Luis; Muñoz-Guerra, Mario F.; Rodríguez-Campo, Francisco J. Journal of Oral and Maxillofacial Surgery. 2013; Vol. 71, Issue 4: e189-e197 OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION The maxilla is the functional and esthetic keystone of the midface, and large maxillary defects remain a challenge for reconstructive surgery. Different regional and microvascularized flaps have been used to restore the hemimaxilla. Distraction osteogenesis offers an alternative to complex flaps, with less donor-site morbidity. This method is also preferable as a secondary reconstruction in cases of serious bone defects where other flaps have failed. Four patients with maxillary defects after oncologic ablation presented at a mean follow-up period of 36 months (standard deviation, 18 mo). In these patients, transport distraction osteogenesis of the zygoma was used to restore the bony support of the low maxilla. After a latency period of 15 days, distraction began at a rate of 0.5 mm/day. A 2-step distraction, by changing the direction of the zygomatic device, was carried out in 3 cases. After a consolidation period of 4 to 6 months for each distraction, the devices were removed and the bone edges were joined together with an autogenous bone graft (anterior iliac crest and calvaria). A good quality of bone was observed in the distracted gap, which allowed for postoperative dental implant placement and prosthetic rehabilitation. In patients with large maxillary defects in which the remaining bone is insufficient and in patients in whom other reconstructive methods have failed, zygomatic distraction is an excellent option to restore the low projection of the maxilla. Bone transport was found to be a stable reconstructive method that allowed for the restoration of function and esthetics in oncologic patients. 目的 材料和方法 上颌骨是面中部功能和美容的重要部分, 对于重建手术来说, 大型上颌骨缺损仍是一大挑战 不同区域以及显微血管皮瓣是用来恢复半侧上颌骨的 牵引成骨术可替代复杂皮瓣, 减少供皮区的发病率 对于严重的骨缺损, 且无法使用其它皮瓣的病例, 该方法也是一种很好的备选重建法 对肿瘤切除后的 4 位上颌骨缺损患者进行了平均 36 个月的观察 ( 标准差,18 个月 ) 在这些患者中, 颧骨输送盘牵引成骨术用于恢复上颌骨下部的骨质支撑物 成果 15 天潜伏期后, 以每天 0.5mm 的速度开始牵引 在 3 个病例中, 采用改变颧骨设备方向的 2 步牵引法 在每次牵引 4 到 6 个月的巩固期后, 移除设备, 骨边缘与自体骨移植连接在一起 ( 髂嵴前部和颅盖骨 ) 通过观察, 牵引间隙的骨质良好, 可以进行术后牙种植体植入和义齿修复 总结 对于大型上颌骨缺损剩余骨量不足和经过其它重建手段失败的患者, 颧骨牵张术是恢复上颌骨低投影状态的极佳选择 骨输送术是一种稳定的重建方法, 能使肿瘤患者的功能和外观得到恢复 33

34 科学总结第一部分 OSSEOINTEGRATED IMPLANT REHABILITATION OF IRRADIATED ORAL CANCER PATIENTS Mancha de la Plata, María; Naval Gías, Luis; Martos Díez, Pedro; Muñoz Guerra, Mario; González García, Raúl; Cho Lee, Gui-Youn; Castrejón Castrejón, Sergio; Rodríguez Campo, Francisco J. Journal of Oral Maxillofacial Surgery, Vol. 70, Issue 5, 2012 OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION The aim of this study is to analyze implant survival in patients who received radiotherapy treatment for oral malignancies and in patients who had suffered mandibular osteoradionecrosis. We reviewed retrospectively 225 implants placed in 30 patients who had received radiotherapy as part of the oncologic treatment. Radiation doses ranged between 50 and 70 Gy. 39 implants were placed after a combined treatment of radiotherapy and chemotherapy. Data referred to tumour type and reconstruction, presence of osteoradionecrosis, region of implant installation and type of prostheses were recorded. Survival rates were calculated with cumulative Kaplan-Meier survival curves and compared between different groups with a log-rank test. 152 osseointegrated implants were placed in patients who presented previous reconstruction procedure. Five patients developed osteorradionecrosis as a complication of the radiotherapy treatment. Once osteoradionecrosis had healed in these patients, 41 implants were installed. The overall 5 year survival rate in irradiated patients was 92.6%. Irradiated patients had a marginally significantly higher implant loss than non-irradiated patients. (p = 0.063). The 5 year survival rate in the osteoradionecrosis group was of 48.3% and in the non-osteoradionecrosis group 92.3%, with a statistically significant difference between both groups (p = 0.002). Osseointegrated implants enhance oral rehabilitation in most irradiated patients, even being an acceptable option for patients who had suffered osteoradionecrosis. Totally implantsupported prostheses are recommended after irradiation providing functional, stable and aesthetically satisfactory rehabilitation. 研究背景材料和方法结果总结 本研究的目的是为了分析接受口腔恶性肿瘤放射性治疗和下颌骨放射性骨坏死患者的种植体存活情况 我们回顾性检查了 225 颗植入在 30 名患者口腔内的种植体, 这些患者都接受过放射治疗作为肿瘤治疗的一部分 放射幅度在 50 到 70 Gy 之间 在接受放射治疗和化学治疗之后, 植入 39 颗种植体 数据记录了肿瘤类别 重建 放射性骨坏死的状态 种植体植入区域和义齿类别 利用累计 Kaplan-Meier 生存曲线计算生存率, 并利用 log-rank 检验对不同组之间进行对比 将 152 颗骨性结合种植体植入到曾进行过重建步骤的患者口腔中 5 名患者出现了放射性骨坏死, 这是放射性疗法的并发症 当这些患者的放射性骨坏死治愈后, 植入 41 颗种植体 植入放疗患者口腔中的种植体总体 5 年生存率为 92.6% 放疗患者的种植体损失要比非放疗患者略高 (p=0.063) 放射性骨坏死组的 5 年生存率为 48.3%, 而非放射性骨坏死的为 92.3%, 在数据上, 两组之间的差异具有明显统计学意义 (p=0.002) 骨性结合种植体促进大部分放疗患者的口腔康复, 甚至是放射性骨坏死患者一种可接受的治疗方案 放疗后, 推荐使用完全植体支持义齿, 患者的功能和外表美观可得到稳定满意的修复 34

35 科学总结第一部分 Clinical study on insertion torque and resonance frequency analysis to evaluate primary and secondary stability in dental implants MG InHex OBJECTIVE Martín C1, Gómez-Polo C2, Gómez-Polo M3, Celemín A4, del Río Highsmith J5 Revista Internacional de Prótesis Estomatológica, Volumen 17, Número 2, 2015 Obtain values of primary stability (final ISQ ), secondary stability (ISQ osseointegration) and final insertion torque (ITV) and study how implant length, diameter, location, genre and bone type affect osseointegration. Analyze the existence of a possible correlation between ITV and final ISQ, and final ISQ and osseointegration ISQ; as well as to assess the variations between the final ISQ and ISQ after osseointegration period. MATERIALS AND METHODS RESULTS CONCLUSION 研究背景 材料和方法 结果 总结 A total of 25 Mozo Grau InHex implants were placed in 12 patients by a very experience surgeon. The moment of the placement surgery, the final insertion torque and the primary stability in ISQ values ( coefficient of primary stability measured by Ostell device ) were registered. After the osseointegration period ISQ was measured again to evaluate the secondary stability. The ISQ average registered at the time of implant placement was 77,34 ± 4,68. The average obtained in the variable ISQ osseointegration was 78,86 ± 4,42. The average value obtained from the insertion torque was 31,80 ± 12,23 Ncm. It was observed a high correlation statistically significant r = 0,755 between final ISQ and maximum ITV. The variables final ISQ and ISQ osseointegration show a moderate correlation statistically significant = 0,470. No differences between final ISQ and ISQ osseointegration were obtained. It was noticed an increased ISQ final value in the mandible, whereas it was found higher osseointegration ISQ value for bones type II and III with regard to type IV with differences statistically significant. On the other side, greater ITV was observed in men, in mandible location and in bones type I and II. The significant correlation between final ISQ and maximum ITV suggests that a greater insertion torque will most likely achieve greater primary stability. It was not found correlation statistically significant between osseointegration. ITV and ISQ. Although without statistic confirmation it seems ISQ values tend to be equal (rising the lowest and lowering the highest) after the osseointegration period. 获得初期稳定度 ( 最终 ISQ 值 ) 后期稳定度 (ISQ 骨整合 ) 以及最终植入扭力值 (ITV) 并研究种植体长度 直径 位置 种类和骨类型是如何影响骨整合的 分析在 ITV 和最终 ISQ 值之间, 以及 ISQ 与骨整合 ISQ 之间可能出现的关联 ; 并评估骨整合期后最终 ISQ 值和 ISQ 之间的差别 由一位经丰富的外科医生给 12 位患者总共植入 25 颗 Mozo Grau InHex 种植体 在进行植入手术时, 对最终植入扭力值和初期稳定度以 ISQ 值的形式 (Ostell device 测量的初期稳定度系数 ) 记录下来 在骨整合期后再次测量 ISQ 值以评估后期稳定度 种植手术当天记录的 ISQ 平均值为 77,34 ± 4,68 获得可变 ISQ 骨整合平均值为 78,86 ± 4,42 获得的植入扭力平均值为 31,80 ± 12,23 Ncm 观察到最终 ISQ 值和 ITV 最大值之间的高度相关有统计学意义 r = 0,755 可变最终 ISQ 值和 ISQ 骨整合之间显示为中度相关有统计学意义 = 0,470 获得的最终 ISQ 值和 ISQ 骨整合之间没有明显差别 应注意到下颌骨的最终 ISQ 值上升, 然而 II 型和 III 型骨与 IV 型骨相比骨整合 ISQ 值更高有统计学意义 另一方面, 在男性 下颌骨位置以及 I 型和 II 型骨观察到 ITV 值更大 最终 ISQ 值和 ITV 最大值之间显著相关提示更大的植入扭力很可能会达到更好的初期稳定度 未发现骨整合 ITV 和 ISQ 之间有统计学意义的相关性 虽然没有经过统计学确认, 但似乎在骨整合期之后 ISQ 值趋于一致 ( 最低值上升和最高值下降 ) 35

36 科学总结第一部分 Impact of crestal and subcrestal implant placement in peri-implant bone: A prospective comparative study OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION Hilario Pellicer-Chover, María Peñarrocha-Diago, David Peñarrocha-Oltra,Sonia Gomar-Vercher,Rubén Agustín-Panadero, Miguel Peñarrocha-Diago Medicina Oral, Patologia Oral, Cirugía Bucal Jan 1;21 (1):e To assess the influence of the crestal or subcrestal placement of implants upon peri-implant bone loss over 12 months of follow-up. Twenty-six patients with a single hopeless tooth were recruited in the Oral Surgery Unit (Valencia University, Valencia, Spain). The patients were randomized into two treatment groups: group A (implants placed at crestal level) or group B (implants placed at subcrestal level). Control visits were conducted by a trained clinician at the time of implant placement and 12 months after loading. A previously established standard protocol was used to compile general data on all patients (sex and age, implant length and diameter, and brushing frequency). Implant success rate, peri-implant bone loss and the treatment of the exposed implant surface were studied. The level of statistical significance was defined as 5% (α=0.05). Twenty-three patients (8 males and 15 females, mean age 49.8±11.6 years, range years) were included in the final data analyses, while three were excluded. All the included subjects were non-smokers with a brushing frequency of up to twice a day in 85.7% of the cases. The 23 implants comprised 10 crestal implants and 13 subcrestal implants. After implant placement, the mean bone position with respect to the implant platform in group A was 0.0 mm versus 2.16±0.88 mm in group B. After 12 months of follow-up, the mean bone positions were -0.06±1.11 mm and 0.95±1.50 mm, respectively - this representing a bone loss of 0.06±1.11 mm in the case of the crestal implants and of 1.22±1.06 mm in the case of the subcrestal implants (p=0.014). Four crestal implants and 5 subcrestal implants presented peri-implant bone levels below the platform, leaving a mean exposed treated surface of 1.13 mm and 0.57 mm, respectively. The implant osseointegration success rate at 12 months was 100% in both groups. Within the limitations of this study, bone loss was found to be greater in the case of the subcrestal implants, though from the clinical perspective these implants presented bone levels above the implant platform after 12 months of follow-up. 研究背景 通过术后超过 12 个月随访评估牙冠及冠下种植术对种植体周围骨组织的影响 材料和方法 结果 将口腔外科 ( 位于西班牙瓦伦西亚的瓦伦西亚大学 ) 的 26 名均为单个牙坏死的患者纳入研究 患者被随机分为两个治疗组 : 即 A 组 ( 牙冠水平种植术 ) 或 B 组 ( 冠下水平种植术 ) 在种植手术当天和牙齿开始负荷后 12 个月, 由一位训练有素的临床医生完成控制随访 使用以前建立的一套标准方案来汇编所有患者的基本数据 ( 包括性别和年龄, 种植体长度和直径, 以及每天刷牙频率 ) 研究指标有种植成功率 种植体周围骨流失量和已暴露的种植体表面治疗 组间差异的统计学显著水平定义为 5% (α=0.05) 共有 23 名患者 (8 名男性和 15 名女性, 年龄范围从 岁, 平均为 49.8±11.6 岁 ) 纳入最后的结果分析, 另外 3 名被排除在外 所有受试者均不吸烟, 其中 85.7% 的人刷牙频率达到每天 2 次 23 例种植术中包括 10 例牙冠种植术和 13 例冠下种植术 种植术后当天, 种植体平台与骨相对位置平均值 A 组为 0.0 mm 而 B 组为 2.16±0.88 mm 而在 12 个月的随访后, 两组的骨相对位置平均值分别为 -0.06±1.11 mm 和 0.95±1.50 mm 这表明牙冠种植术的骨流失为 0.06±1.11 mm, 而冠下种植术为 1.22±1.06 mm(p=0.014) 4 例牙冠种植术患者和 5 例冠下种植术患者出现种植体周围骨水平低于平台, 两组表面暴露的平均值分别为 1.13 mm 和 0.57 mm 两组在术后 12 个月的种植体骨整合成功率均为 100% 总结 由于本研究的局限性, 结果显示冠下种植术后的骨流失更多, 但从临床前景展望, 在 12 个月的随访后, 冠下种植体表现出骨水平高于种植体平台 咀嚼负荷后螺钉基台的明显损害与种植体基台交界处微渗漏的关系 36

37 科学总结第一部分 OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION PREDICTABILITY OF THE RESONANCE FREQUENCY ANALYSIS IN THE SURVIVAL OF DENTAL IMPLANTS PLACED IN THE ANTERIOR NON-ATROPHIED EDENTULOUS MANDIBLE González García, Raúl; Monje Gil, Florencio; Moreno García, Carlos Medicina Oral, Patologia Oral, Cirugia Bucal. 2011; 1;16 (5): e664-9 Dental primary implant stability is considered essential in the success of the osseointegration process. The recent advent of the resonance frequency analysis (RFA) seems to effectively measure primary implant stability, although its relationship with implant survival has to be further established. Seventeen patients with complete mandibular edentulism underwent dental implant rehabilitation by means of the placement of 68 dental implants within the interforaminal region and subsequent placement of an overdenture. Primary implant stability was measured by means of RFA and it was expressed in terms of implant stability quotient (ISQ) on the day of the implant insertion and at the time of the healing abutment placement in a conventional implant two-stage surgical procedure. Overall implant survival rate was 97.1% at the end of the follow-up period. The mean ISQ value for 3.75 and 4.25 mm diameter implants was 78.4 ± 5.46 and ± 5.35 respectively, at the time of the implant placement; and ± 4.34 and ± 6.87 respectively, at the second surgical stage. No statistical differences were observed in relation to changes in mean ISQ value along the healing process. No statistical differences in terms of primary and secondary implant stability measured by RFA exists between 3.75 mm and 4.25 mm diameter implants in the conventional implant two-stage surgical procedure in patients with non-atrophied edentulous mandible being restored with an overdenture. Furthermore, no statistical association between RFA and the implant insertion torque was observed for endosseous dental implant placement at the first surgical stage. 研究背景 牙种植体的初期稳定度对于骨性结合的成功极为重要 共振频率分析 (RFA) 的最新进展为有效地测算种植体初期稳定度, 尽管需要进一步建立其与种植体存活的关系 材料和方法 17 位上颌骨完全缺损的患者通过在两颌孔间区域和之后植入覆盖式义齿的位置内植入 68 颗牙种植体完成种植体修复 种植体初期稳定度是通过 RFA 测算的, 它以种植体稳定度系数的形式表现, 该系数是牙种植体植入的当天和在常规种植体两阶段手术的恢复基台植入时的数据 结果 在观察期结束后, 种植体的整体存活率为 97.1% 在植入种植体时, 直径为 3.75mm 和 4.25mm 的种植体的平均 ISQ 值分别为 78.4 ± 5.46 和 ± 5.35, 在第二手术阶段的 ISQ 值则分别为 ± 4.34 和 ± 6.87 在愈合过程中, 平均 ISQ 值的变化并没有统计上的差异 总结 用覆盖式义齿修复的非萎缩性无齿下颌骨患者在常规种植体两阶段手术中使用了直径分别为 3.75 mm 和 4.25 mm 种植体, 这些种植体的由 RFA 测算的初期和后期稳定度不存在统计上的差异 此外, 在第一手术阶段的骨内牙种植体植入中的 RFA 与种植体植入扭力之间并不存在统计学相关性 37

38 科学总结第一部分 SINUS ELEVATION BY IN SITU UTILIZATION OF BONE SCRAPERS: TECHNIQUE AND RESULTS N OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION Martos Díaz, Pedro; Naval Gías, Luis; Sastre Pérez, Jesús; González García, Raúl; Bances del Castillo, Fernando; Mancha de la Plata, María; Galindo Moreno, Pablo; Muñoz Guerra, Mario Medicina Oral, Patología Oral, Cirugía Bucal: 2007; 12: The objective was to present a novel technique for antrostomy performed before sinus elevation in atrophic maxilla for subsequent implant placement. The study included 10 sinus elevations performed by the proposed technique in nine consecutive patients presenting with inadequate posterior maxillary height. The technique is described, calculating the antrostomy surface area, volume of bone tissue obtained and final height attained in each case. A total of 16 Mozo Grau threaded implants were placed (3 implants of 3.75 x 10 mm, 7 implants of 3.75 x 11.5, 2 implants of 3.4 x 11.5 and 4 implants of 3.75 x 13). All ten elevations were accomplished. Mean antrostomy surface area was 0.55 mm², mean bone volume obtained was 0.56 cm³ and mean height attained was 11.7 mm from a baseline mean height of 5.6 mm. Out of the 16 implants, 14 were inserted immediately after the elevation and 2 were inserted in a second step, after ossification; 93.7% of the implants were osseointegrated at 6 months after prosthesis placement. The use of bone scrapers to create antrostomy for sinus elevation is a simple and very safe procedure. It provides a variable amount of particulate bone graft that is easily handled and highly useful for packing the cavity that will elevate the sinus membrane. 目的材料和方法成果总结 本文旨在介绍一种新的窦造口术, 该技术是在上颌骨萎缩患者接受窦提升术之前使用, 目的是为随后的种植体植入做好准备 本研究包括对 9 例后上颌骨高度不足患者使用的 10 种窦提升术 该技术会描述和计算每个病例中窦造口表面积 获取的骨组织量和达到的最终高度 我们一共植入了 16 颗 Mozo Grau 带螺纹种植体 (3 颗尺寸为 3.75 x 10 mm 7 颗尺寸为 3.75 x 颗 3.4 x 11.5 和 4 颗 3.75 x 13) 我们完成了所有 10 次提升术 平均窦造口表面积为 0.55 mm², 平均获取骨量为 0.56 cm³ 平均达到高度为 11.7 mm, 而基准平均高度仅为 5.6 mm 16 颗种植体中, 有 14 颗在提升术后即刻植入,2 颗在第二步骤植入 ; 假体植入后 6 个月,93.7% 的种植体都已骨性结合 使用骨刮器为窦提升进行窦造口是一种简单且安全性高的方法 它能提供不同的颗粒状骨移植物, 使用便捷, 能很好地填充齿洞, 以提升窦粘膜 38

39 科学总结第一部分 In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants Herminio García-Roncero, Jordi Caballé-Serrano, Jordi Cano-Batalla, Josep Cabratosa-Termes, Oscar Figueras-Álvarez The Journal Advanced Prosthodont Apr;7(2): OBJECTIVE MATERIALS AND METHODS In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants.. Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous ; Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30o in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student s t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants. 目标 在本研究中, 已研发出颞骨基台修复螺钉, 它是根据足够的咬合力产生关键的微运动的应用, 为可控方式产生的断裂而设计 该螺钉是为了保护即刻负重种植体的骨性结合 材料和方法 结果 通过固定钛合金基台和 112 颗 Mozo-Grau 外部六角种植体 (MG Osseous ; Mozo-Grau, S.A., 巴利亚多里德, 西班牙 ) 对 7 个不同的螺钉原型进行了检验 每个螺钉在两个小组进行了 30 度的断裂强度检验 : 一组进行动荷载, 另外一组不进行动态荷载 动态荷载是使用 50 N 的 周期荷载在一个单轴咀嚼模拟器中执行 在正常分配的获取数据经过 Kolmogorov Smirnov 检验后, 执行过和未执行动态荷载的样本之间的抗断裂性通过 Student s t-test 进行了检验 不同螺钉设计的抗断裂性通过差异单项分析法进行了对比 置信区间设定为 95% 所有的螺钉都出现了断裂的情况, 可进行便捷的回收 在动态荷载中, 螺钉原型 2 5 和 6 执行失败, 且其它原型的统计差异十分显著 总结 当在即刻负重种植体中咬合过载时, 原型 2 5 和 6 能提供有效的保护机制 39

40 科学总结第一部分 TRANSPORT OSTEOGENESIS IN THE MAXILOFACIAL SKELETON. OUTCOMES OF A VERSATILE RECONSTRUCTION METHOD FOLLOWING TUMOR ABLATION González García, Raúl; Naval Gías, Luis Arch Otolaryngol Head Neck Surgery. 2010; 136 (3): OBJECTIVE PATIENTS RESULTS CONCLUSION To report our clinical experience using bifocal distraction osteogenesis (BDO) with internal devices to treat patients having bony defects of the maxillofacial skeleton following tumor ablation and to focus on outcomes of dental implant placement in patients having maxillomandibular segmental defects. Patients were selected according to the following inclusion criteria: a bony defect in the maxillofacial skeleton, moderate soft-tissue defect, local or general conditions that preclude more aggressive surgery, and adequate patient compliance. Types of BDO included [...]. Twenty-eight patients having bony defects of the maxillofacial skeleton underwent BDO. The mean (SD) bony defect length was 47.0 (20.1) mm. The mean (SD) distracted bone lengthening was 36.5 (20.0) mm, with a mean (SD) consolidation period of 16.4 (8.0) weeks. The bony defect involved the hemimandibular body in 12 patients, with greater involvement of the body and symphysis in 4 patients and of the bilateral mandibular body in 2 patients. Complications after BDO included the following: discomfort in 8 patients, complete intraoral exposure and infection in 3 patients, partial cutaneous exposure in 1 patient, premature consolidation in 1 patient, and temporomandibular joint ankylosis in 1 patient. Overall, BDO for reconstruction of bony defects was successful in 22 patients and failed in 6 patients. Bifocal distraction osteogenesis potentially benefits patients with bony defects following tumor ablation at various locations in the maxillofacial skeleton. Sufficient bone is gained to allow dental implant placement, an important functional outcome. 目的 患者 成果 报告我们采用两焦点牵引成骨 (BDO) 术和使用内部设备治疗肿瘤切除后颌面骨缺损的患者的临床经验, 并关注上下颌骨节段性缺损患者的牙种植体植入的疗效 根据以下入选标准筛选患者 : 颌面骨缺损 中度软组织缺损 局部或全身条件不允许更激进的手术治疗, 以及充分的患者配合 BDO 的类别包括 名颌面骨缺损患者接受了 BDO 治疗 其平均 (SD) 骨缺损长度为 47.0 (20.1) mm 平均 (SD) 牵引骨加长为 36.5 (20.0) mm, 平均 (SD) 巩固期为 16.4 (8.0) 周 骨缺损包括 12 名患者的半下颌骨体缺损,4 名患者的耻骨联合缺损和 2 名患者的双侧下颌骨体缺损 BDO 治疗后的并发症如下 :8 名患者不适,3 名患者完全口腔内暴露和感染,1 名患者部分皮肤暴露,1 名患者出现不成熟实变和 1 名患者颞下颌关节强直 总体上看,BDO 术的骨缺损的重建情况为 : 22 名患者治疗成功,6 名患者治疗失败 40

41 科学总结第一部分 MULTICENTRIC PROSPECTIVE STUDY WITH MG OSSEOUS IMPLANTS. TWO YEARS FOLLOW-UP OBJECTIVE MATERIALS AND METHODS RESULTS DISCUSSION CONCLUSION Martín-Granizo López, Rafael; Serrano Caturla, Eduard REVISTA ESPAÑOLA DE CIRUGÍA ORAL Y MAXILOFACIAL. 2009; VOLUME 31,ISSUE 5: We present this truly scientific trial using MG-OSSEOUS implants (Mozo- Grau SL, Valladolid, Spain) as a humble contribution, based on well defined and realistic clinical uses. The Spanish company Scientific Management in O&SS (Barcelona) designed a complete questionnaire to be completed by the implantologist dealing with each clinical case. Data was managed, from the total rate of implants (N), to conclude if it was possible to obtain true data of different samples, and using ANOVA, to analyze selected parameters from these samples, in order to see the direct relation between them and the failure of the implants. 1,475 dental implants were placed in 480 patients, between June 2005 and May The global implants success rate was 98.2% with an average of 2 years follow-up with the connected prostheses. The implants position, length and diameter are detailed and the samples are also analyzed, as post extraction implants, immediate loading implants and implants associated with grafts. We focused on, completing an exhaustive revision of actual bibliographical sources, the high failure rate obtained by the wide diameter implants (4,25 mm) post extraction and on the versatility of the strength diameter implants (3,4 mm) to be placed anywhere in the mouth, with no mean of the type of prosthesis associated. This trial can be defined as the philosophy s antithesis, in which we allow scientific and reproducible conclusions in implant surgery, our scientific truth. We will extend this trial to reach, at least, 5 years of follow-up 目的 我们选用 MG-OSSEOUS 种植体 (Mozo- Grau SL, 巴利亚多里德, 西班牙 ) 来进行这项真正的科学实验, 这是基于明确和实际的临床用途, 希望此试验成果能够有一定贡献 材料和方法成果讨论总结 位于 O&SS( 巴塞罗那 ) 的名为 科学管理 的西班牙公司设计了一套完整的调查表, 由处理各个临床病例的种植体专家完成 对种植体总比率的数据进行处理, 推断是否可能获取不同样本的真实数据, 并使用方差分析来分析从这些样本中获取的数据, 从而找到这些数据与种植体的失败之间的直接关系 2005 年 6 月到 2006 年 5 月, 我们将 1475 颗牙种植体植入到 480 名患者口腔中 通过平均 2 年对植入义齿的随访, 总体种植体成功率为 98.2% 种植体的位置 长度和直径都会详细介绍, 样本 ( 例如拔牙后种植体 即刻负重种植体和与移植物相关的种植体 ) 也会进行分析 我们专注于对实际文献来源和种植体高失败率的全面改善, 这些种植体包括拔牙后宽直径种植体 (4,25 mm) 植入在口腔中的多种直径增加种植体 (3,4 mm) 和各种相关义齿 该实验可以定义为哲学的对立面, 我们能从种植体植入手术中获得科学和可重复的结论, 这是科学真理 我们将会对此试验进行至少 5 年的随访. 41

42 科学总结第一部分 CLINICAL ANALYSIS OF OUR EXPERIENCE IN OVER 100 CASES OF MAXILLARY SINUS LIFT Cho-Lee, Gui Youn; Naval-Gías, Luis; M. Mancha de la Plata, J. Sastre-Pérez, A.L. Capote-Moreno, M.F. Muñoz-Guerra, F.J. Rodríguez-Campo Revista Española de Cirugía Oral y Maxilofacial 2009; Volume 31, Issue 4: Implantologia Stomatologiczna / PSI Implant Dentistry OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION Maxillary sinus elevation surgery is one of the most versatile surgical procedures in maxillofacial surgery: there are various approaches to the sinus, different materials for sinus grafting, other preprosthetic procedures can be associated and the implants placement can be simultaneous or delayed, depending on the initial bone height. The aim of this study was to demonstrate this versatility by means of reporting the clinical outcome of sinus augmentation surgery in 131 cases. 131 sinus augmentation procedures were undertaken on 91 consecutive patients (mean age 50,43 years (26-69)). The preoperative and postoperative radiological study was developed by means of orthopantomography and Dental-TC. The survival rate of implants, as measured by integration and succesfull loading, was compared between different graft materials, smoking/non-smoking patients, different groups of associated pathologies and simultaneous/delayed implants placement. The time (months) necessary for prosthesis loading was measured and compared between the different graft material groups. 228 screw-type implants were placed in sinus lifted regions. The mean residual ridge height was 6,59±2,11 mm. The mean postsurgical ridge height was 14,57±2,33 mm. After a mean follow-up period of 2,94 years (range 1 to 12 years) the global implant survival rate was 96,91%. There were not significant differences between different bone grafts, associated comorbidity and smoking habits. On the basis of this retrospective study, it might be concluded that the sinus augmentation surgery is a very versatile procedure. Its efficacy and predictability in terms of implant survival rate is extremely high and independent on the bone graft material, surgical technique, associated morbility, smoking habit and immediate/delayed implant placement. The use of autologous bone requires less time to load the prosthesis. 目的材料和方法成果总结 上颌窦提升术是最为通用的颌面外科手术之一 : 该技术拥有多种窦处理方法和不同材料的窦移植物, 可以采取其它假体植入前的处理方法, 根据初始骨高度, 种植物的植入可以是即时或延时的 该研究旨在通过报告 131 例窦提升术的临床疗效说明其通用性 对 91 名连续患者 ( 平均年龄 50,43 岁 (26-69)) 进行了 131 次上颌窦提升术 通过全颌曲面断层片和 Dental-TC 进行了术前和术后影像学研究 种植体的存活率是通过整合和成功负载测算而来, 我们对比了不同移植材料 吸烟 / 不吸烟患者 不同组的相关病理状况和即时 / 延时种植体植入之间的种植体存活率 我们计算和对比了不同移植材料组之间的假体负载所需时间 ( 月 ) 228 颗螺钉型种植体植入到了窦提升区域 平均残余牙槽嵴高度为 6,59±2,11 mm 平均术后牙槽嵴高度为 14,57±2,33 mm 经过平均 2.94 年 ( 范围为 1 到 12 年 ) 的随访期, 整体种植体存活率为 96,91% 在拥有不同的骨移植 相关并发症和吸烟习惯的患者组别之间的存活率差异并不显著 基于本回顾性研究, 可以得出结论, 窦提升术是一种通用的方法 从种植体存活率来看, 该技术的功效和预测能力都很高, 它不受移植材料 手术方法 相关并发症 吸烟习惯和种植体植入时机的制约 使用自体骨负载假体, 花费时间更少. 42

43 科学总结第一部分 MG OSSEOUS IMPLANTS. A MULTICENTRIC RETROSPECTIVE STUDY Martín-Granizo López, Rafael; Serrano Caturla, Eduard Revista Española de Cirugía Oral y Maxilofacial 2006; Volume 28, Issue 6: OBJECTIVE MATERIALS AND METHODS RESULTS CONCLUSION We present some statistically contrasted results regarding the survival and incidences of MG-OSSEOUS implants and prosthetic components (Mozo-Grau, S.L., Valladolid, Spain), and we prove that they have the same efficacy when comparedwith other commercial implants. This is a retrospective multicentric study coordinated by a company called Scientific Management in O&SS (Barcelona, Spain) dental implants were placed in 247 patients and 328 prostheses were designed between 2004 and 2005, with a follow-up of two years.all implants were loaded with prostheses. We detail and analyze each implant, according to the diameter, length, position, surgical timing, loadings, design and types of prostheses and complementary surgical procedures, either synchronic or metachronic. After the statistical method was homogenized, we were able to report an overall implant survival rate of 97.8% with monitoring of two years. The failures depending on the peculiarities of each clinical case are provided. No prosthetic failures are reported. The mixture between the quality of the MGOSSEOUS implants and the scientifically supported criteria regarding the implants, reveals an implant failure of 2.2% over two years, with a survival of 100% of both the replaced implants and the loaded prostheses. 目的材料和方法成果总结 我们会展示出一些关于 MG-OSSEOUS 种植体和假体部件 (Mozo-Grau,S.L., 巴利亚多里德, 西班牙 ) 的存活和并发症统计对比结果, 并且会证明其与其它商业种植体拥有相同的效果 这项回顾性多中心研究是由一家位于 O&SS( 巴塞罗那, 西班牙 ) 名为科学管理的公司协助完成的 我们对 247 名患者进行了 1001 颗牙种植体的植入, 在 2004 到 2005 年间, 设计了 328 颗义齿, 并进行了为期 2 年的术后随访 所有的种植体都负载了义齿 根据直径 长度 位置 手术时机 负载 设计 义齿的种类和补充手术方案 ( 同步或非同步 ), 我们会详细介绍和分析各个种植体 在对统计方法均化后, 通过 2 年的观察, 我们得出了总体种植体存活率为 97.8% 的结果 我们也提供了基于每例临床病例特点的失败案例 没有义齿失败的报告 结合 MGOSSEOUS 种植体质量和种植体的科学支持标准可以解释 2 年间 种植体失败率为 2.2%, 替换种植体和负载义齿的存活率达到了 100% 43

44 科学总结第一部分 Relation between macroscopic damage of abutment screws after chewing loads and the microleakage in the implant-abutment interface. Javier Montero Martín, Beatriz Pardal-Peláez. Labor Dental Clínica, Vol. 17, nº 1 1-3/2016 OBJECTIVE Establishing the relation between the macroscopic damage in abutment screws after chewing cycles and the microleakage in the implant-abutment interface. MATERIALS AND METHODS RESULTS We used 30 implants Mozo Grau SA. 20 were external connection and 10 internal connection with Estandar and Star abutment screws torqued differently. We analyzed the macroscopic damage in the screws after cyclic loading. After that, they were used for a leakage study. The internal connection screws presented more damage in apical (93.3% and 91.7%), external connection with Star screw and experimental torque in the middle third (53.3%) and external connection with Estandar screw at recommended torque in the cervical third (52.0%). Internal connection implants showed less leakage in the interface. DISCUSSION There is not apparent relation between superficial damage in abutment screws and leakage. CONCLUSION On Internal connection implants a total seal is achived when the experimental torque is applied, but not on the external connection, regardless the state of the screw or the torque. 介绍 牙种植体术后最普遍的问题就是螺钉松动和种植体周围骨流失 目标 : 研究 次咀嚼周期后螺钉基台的明显损害与种植体基台交界处微渗漏的关系 材料和方法 结果 我们使用了 30 例 Mozo Grau SA 的种植体 其中 20 例为外部连接,10 例为内部连接, 均使用两种不同扭矩的标准基台螺钉和星形基台螺钉旋入 我们分析了周期负荷后螺钉中的明显损害 之后, 再对螺钉进行微渗漏研究 与在中三分之一处使用星形螺钉和实验扭矩的外部连接 (53.3%) 和颈部三分之一处使用标准螺钉和推荐扭矩的外部连接 (52.0%) 相比, 内部连接螺钉表现出更多的根尖损害 (93.3% 和 91.7%) 内部连接种植体在交界处微渗漏更少 讨论 螺钉基台的表面损害和微渗漏之间没有明显的相关性 总结 内部连接的种植体使用实验扭矩时可达到完全封闭, 但外部连接不管用何种类型的螺钉或扭矩均不能实现 44

45 Scientific Summary: 科学总结 : Part II 第二部分 病例报告 ABSTRACTS 摘要 45

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47 科学总结 : 第二部分 Stabilization of peri-implant tissues by immediate screwed provisionalization of concave subgingival contour: a technical proposal Alberto González-García, Pablo Domínguez-Cardoso Revista Internacional de Prótesis Estomatológica, Volumen 17, Número 2, 2015 ABSTRACT To obtain good results in implant supported rehabilitation that involves the anterior aesthetic sector, several techniques and concepts must be handled and integrated to provide predictability to our treatment. This article described a specific technique of immediate screwed provisionalization for restorations on implants with the concave subgingival contour that can improve the stabilization of peri-implant tissues and that perfectly integrate the rest of current concepts which seek to enhance this effect. 概要 种植体支持的组织再生治疗涉及前面部美学, 为得到更好的疗效, 必须使用好几种技术和观念并整合, 以达到治疗的可预见性 本文介绍了一种特别的技术, 通过螺钉加压临时义齿的组织面外形, 恢复种植体, 加强种植体周围软组织稳定性, 并完美的整合其他力图增强此效应的观念 47

48 科学总结 : 第二部分 Stereophotogrammetry for Recording the Position of Multiple Implants: Technical Description. Rubén Agustín-Panadero, David Peñarrocha-Oltra, Sonia Gomar-Vercher, Miguel Peñarrocha-Diago, The International Journal of Prosthodontics Volume 28, Number 6, 2015 ABSTRACT Dental implants are one of the most widely used treatments for the rehabilitation of partially or completely edentulous areas. Achieving proper passive adjustment of the implant-supported prosthesis improves its long-term prognosis. This article discusses a new technique for digitally printing prostheses supported by multiple implants with optimum passive fit. The technique is based on a stereophotogrammetry system that captures the exact location of prosthetic implant platforms. This photogrammetry device takes 10 pictures per second with an error margin of less than 10 mm between two scanbodies and identifies the spatial position of each implant without physical contact. Three-dimensional data for each implant are registered in vector format, together with interrelated implant angles and distances. The information is then stored in an STL file. 概要 种植牙是现在修复部分或完全无齿区域最为广泛的治疗手段之一 科学证明获取种植体支持假体合适的被动就位会提升其长期预后诊断能力 1-8 制作多种植体支持的植入固定假体的传统系统包括使用印模材料制作印模, 然后在印模位置植入种植体, 最后用石膏进行修复 最近, 新型数字口腔扫描器开始用于印模的制作, 在限制牙缺损区的多种植体植入修复的病例中, 其可靠性得以突显 但是, 当口腔扫描用于全牙弓假体修复中时, 其可靠性就要大打折扣 摄影测量是另一种直接可靠的记录口腔内植入物位置的方法 它会自动记录捕捉图像中的三维 (3D) 物体和其相关的空间位置的几何特性 其最重要的特征是无接触测量物体和距离的精确度 48

49 科学总结 : 第二部分 Maxillary Full-Arch Immediately Loaded Implant-Supported Fixed Prosthesis Designed and Produced by Photogrammetry and Digital Printing: A Clinical Report ABSTRACT David Peñarrocha-Oltra, Ruben Agust ın-panadero, Guillermo Pradíes, Sonia Gomar-Vercher, Miguel Peñarrocha-Diago. Journal of Prosthodontics 00 (2015) by the American College of Prosthodontists The present clinical report describes the use of a photogrammetry system (PICcam- era) for obtaining impressions and designing and producing an immediately loaded CAD/CAM provisional fixed prosthesis delivered in the mouth within 24 hours after implant placement in the maxilla. The stereo camera was used to capture the implant positions, automatically taking 350 images in less than 2 minutes. This photogram- metry system takes 10 pictures per second with a margin of error of under 10 μm between two scan bodies, and identifies the spatial position of each implant without physical contact. The three-dimensional data for each implant are registered in vector format, together with all interrelated implant angles and distances. The information is stored in an STL file (PICfile). Information on soft tissues was obtained from an irreversible hydrocolloid impression that was poured in stone and scanned. An im- mediately loaded screw-retained fixed prosthesis was made from acetalic resin using CAD/CAM, and its passive fit was evaluated in the mouth using the Sheffield test and screw resistance test. 概要 该临床报告将会描述运用摄影测量系统 (PICcam- era) 在上颌植入物种植后的 24 小时内制作印模, 并设计和生产即刻负重植入口腔式 CAD/CAM 临时固定假体 本立体摄像机用于捕捉植牙位置, 在不到 2 分钟的时间里, 自动拍摄 350 张照片 该摄影测量系统每秒能拍摄 10 张照片, 在两个扫描体之间的误差幅度不超过 10 μm, 且能够标识各个植入物的空间位置, 无需直接接触 每个植入物的三维数据以及所有相关的植入角度和距离都会以矢量格式的形式记录 这些信息会以 STL 文件格式 (PICfile) 储存 软组织信息是从经过浇石处理和扫描的不可逆性水胶体印模中获得 即刻加载条件下螺丝固定式固定假牙的制作材料为缩醛树脂, 运用了 CAD/CAM 技术, 通过 Sheffield 测试和螺丝阻力测试在口腔内对其被动就位进行了评价 49

50 科学总结 : 第二部分 ALVEOLAR DISTRACTION OSTEOGENESIS IN POSTERIOR ATROPHIC MANDIBLE: A CASE REPORT ON A NEW TECHNICAL APPROACH ABSTRACT Felice, Pietro; Lizio, Giuseppe; Checchi, Luigi Implant Dentistry. 2013; Volume 22, Issue 4: Objective: To report a clinical case of dental implant rehabilitation of an atrophic posterior mandible with the usage of a new alveolar distraction protocol. Materials and methods: A posterior atrophic mandible was treated with distraction osteogenesis; after the first phase of latency (10 days), the activation phase (24 days), and the consolidation phase (30 days), the distractor was removed, and 2 implants were placed; 4 months thereafter, the fixtures were provisionally loaded. Results: No complications were recorded during the treatment. At the end of the activation phase, a mean of 5 mm of vertical bone augmentation was obtained, and it allowed the placement of two 10-mm long fixtures. No periimplant bone resorption was detected at the time of definitive prosthetic loading. Conclusion: The proposed protocol secured a sound prosthetic rehabilitation on an otherwise atrophied posterior mandible so as to avoid grafting procedures. 目标 : 报告一例应用新的牙槽牵引方案进行萎缩性后下颌骨牙科种植体修复的临床病例的 摘要 材料和方法 : 采用牵引成骨法治疗萎缩性后下颌骨 ; 在第一个潜伏阶段 (10 天 ), 激活阶段 (24 天 ) 和巩固阶段 (30 天 ) 之后, 移除牵引器, 植入 2 颗种植体 ;4 个月后, 安装临时固定装置 结果 : 在治疗过程中, 无并发症报告 在激活阶段尾声, 获取平均长度 5mm 的垂直骨量扩增, 允许安装 2 个 10 mm 长的固定装置 在最后的义齿负载阶段, 没有发现种植体周围的骨吸收 总结 : 该方案保证了其它萎缩性后下颌骨的良好的假体修复, 因此避免了移植术 50

51 科学总结 : 第二部分 THE TORONTO PROSTHESIS, AN APPEALING METHOD FOR RESTORING PATIENTS Montero, Javier; Macedo de Paula, Carla; Albaladejo, Alberto Medicina Oral, Patología Bucal y Cirugía Bucal. J Clin Exp Dent. 2012; 4(5): e ABSTRACT The implant is a therapeutic resource in constant evolution, and the different types of implants and techniques have been increasingly used in cases of both fully or partially edentulous patients. In some cases they provide more conservative treatment, and in others better stability, retention, and function. To achieve a satisfactory result, there are several factors that should be taken into account: the type and quality of the bone, bone density, the placement location of implants, retrievability of restorations, the patient s motivation, and economic issues. Trainees should be aware of the limitations of the techniques that can be used for successful prosthetic rehabilitation. This work describes the prosthetic rehabilitation of a fully edentulous mandible treated with dental implants using the Toronto Bridge technique for restoring both function and aesthetics. This type of prosthesis is a screwed-in mesostructure with milled abutments for the cementation of single or multiple suprastructures. This device could also be named abutment-hybrid overdenture The main advantages and disadvantages of this protocol are discussed. 摘要 种植体是一种不断发展的治疗资源, 不用种类的种植体和技术正不断应用于全或部分牙缺损患者的治疗中 在一些病例中, 它们能提供更为保守的治疗方案 而在其他病例可获得更好的稳定性 保持力和功能 为达到满意的疗效, 应考虑若干因素 : 骨的质量和类别 骨密度 种植体植入位置 修复方案的可修补性 患者的动机和经济问题 学习者应该意识到该技术的局限性, 这可以运用到成功的义齿修复中 本报告描述了用牙种植体治疗全下颌牙缺损的义齿修复法, 并采用 Toronto Bridge 技术达到功能和美容修复 义齿的种类为带有切削基台的旋进式微结构, 用于单个或多个上部结构的粘结 该装置也能称为 基台混合型覆盖式假体, 我们还讨论了该方案的主要优势和劣 51

52 科学总结 : 第二部分 RESTORATION OF RESTORATION EDENTULOUS MAXILLAE IMPLANT SUPPORTED PROSTHETIC Zawadzki, Paweł Quintessence Periodontologia-Implanty 3/2013, Poland ABSTRACT Implant supported restorations have become a viable and optimal option for patients treatment, allowing teeth restoration in case of their partial or total loss. Taking into account the conditions of the bone and the need to carry out a sinus lift procedure, as in this case, it is important to observe an appropriate time protocol. Thanks to a correct planning and carrying out of surgeries, excellent results can be achieved in cases of edentulous patients, meeting both their individual needs and expectations. In this case, 10 Mozo Grau Inhex Implants, internal connection, were placed in a two-stage surgical procedure with a previous sinus lift in an oncology patient. To that end an alloplastic material and collagen membranes have to be used, resulting in an optimal, functional and successful solution for the patient. 摘要 种植体支持修复现在已成为一种切实可行和最佳方案用于患者治疗, 该法能对患者部分或整体牙缺损进行修复 考虑到骨的条件和要进行窦提升术的需求, 在本病例中, 制定合适的时间方案尤为重要 得益于正确的规划和手术的执行, 牙缺损患者取得了良好的疗效,, 达到了其个人需求和期望 在本病例中, 一名曾接受过窦提升术的肿瘤患者在两阶段手术中植入了 10 颗 Mozo Grau Inhex 种植体和内部连接 在最后, 使用了异质成形材料和胶原基膜, 结果表明这是对于患者来说最理想 实用和成功的治疗方案 52

53 科学总结 : 第二部分 NEW SYNTHETIC BIOMATERIAL IN SINUS AUGMENTATION: A CASE REPORT ABSTRACT González, Alberto; Ríos, Vicente; Herrero, Mariano; Bullón, Pedro Periodoncia y Osteointegración. 2011; Volume 21, Issue 4 We present a case of bilateral agenesis of maxillary second premolars with severe alveolar atrophy, which has been treated by guided bone regeneration with a synthetic biomaterial based on hydroxyapatite and tricalcium phosphate (MG-Osteodrive) and with resorbable membrane (MGReguarde), together with bilateral maxillary sinus lift, deferred placement of implants and subsequent prosthetic restoration. Female patient, 28 years of age, non-smoker and with no relevant medical history. In this case we have used MG Osteodrive (Mozo-Grau) in its cancellous granule presentation, with a grain size of m per particle and composed of hydroxyapatite and tricalcium phosphate, with a totally synthetic manufacturing process. This biomaterial is easy to manipulate, according to the operator s experience, as well as having a relatively short resorption time, three to six months (Bifano et al. 1998). The membrane, MG Reguarde (Mozo-Grau), is manufactured from collagen fibres originating from bovine Achilles tendons and has a resorption time of around six months (McNeil et al. 1994) and a consistency and clinical manipulation similar to other resorbable membranes. After eight months of maturation of the newly formed bone tissue and after a control x-ray, the edentulous segments are addressed again removing the fixing microscrews and observing a newly formed bone tissue of mature and consistent appearance. The implants, MG InHex (3.75 x 13 right side and 4.25 x 13 left side), are placed with a 40 Ncm insertion torque. The use of allografts based on fully synthetic hydroxyapatite and tricalcium phosphate seems to achieve clinical results similar to those obtained with other reference biomaterials in guided bone regeneration and bilateral maxillary sinus lift in cases of severe alveolar atrophy. 摘要 我们将展示上颌骨第二前臼齿的双边发育不全, 并带有严重的牙槽萎缩的病例, 采取基于羟基磷灰石和三钙盐磷酸盐 (MG-Osteodrive) 的人造生物材料和可吸收薄膜 (MGReguarde) 的引导骨再生法, 双边上颌骨窦提升术 种植体延时植入和之后的假体修复治疗 女性患者,28 岁, 不吸烟, 没有相关的病史 在此病例中, 我们对其松质骨颗粒使用了 MG Osteodrive (Mozo-Grau), 这种材料的每个粒子拥有 m 的大尺寸, 并由羟基磷灰石和三钙盐磷酸盐构成, 经过人工制造过程 根据使用者的经验, 该生物材料使用便捷, 并且拥有相对较短的吸收时间 (3-6 个月 )( Bifano et al.1998) 薄膜, 即 MG Reguarde (Mozo-Grau), 的材料源于牛跟腱的胶原纤维, 有 6 个月的吸收期 ( McNeil et al.1994), 一致性和临床操作类似于其他可吸收薄膜 在新生成骨组织 6 个月的成熟期之后, 并经过可控 x- 射线处理, 再次处理牙缺损部分, 移除固定显微螺钉, 观察成熟和外观一致的新生成骨组织 种植体, 即 MG InHex ( 右侧 3.75 x 13 和左侧 4.25 x 13 ), 使用 40 Ncm 的植入扭力种植 如治疗严重牙槽萎缩时诱导骨再生和双边上颌骨窦提升, 使用基于完全人造羟基磷灰石和三钙盐磷酸盐的异体移植物能达到类似于其它相关生物材料的临床效果 53

54 科学总结 : 第二部分 REPLACING TWO CENTRAL INCISORS: PARAMETERS FOR AESTHETIC SUCCESS González García, Alberto Periodoncia y Osteointegración, Volume 20 - Issue 2 ABSTRACT Implant-supported restorations in the anterior superior area generally involve the requirement of achieving success in the cosmetic outcome in the short and long term, which makes the choice of surgical and restoration technique more demanding. We present a fully documented clinical case which illustrates the preservation of alveolar bone during and after extraction, immediate implant placement and the use of low-profile titanium abutments combined with zirconium crowns in the prosthetic phase, discussing other possible treatment forms, analysing their advantages and disadvantages. To achieve these cosmetic parameters, concepts such as the preservation of alveolar bone during and after extraction, immediate implant placement and use of zirconium in the prosthetic phase, are valued in all implant restorations, but they are most prominent when replacing teeth in the anterior front, as in the clinical case we present. 摘要 前上区的种植体支持修复一般需要达到短期和长期成功的美容效果, 这对手术和修复技术的要求会更高 我们在此展示一份完整记录的临床病例, 来说明拔牙过程中和拔牙后的牙槽骨保存, 即刻种植体植入和在义齿阶段联合使用低剖面钛合金基台与锆牙冠, 并讨论其他可行的治疗方案, 分析其优势和劣势 为达到这些美容参数, 某些观念如拔牙过程中和拔牙后的牙槽骨保存 即刻种植体植入和义齿阶段锆的使用等对种植体修复很有价值, 但替换正前面的牙齿时, 在我们所展示的临床病例中有提及, 这些概念是最为重要的 备注 REPLACING TWO CENTRAL INCISORS: PARAMETERS FOR AESTHETIC SUCCESS. FOUR YEARS FOLLOW-UP Dentist Bridge. 2013; Taiwan 54

55 科学总结 : 第二部分 CONVENTIONAL ULTRASONIC OSTEOTOMY IN OPEN MAXILLARY SINUS AUGMENTATION ABSTRACT González García, Alberto; Diniz, Márcio; Somoza, Manuel; García, Abel Implantologia Stomatologiczna PSI Implant Dentistry. 2011; Issue 03 Periodoncia y Osteointegración. 2010; Volume 20 We present a fully documented case of maxillary sinus lift where we employ conventional rotary osteotomy in combination with ultrasonic osteotomy, this being performed with a conventional descaling apparatus. A male patient, 53 years old, non-smoker and with no relevant medical history, visits our clinic requesting implant treatment to restore several edentulous segments. In the left posterior superior edentulous segment we observe little residual bone height, so it was decided to perform an open maxillary sinus lift with deferred implant placement as it was considered not possible to ensure good primary stability of all implants. Detachment of the sinus membrane is performed manually with specific curettes, which ensures sufficient height to achieve future placement of implants and is filled with xenografting MG Osteodrive (Mozo-Grau. Valladolid, Spain), covering the surgical window with a resorbable membrane, MG Reguarde (Mozo-Grau), fixed with two titanium pins, and repositioning the flap with 4-0 monofilament suture. After waiting for eight months and performing a control an x-ray, the edentulous segment is addressed again with a conservative incision and MG In-Hex implants are placed. Summary: Open maxillary sinus lift is one of the complementary techniques most commonly used in Implantology, with the perforation of the Schneider membrane being the most frequent intraoperative complication. In order to reduce its incidence, whilst not prolonging surgery time, the combined use of osteotomy with rotary instruments in conjunction with ultrasonic osteotomy performed with a conventional descaling apparatus is a technique which is safe, effective and with a very conservative cutting line. 摘要 我们在此展示一份上颌骨窦提升术的完整记录病例, 其中使用常规旋转式截骨术和超声截骨术, 并采用常规去氧化皮装置 一名男性患者,53 岁, 不吸烟, 无相关病史, 来到我们诊所就诊, 要求进行种植体治疗, 以修复严重的牙缺损部分 在左前下牙缺损区, 我们发现一些剩余骨, 随即决定采取种植体延时植入, 进行开放式上颌骨窦提升术, 因为该区域不能保证种植体良好的初始稳定性 使用特定的刮器对窦粘膜进行手动分离, 这能确保足够的高度, 便于以后种植体的植入, 并填充异种组织移植物 Osteodrive (Mozo-Grau. 巴利亚多里德, 西班牙 ), 使用可吸收薄膜 (MG Reguarde (Mozo-Grau)) 覆盖手术窗口, 使用两颗钛合金钉固定, 使用 4-0 单纤维缝线重新定位皮瓣 在 8 个月之后, 经过可控 x- 射线处理, 再次处理牙缺损部分, 小心切割该部分, 植入 MG In-Hex 种植体 总结 : 开放性上颌骨窦提升术是一种在种植技术中最为常见的补充技术,Schneider 薄膜的穿孔是最常见口腔手术并发症 为了减少并发症的发生, 同时不延长手术时间, 联合使用旋转式器具截骨术和超声截骨术, 并使用常规去氧化皮装置, 这项技术安全 有效且采用保守切割线 55

56 科学总结 : 第二部分 NEUROGENOUS OROFACIAL PAIN OF TRAUMATIC ETIOLOGY ABSTRACT Navarro Cuéllar, Carlos ; Cebrián Carretero, José Luis Chirurgia Czaszkowo-Szczekowo-Twarzowa i Ortopedia Szczekowa. 2009; Volume 4 The neurogenous orofacial pain is often overdiagnosed as an idiopathic trigeminal neuralgia. The buco-dental origin of this pain was described more than fifty years ago. Description of two cases of patients diagnosed with essential trigeminal neuralgia. Both are edentulous with full maxillar and mandibular prostheses, and present a severe maxillo-mandibular atrophy. There is submucosal exposure of the mental nerve due to the loss of the mandibular nerve canal. The submucosal compression of the inferior alveolar nerve as the result of pressure exercised by dental prostheses can cause orofacial pain which can lead to its incorrect diagnosis. Prosthetic rehabilitation over osseointegrated implants eliminates pain symptoms and saves patients from further medical treatment. 摘要 神经源性口面疼痛被经常过度诊断为一种突发性三叉神经神经痛 50 痛来源于口腔 - 牙齿进行了描述 多年前, 人们就对该疼 两例诊断为基本三叉神经痛的病例描述 二者均出现了牙缺损的情况, 要进行全上下颌骨修复术, 并出现严重的上下颌骨萎缩 由于下颌骨神经管的缺失, 出现了颏神经黏膜下暴露. 由于义齿压力导致的下牙槽神经黏膜下压迫可以引发口面疼痛, 导致错误的诊断 通过骨性结合种植体的假体修复能消除疼痛, 使患者免除进一步地治疗 56

57 科学总结 : 第二部分 ALVEOLAR BONE RECONSTRUCTION OF ATROPHIC MAXILLA WITH CALVARIAL BONE GRAFT. TWO CASE REPORTS A Modelo Pérez, Antonio; Rendón Infante, Juan Ignacio; Budiño Carbonero, Silvia Avances en Periodoncia e Implantología Oral. 2009; Volume 21, Issue 3: ABSTRACT The alveolar atrophy of superior maxilla is a difficult challenge to resolve in clinical practice for the dental rehabilitation on implants. There are several methods of reconstruction with this purpose. Although the election of the method depends on several factors, most importantly the amount of bone surplus and the patient s desires. We presented/displayed two cases in which we have carried out the prosthodontist rehabilitation on MG Osseous implants, non removable in one and removable in the other case. Previous to the positioning of the implants alveolar reconstruction was carried out with calvarial bone graft. 前上颌骨的牙槽萎缩是种植体牙修复临床实践的一大挑战 有几种重建法能达到此目的 摘要 尽管治疗方法要根据一些因素进行选择, 最重要的还是骨剩余量和患者的期望 我们展示了两例病例, 其中我们的镶牙医师采取了 MG Osseous 种植体 ( 一例为不可移动式, 另外一例为可移动式 ) 进行修复 种植体定位之前通过颅盖骨移植进行骨牙槽重建 57

58 科学总结 : 第二部分 MANDIBULAR RECONSTRUCTION WITH A MICROSURGICAL FIBULA FREE FLAP AND IMPLANT-SUPPORTED PROSTHESIS IN A PATIENT UNDERGONE RADIOTHERAPY Maniegas Lozano,Mª Lourdes; Martín-Granizo López, Rafael Revista Consejo de Odontólogos y Estomatólogos. 2008; Volume 13, Issue 1: ABSTRACT In this paper we present a complex clinical case of a reconstruction of an oncologic defect in the mandibular area, including the different therapeutic steps, pathological diagnosis and several imaging tests. Dental rehabilitation was provided by means of a removable implant-supported prosthesis on a osteo-fascio-cutaneous fibula free graft. The patient received previously radiotherapy. The results are analyzed and discussed. The decision-making process was based on current related literature. 摘要 在本文中, 我们会展示一例复杂的临床病例, 关于下颌骨区域肿瘤缺损的重建, 其中还包括不同的治疗步骤 病理诊断和一些影像学检查 在骨筋膜皮肤腓骨游离移植体上通过一个可摘除的种植体支持义齿进行牙修复 患者之前接受过化疗 我们还会分析讨论其疗效 决策过程是基于当前相关文献 58

59 科学总结 : 第二部分 COMPUTER-BASED APPLICATIONS IN IMPLANTOLOGY (Conference Summary) ABSTRACT Salmerón Escobar, José Ignacio Revista del Colegio Oficial de Odontólogos de Madrid In this conference we will review various IT applications, which are useful for planning and implant treatment. Via a CAT scan of the patient, a 3D-reconstruction of the jaw is performed, having as well views of cross, axial and panoramic sections. Thus we acquire perfect knowledge of the patient s anatomy and of structures of great interest, such as the sinus cavities and the dental nerve. With this same system we can place the implants, observing down to the last detail the right sizes, inclination and appropriate angles for the anatomical bone structure of the patient. This way allows us to carry out precise planning, perform virtual surgery and if we so wish, obtain a splint which will allow us to place the implants in the right way. The characteristics and differences between planning and traditional surgery and guided surgery are as follows: Traditional Surgery: An approximate plan is created from an orthopantomography. You can get a basic idea of bone density and position of the anatomical structures. The spatial location of the implant is determined after surgery via an impression. Guided Surgery: A CT scan provides an accurate assessment of the nerves, sinuses and bone density. We perform surgical planning with software. We obtain a surgical guide from planning. Guided surgical procedures provide precision. Possibility of immediate restoration. Conclusions: Planning systems, such as Simplant, provide perfect knowledge of the case avoiding complications due to errors. Splints planned with software allow implant placement in special situations or angles with minimally invasive surgery. 在该大会中, 我们将回顾多种对规划和种植体治疗有价值的 IT 应用 患者通过 CAT 扫描, 进行了颌骨的 3D- 重建, 很清晰地看到了横向截面 轴向截面和全景截面 因此我们要获取患者解剖学和关键部分的结构信息, 例如窦腔和牙神经 利用这种相同的系统, 我们可以植入种植体, 观察得到最后的细节信息 ( 患者解剖骨结构的正确大小 倾角和合适的角度 ) 该法使我们能够进行精确地规划和虚拟手术, 如果我们愿意, 还能获取一个医用夹板, 它能使我们以正确的方式植入种植体 有规划的传统手术和引导手术的特点和差异如下 : 传统手术 : 根据颌骨正位全景断层照片进行大致的规划 您可以获取一个基本的骨密度数值和解剖结构的位置 术后通过印模确定种植体空间位置 引导手术 :CT 扫描会对神经 窦和骨密度进行精确地评估 我们会通过软件进行手术规划 我们会从规划中获取手术指导 引导手术过程十分精确 可能实现即刻修复 总结 : 规划系统 ( 例如 Simplant) 提供了完整丰富的病例信息, 避免因错误导致的并发症 通过软件规划的夹板能帮助我们通过微创手术在特殊的情况或角度植入种植体 59

60 科学总结 : 第二部分 Bone regeneration with root level overcontouring in implantsupported restorations of the aesthetic area. Dr. Alberto González García y Dra. Carolina Pérez García Maxilaris, Junio 2016 ABSTRACT There is scientific literature with sufficient evidence about treatment with implant-supported restorations regarding the function and aesthetics with long-term results, so that we can ensure dental implants play an important role in the restorative treatment of daily clinical work. However, in the upper anterior area the aesthetic considerations are increasing its importance and such implant-supported restorations are supposed to meet certain expectations as restoration and peri-implant tissue must be in harmony with the surrounding structures as height, volume, color, texture, contour and health. Therefore, knowledge of the biological changes after tooth extraction, as well as its prevention and treatment is crucial to avoid significant negative consequences. When an upper front tooth should be replaced by an implant restoration, it is necessary to handle with dexterity various techniques and concepts to ensure the aesthetic success and its maintenance in time. The imminent and inevitable process of bone resorption of the vestibular area after tooth extraction and / or the pathological process itself which leads to extract this piece make, among other techniques, that it must be treated with guided bone regeneration (GBR) to ensure the aesthetic long-term success. The purpose of this article is to illustrate with a case report the importance of horizontally overcontouring in that GRB. 概要 这篇科学文献有充足的证据关于种植体支持下修复治疗得到的功能和美容方面的长期结果, 因此我们可以确信牙种植体在日常临床工作的修复治疗中扮演重要的角色 然而, 在前上区对美容因素的考虑愈发重要并且这种种植体支持的修复都应达到一定的期望值, 种植体周围组织必须周围结构如高度 体积 颜色 质地 轮廓和健康状况相协调 因此, 拔牙术后生理变化的相关知识, 以及相关预防和治疗对于避免严重的不利后果很重要 若上颚前门牙需用种植体修复更换, 熟练掌握各种技术和概念以保证美容效果并及时维护是非常有必要的 拔牙术后前庭区域将发生不可避免的骨吸收过程, 和 / 或其他技术导致牙拔出的病理过程, 必须通过诱导骨再生处理以保证长期的美容效果 本文的目的在于展示一份病例报告, 关于 GRB 中水平方向过度修整的重要性 60

61 科学总结 : 第二部分 Immediate aesthetic in implants post extraction and connective tissue graft: Step-by-step protocol ABSTRACT Dr. Herminio García Roncero Maxilaris, Junio 2015 Nowadays, we have enough scientific evidence related to implant placement at the same moment when performing dental removal. However, in the publications we have still little evidence in relation with the long-term aesthetic result, especially in patients with thin biotype. Neverthesless, more and more publications associate this kind of procedure using connective tissue graft with the aim to increase the vestibular width and, in this way, improve the tissues stability in the long run. Besides, the immediate placement of a provisional crown brings many advantages such us the maintenance of gingival scalloped, the creation of a correct emergency profile and in a simple way, reduction in number of visits and prosthetic handlings, comfort for patient and finally support for biomaterial placed in the alveolus and for the connective tissue graft incorporated by vestibular. Regarding the connective tissue donor area, we consider the tuberosity as the chosen area for this kind or procedures. Graftings from this area are thicker and more consistent than those from anterior palate, what make them less susceptible to post- operative reabsorption, but they are less vascularized. Besides, Tissue taken is performed by a simple and reduced morbility. 概要 目前已有足够的科学证据支持拔牙的同时可放置种植体 但是, 已发表的文献中极少提及到远期美学效果, 特别是薄生物型牙龈的患者 尽管如此, 越来越多的文章提到在进行这种操作时使用牙周组织移植从而增加前庭宽度, 并且改善长期的组织稳定性 另外, 即刻放置临时齿冠有诸多好处, 如保持圆齿状牙龈 以简单方式获得正确的急诊方案 减少患者就诊次数及义齿操作次数 患者感到舒适并最终 - 支持生物材料置入齿窝, 牙周组织移植物并入前庭部 对于牙周组织供体部位, 考虑选择结节状组织进行操作 在此部位移植组织更厚并且与前腭一致性更佳, 从而减少术后重吸收的敏感性, 但其血管化较差 另外, 提取组织的操作应简单并减少移动 61

62 科学总结 : 第二部分 ABSTRACT Implant supported rehabilitation with guided surgery in upper front sector affected by radicular cysts Dr. Pedro C. Peguero Moreira, Dra. Arantzazu Fernández Larrañaga, D. Juan Manuel Cuevas Maxilaris, Enero 2015 Many times maxilla cysts, and especially those from dental origin, which not also are the most common but they can compromise the bone quantity when rehabilitating with implants. Patients are asking for more implant solutions, but there are certain situations which can modify the treatment make it longer. If the bone loss is due to a cyst, firstly it has to be removed, secondly make bone regeneration and then, when the bone is consolidated, proceed to place the fixings. If these big cysts are placed in the anterior sector, the aesthetic compromised is larger when replacing dental pieces. To achieve favourable results, we have to try to regenerate as much bone as possible, since vestibular reabsorption will happen. Besides, the quantity regenerated must be enough to achieve good results with our implants. We must not forget about the quality and quantity of keratinized gum as this is of a great importance to get good rehabilitations result. In case the gum has not an appropriate width, it would be convenient to increase the keratinized gum To achieve patients satisfaction, we must respect the following aspects: place implants able to support the prosthesis, try to preserve the keratinized gum, respect the minimum distance between implants, try to provide a biological space in the interfase implant-prosthesis and place the implants guided prosthetically In this way we will be able to manufacture a prosthesis aesthetic enough to achieve patient agreement. Regarding prosthesis, this has to have a good fitting and a good manufacturing. Cad-Cam procedures are a good option to get appropriate results. Prosthesis manufacturing procedures are the following: 1.Take implant impressions 2.Scan the impression 3.Manufacture Cad-Cam structure 4.Place last-generation porcelain 5.Finish The objective of this article is to show how with significant bone losses caused by cysts in the upper front sector we can achieve good results with implant- supported rehabilitations. 概要 上颌骨囊肿中特别是牙源性囊肿, 虽不是最常见类型, 但其可在种植体修复时损害牙的骨量 患者会要求更多的种植体解决方案, 但某些情况下可以调整治疗使得种植体维持更长时间 若骨量丢失源于囊肿, 首先应摘除囊肿, 然后进行骨再生治疗, 当骨缺损愈合后, 再放置固定装置 若这些大囊肿位于前面部, 则置换牙件时需要牺牲更多的美观 为达到更好的效果, 必须进行骨再生诱导出尽可能多的骨量, 因为会出现前庭的骨重吸收 另外, 再生的骨量必须足量, 种植体才能达到好的疗效 我们还不能忘记角化牙龈的数量和质量, 因为这对达到好的修复效果非常重要 若牙龈宽度不合适, 则有利于角化牙龈的增长 为使患者满意, 必须遵守以下几项原则 : 放置种植体能够撑住义齿, 尝试保留角化牙龈, 两个种植体间保持最小间距, 在种植体 - 义齿交界处留有生物学空间并以义齿为导向放置种植体通过这种方式即可生产出在美观上达到患者要求的义齿 义齿必须尺寸合适并制造精良 Cad- Cam 制作流程是较好的选择, 可获得不错的效果 义齿制作流程如下 : 1. 取出种植体印模 2. 扫描印模 3. 制作 Cad-Cam 结构 4. 配置上一代陶瓷材料 5. 完成本文的目的是展示如何在囊肿导致扇形大量骨缺损时进行种植体支持的修复治疗并获得好的疗效 62

63 科学总结 : 第二部分 MAXIMUM ACCURACY WITH MINIMAL RESOURCES IN IMPRESSIONS FOR IMPLANTS Fernández Encinas, José Raúl; Navarro Camacho, Manuel; Fernández Mileti, Silvina Maxillaris ABSTRACT The purpose of taking an impression in implantology is to accurately copy the position of the implants and other oral structures to make a model or an exact replica in plaster on which to perform the restoration. Accuracy is vital for the clinician when taking an impression, because otherwise all subsequent work will be useless, with consequent loss of time, money and effort, as well as being perceived negatively by the patient. There are many materials and techniques for this purpose, so it will be essential to choose the most suitable to our needs. 概要 在种植技术中使用印模的目的是为了精确地复制种植体位置和其它口腔结构, 以在修复位置制作模具或精确的石膏复制品 在制作印模时, 精确度对于临床医生来说至关重要, 因为如果精确度不够, 后续工作就毫无意义, 只会徒费时间 资金和精力, 而且还会对患者造成负面影响 为了达此目的, 可以使用很多材料和技术, 所以有必要选择最为满足您需要的方案 63

64 科学总结 : 第二部分 COMPLETE RESTORATION OF THE MAXILLA WITH PROSTHESIS CEMENTED ON SIX IMPLANTS ABSTRACT González García, Alberto Maxillaris Sztuka Implantologii In this paper we present all the steps in the restoration of an edentulous maxilla with implantsupported fixed prostheses cemented over six osseointegrated implants, graphically documenting the surgery, the preparation and the placement of the prosthesis. Clinical case: A 59-year-old female patient with no relevant clinical history. The patient presents a partial resin prosthesis in the upper arch retained by three teeth with cavities and periodontal disease [ ]. After the study, we decided to restore the upper jaw with an implant-supported metal-ceramic prosthesis cemented on six pillars on implants [ ]. We placed six MG Inhex (Mozo-Grau S.L., Valladolid. Spain) implants. The design of the internal connection implant will allow us to minimise peri-implantation bone loss and achieve better aesthetics, especially when the anterior section is involved, as is the case here. Due to the narrow width of the residual alveolar bone, we needed to perform bone expansion via expansion osteotomes and self-tapping expanders, and we placed abutments at a 15º angle for Inhex (Mozo-Grau S.L.) to correct the observed disparallelism. Conclusions: Given the multitude of possibilities which restorative Implantology allows today, we must know their advantages and disadvantages to individually choose the most appropriate one in each situation. As we see in this case, if the residual maxillary alveolar ridge and the surgical technique allow us to place a minimum of well distributed fixations, implant-supported restoration with a cemented metal-ceramic prosthesis is a good restoration choice, as far as comfort and aesthetics are concerned, in addition to correcting parallelism. 摘要 在本文中, 我们将展示上颌骨牙缺损修复的所有步骤, 该法会在 6 颗骨性结合种植体上接合种植体支持的固定义齿, 我们会采取图解法记录手术和义齿的准备和植入 临床病例 : 一位 59 岁女性患者, 无相关的临床病史 该患者在上牙弓的三颗患有龋齿和牙周疾病的牙齿装有部分树脂义齿 [ ] 在研究后, 我们决定对其上颌骨进行修复, 在 6 颗种植体上粘合一颗种植牙支持的金属陶瓷义齿 [ ] 我们植入了 6 颗 MG Inhex Mozo-Grau S.L., 巴利亚多里德, 西班牙 ) 种植体 其内部连接种植体的设计最大程度地减少植牙周围的骨损失, 达到更好的美容效果, 特别是在前区, 正如本病例所示 由于剩余牙槽骨的宽度狭窄, 我们需要使用扩张骨凿和自攻式螺钉扩张器对骨进行扩张, 还在 Inhex (Mozo-Grau S.L.) 的 15º 角植入基台, 修正可见的不平行 总结 : 给予考虑到现在修复种植术种类繁多, 我们必须了解其优势和劣势, 以便在不同的情况中选择最合适的方案 正如我们在本病例中看到的, 如果剩余上颌骨牙槽嵴和手术技术允许我们使用一颗粘合性金属陶瓷义齿进行最小化的全分布固定术和种植牙支持修复术, 这就会是一种很好的修复选择, 能达到良好的舒适和美容效果, 另外还能修正平行情况 64

65 科学总结 : 第二部分 DEFINITION AND MAINTENANCE OF THE EMERGENCE PROFILE ABSTRACT Núñez, Juan Maxillaris As Stomatologii One of the most important things in cosmetic dentistry is the seamless integration of the prosthesis with all the teeth in the arch; this is more difficult the more visible the tooth is, therefore the anterior superior sector is the one with the most aesthetic engagement. To achieve this we need a good prosthesis, as close as possible to the natural teeth and especially the equivalent of the other hemi-arch, in order to achieve symmetry in the mouth that will extend to the face and its expression. But something that we sometimes forget is that no matter how aesthetically pleasing the prosthesis, it is nothing without a soft tissue that is also as close as possible to the same tooth of the other hemi-arch or to the tooth we have extracted, should this be the case. This soft tissue is the framework for our prosthesis; it is best to maintain the emergence profile of the natural tooth we are going to extract by placing an immediate implant and a provisional one which provides aesthetics, serves as support for the soft tissue and maintains that profile; if we have to create this ourselves, it is more complicated and time consuming. 摘要 美容牙科中一件最重要的事是牙弓上所有牙齿与假体的无缝结合 ; 难度越高, 牙齿就更为美观 因此前上区对于牙齿美容来说最为重要 为达到这种效果, 我们需要的良好假体, 尽可能贴合自然牙, 尤其是其它的半牙弓, 以达到口腔的对称, 这也会使面部和表情对称 但是有时我们会忘记没有尽可能贴合其它半牙弓上相同牙齿或我们拔除的牙齿的软组织, 无论多么美观的假体都无法使用, 应为本病例所示 这种软组织是我们义齿的框架 ; 最好能保持将要拔除自然牙的萌发形态, 可通过在拔除位置要植入一颗即刻种植体和临时种植体, 它能带来美容效果, 支持软组织并保持萌发形态 ; 如果我们要自行创造, 则更加复杂耗时 65

66 科学总结 : 第二部分 BIMAXILLARY IMPLANT-SUPPORTED RESTORATION AND PROVISIONAL IMMEDIATE LOADING ABSTRACT Fernández de Peñaranda, Antonio; González Martín, Maribel Stuka Implantologii Gaceta Dental Maxillaris The concept of Immediate Loading in Implantology was demonstrated during the 1980s. It was observed that dental implants exposed to an oral environment and subjected to operating loads reproduce a biological model similar to natural dentition. A male patient, 65 years old, non-smoker and with no relevant medical history. The patient has chronic adult periodontal disease in an advanced state. The placement of six transmucosal implants in the upper maxilla was planned and we planned six for the mandible. All the implants placed were MG Osseous from Mozo-Grau S.L., anatomical, self-tapping, with universal external hex and treated surface (RBM). First we performed surgery on the the upper jaw, placing the planned implants, and the following week we inserted the implants in the lower jaw. The provisional prostheses were made of resin and were placed in both cases 24 hours after each surgery. After the six weeks needed for the implant osseointegration passed, we began preparing the permanent prostheses. Conclusions: 1. Today there is a high predictability in immediate implant-supported restorations. 2. The advantages of this type of prosthetic restorations to the patient are a high degree of comfort and immediate aesthetics and function. 3. It is sufficient to place 6 implants in both arches to perform immediate implantsupported restorations. 4. It is necessary to seek a symmetrical insertion of the fasteners, as well as an insertion torque of 35 to 45 Ncm. 5. In rare cases, if there is sufficient availability of bone volume in both height and width and appropriate professional experience, we can choose to perform noninvasive surgical techniques using transmucosal implant placement. 6. Provisional prostheses should be made of resin and all implants that have obtained primary stability during insertion must be splinted. 7. Six weeks of healing is enough to consider carrying out the patient s final prostheses. 种植技术中即刻负载的概念在 20 世纪 80 年代就有人进行了阐述 我们发现牙种植体暴露于口腔环境中, 手术负载复制了一种类似于自然牙体的生物模型 摘要 一名男性患者,65 岁, 不吸烟, 没有相关的病史 患者患有后期慢性成人牙周疾病 我们在上下颌骨各规划了 6 颗透黏膜种植体 所有植入的种植体均为 Mozo-Grau S.L. MG Osseous 该产品符合解剖学原理, 自攻式, 带有通用外六角和治疗面 (RBM) 首先, 我们对上颌骨进行了手术, 植入规划种植体, 在接下来的一周, 我们在下颌骨植入了种植体 临时义齿的材料为树脂, 均在手术后 24 小时内植入 6 周后, 需要进行种植体骨性结合, 我们开始准备永久假体 总结 :1. 现在在即刻种植体支持修复中, 拥有很高的预测能力 2. 此种类型的义齿修复优势在于使患者更为舒适 即刻拥有更好的美容和功能疗效 3. 在牙弓上足以植入 6 颗种植体, 进行即刻种植体支持修复 4. 有必要寻求固定器的对称嵌入, 保持 35 to 45 Ncm 的嵌入扭力 5. 在很少的病例中, 如果有足够的各个高度和宽度的可用骨量和和足够的专业经验, 我们可以选择使用透黏膜种植体植入的无创手术技术 6. 临时义齿的制作材料应为树脂, 所有在嵌入时获得初期稳定度的种植体必须使用夹板固定 7.6 周的恢复期足以考虑进行最终的义齿植入 66

67 科学总结 : 第二部分 BIMAXILLARY DENTAL RESTORATION WITH POST-EXTRACTION IMPLANTS AND MANDIBULAR IMMEDIATE LOADING Caubet Biayna, Jorge; Sánchez Mayoral, Jacobo; Iriarte Ortabe, José Ignacio; Morey Más, Miguel Vich Calafell, Bartolomé; Tomás Galmés, Alberto Sztuka Implantologii Maxillaris ABSTRACT Objective: Reporting a clinical case of bimaxillary dental restoration with post-extraction dental implants. Clinical case: A 65-year-old male, moderate smoker, partial edentulism in both arches with advanced periodontal disease on what remains, with exposed root furcation that causes significant tooth mobility (grade II) and requires a definitive treatment for his dental disease, an acceptable immediate cosmetic solution and a final result according to his previous appearance. During the same surgery, the following will be performed: extraction of all teeth, implant placement of six MG Osseous (Mozo-Grau) maxillary implants and six mandibular implants of the same brand (except at canine level), restoration with immediate complete removable prosthesis in the maxillary and an implant-supported fixed prosthesis to be loaded within 24 hours of surgery, occlusally perforated allowing the exit of the transfers and outstripped with autopolymerising resin. The permanent ones were two metal-composite hybrids on six implants, gold cylinder directly on the implant with a structure of a seminoble metal, made of three sections, splinted in the mouth and welded later with laser. Results: A clear facial improvement with comprehensive stomatognathic restoration, which did not cause a significant change in the patient s appearance, a fact he demanded from the first day he visited the clinic. 摘要 目标 : 报告拔牙后种植物和下颌骨即刻负重的双侧牙修复的临床病例 临床病例 : 一位 65 岁男性, 中度吸烟者, 牙弓部分牙缺损, 患有重度牙周疾病, 并且牙根暴露性分叉, 造成重度牙松动 (II 级 ), 该患者要求对其牙疾病进行确定性治疗, 采取可接受的即时美容方案, 恢复到患者以前的外貌 在相同的手术中, 要进行以下步骤 : 拔除牙齿, 植入 6 颗 MG Osseous (Mozo-Grau) 上颌骨种植体和 6 颗相同品牌的下颌骨种植体 ( 除了犬齿部位 ), 在上颌骨使用即刻可摘除的全口义齿进行修复, 并在手术的 24 小时内负载一颗种植体支持的固定义齿, 进行允许移植物存在的咬合钻孔, 效果优于自凝硅橡胶树脂 在 6 颗种植体上永久负载 2 个金属复合物和金制圆柱体, 该圆柱物的材质为半贵重金属,3 部分结构, 在口腔中使用夹板, 稍后用激光焊接 结果 : 通过全面的口颌修复, 获得了明显的面部改善, 没有对患者外貌造成大的变化, 达到了他在就诊第一天所提出的要求 67

68 科学总结 : 第二部分 ORAL RESTORATION WITH PROSTHESIS ON IMPLANTS PLACED IN FIBULA MICROSURGICAL AUTOGRAFT ABSTRACT Martín-Granizo López, Rafael; Domínguez Cuadrado, Lara; Berguer, Alberto Maxillaris When there is a bone defect in the upper maxilla or mandible we have to select the most appropriate procedure for reconstruction, depending on size, soft-tissue involvement and patient characteristics. We must always seek to ensure that the technique with less morbidity achieves better aesthetic and functional results, aimed at early prosthetic restoration. Below we present a case where there is a defect of more than 50% of the upper maxillary bone with central oronasal communication. We opted to use a microvascular fibula flap for bone support and to seal the fistula. A year later, we placed six titanium implants on which we subsequently implanted a tooth-supported prosthesis. Different types of materials can be used for the reconstruction of bone defects of the upper or lower jaw and subsequent dental restoration, from membranes (closely linked to the concept of guided tissue regeneration) to stabilisers (elements capable of binding and/or converting particulate fillers into a non-dispersible mouldable mass) and fillers (autologous bone, homologous bone, heterologous bone and nonosseous synthetic and organic materials). The reconstruction of extensive upper maxilla bone defects requires careful surgical planning, designed to provide the patient with good aesthetic and functional results. Currently, microvascular flaps represent the best option and if there is also a significant soft tissue defect, the type of graft to be used must be carefully selected. In our experience, microvascular fibular grafting can provide, apart from soft tissue, bone extension, which, if not of the best quality, is still sufficient for the subsequent placement of implants and prosthetic restoration. 摘要 当上颌骨或下颌骨出现骨缺损时, 我们必须根据尺寸 涉及的软组织和患者特点选择最合适的重建方法 我们必须保证治疗方法的发病率低, 且能取得更好的功能和美容疗效, 达到早期的义齿修复效果 下面我们展示的病例中, 用中央口鼻穿孔后上颌骨骨缺损超过了 50% 我们使用了微血管腓骨皮瓣进行骨支撑, 并密封瘘管 一年后, 我们植入了 6 颗种植体, 并随后植入自然牙支持义齿 上下颌骨的骨缺损重建和随后的牙修复可使用不同的种类的材料, 包括薄膜 ( 与引导组织再生的概念联系紧密 ), 稳定剂 ( 能够结合和 / 或将颗粒填充物转化为非扩散性可塑物质的元素 ) 和填充物 ( 自体移植骨 同种异体骨 异种骨 非骨合成物和有机材料 ) 大量的上颌骨缺损重建要求进行仔细的手术规划, 为患者带来良好的美容和功能效果 目前, 微血管皮瓣是最佳的选择, 如果仍然存在严重的软组织缺损, 移植物的种类需要仔细挑选 根据我们的经验, 除了软组织和骨延长, 均可使用骨显微血管腓骨移植, 即便其质量不是最佳, 也足用以的之后种植体和义齿修复的植入 68

69 科学总结 : 第二部分 THE IMPLANTOLOGICAL TREATMENT OF SEVERELY ATROPHIC ALVEOLAR PAT OF THE MANDIBLE Damian Dudek, Oliwia Segiet, Edyta Reichman-Warmusz, Michał Matusek, Karolina Wałach i Krzysztof Helewski Implants. international magazine of oral implantology, 2014 ABSTRACT The authors present a case of implantological treatment in edentulous mandible by 60 years old women with using a Mozograuimplantological system. The retainedimplants in the front of the mandiblewere immediate loading. The most dificulty was a severely atrophic of alveolar part of the mandible and advantage of a hard bone tissue. In the 4 years follow-up in the short time after the osseointegration the complications was observed. One implant was failed. 摘要 作者展示的一份病例为,60 岁老年女性无牙下颌骨使用 Mozograu 植入系统进行植入性治疗 下颌骨前方保留的种植体即刻可以负重 最困难的是下颌骨齿槽块严重萎缩部分以及坚硬骨组织的好处 在 4 年的随访期中观察了骨整合后短期并发症的情况 有一处种植体失败 69

70 科学总结 : 第二部分 The application of methodology for bone splitting and bone condensation Michał Fidecki, Izabela Strużycka Implants. international magazine of oral implantology, 2014 ABSTRACT The objective of the studio is to present the restoration report with fixed prosthesis in a patient using atraumatic expanders in the maxillary bone and the subsequent placement of 6 MG Inhex implants as well as the implant success assessment after 5 years of clinical follow-up. 摘要 研究目的在于介绍一份关于固定修复体的修复报告, 对患者下颌骨使用无损伤扩展器然后植入 6 MG Inhex 种植体, 并在术后成功进行 5 年的临床随访 70

71 科学总结 : 第二部分 Rehabilitation with dental implants in the posterior maxilla ABSTRACT Dr. Alfonso Mogedas Vegara, Dr. Juan Antonio Hueto Madrid, Dr. Javier González Lagunas. Gaceta Dental, Febrero 2015 The rehabilitation with dental implants in the posterior maxi- lla is not always possible mainly due the alveolar resorption. Different techniques may be use to restore the maxilla when conventional dental implants are not suitable. An updated review focused on the different techniques to rehabilitate the posterior maxilla was performed and also different clini- cal cases solved by the Oral and Maxillofacial department of Hospital Quiron Barcelona are presented. 摘要 在后上颌骨进行牙种植体修复并非总能实现, 主要因为牙槽骨的再吸收作用 当传统的牙种植体不适用时, 可选择不同的技术手段来修复上颌骨 一份最新的研究综述重点关注了使用不同技术修复上颌骨的操作方法, 并展示了在巴塞罗那 Quiron 医院口腔颌面外科进行治疗的多个不同临床病例资料 71

72 科学总结 : 第二部分 Immediate post extraction bone regeneration without flap by means of an implant of a superior central incisor Dr. Carlos Bonilla Mejías, Dra. Begoña Faus Mascarell, Dra. Regina María Mosquera Pérez, Dr. Daniel Torres Lagares, Dr. José Luis Gutiérrez Pérez Gaceta Dental, 2015 ABSTRACT Replacing a central incisor with an implant in a patient with a high smile line is always a challenge that leads the clinician to consider various treatment plans in view of the multitude of existing techniques. The case presented is built from the previous difficulty of these aesthetic demands couple with the tooth was affected by an infectious process which had caused destruction of the vestibular table. The objective is to perform the treatment that achieves the best long-term outcome. It was used the cone shape regeneration with membrane technique from the English ice-cream cone technique with the goal to attain a good bone volume. In cases of aesthetic compromise, the cone shape technique results in a good choice to regenerate defects on vestibular level without performing vertical discharges. The result success will lie in a correct planning and in the choice of the most appropriate technique for the implantology rehabilitation with a satisfactory, stable and long-term aestheti. 概要 为具有高微笑线的患者进行中切牙种植体置换始终具有挑战性, 因此医生会考虑到现有的各种技术来制定不同的治疗计划 本文介绍的病例即存在之前所述的困难, 包括美观的需求, 以及受感染的牙齿导致前庭骨板毁坏 治疗目的在于达到最佳的长期疗效 使用了锥状再生结合膜技术, 这源自英语中 冰淇淋锥技术, 目的是获得足够的骨量 若在美观上要求不高, 则锥状技术是一个好的选择, 无需进行垂直引出即可在前庭水平使缺损再生 获得良好疗效的秘诀在于正确的治疗计划, 选择最适当的技术进行移植学康复治疗, 并获得满意 稳定和长期的美学效果 72

73 科学总结 : 第二部分 GUIDED BONE REGENERATION STUDY ABSTRACT Castillo Dalí, Gabriel; Batista Cruzado, Antonio; González Martín, Maribel ; Torres Lagares, Daniel; Gutiérrez Pérez, José Luis Gaceta Dental Objective: The histological and histomorphometric evaluation of the use of MG-Reguarde combined with MG-Osteodrive applied to bone regeneration, compared to a negative control. Materials and method: Ten patients were included, aged 18 to 30 years, of both sexes, requiring the removal of a lower third molar. The wisdom tooth needed to be found with bone retention without breaking the mucosa. There were two random study groups: Group 1.- Regeneration with MG-Reguarde and with MG-Osteodrive (5 patients); Group 2.- No regeneration (5 patients). A bone sample was taken three and six months after surgery. The following variables were evaluated: new tissue area (units; μm² x 10 4 ) and newly formed bone percentage (% units). A non-parametric U-Mann Whitney analysis was used. Results: The experimental group showed better results in both variables than the control group, both in relation to the area of formed bone variable (7.06 x 104 µm2 ± 1.78 vs x 104 µm2 ± 2.69 at three months and x 104 µm2 ± 4.19 vs x 104 µm2 ± 5.05 at six months; p<0.001) and the percentage of newly formed bone variable (6.32% ± 1.70 vs % ± 4.56 at three months and 18.20% ± 5.15 vs % ± 11.8 at six months; p<0.001). Conclusions: From a clinical and statistical view, MG-Osteodrive membranes and MG-Reguarde bone substitute fulfil all the characteristics to be used in Oral Surgery, improving the percentages of bone regeneration in post-extraction alveolus after 3 and 6 months period when compared with control group. 摘要 目标 :MG-Reguarde 和 MG-Osteodrive 结合使用的组织学和形态计量学评估应用于骨再生术中, 并与阴性对照进行对比 材料和方法 : 挑选的 10 位患者为年龄在 18 至 30 岁之间, 男女均有, 需要移除下颌第三磨牙的患者 需要通过骨内滞留术, 且不破坏粘膜, 找到智齿 分成了两个随机研究小组 : 第一组.- 使用 MG-Reguarde 和 MG-Osteodrive 的再生术 (2 名患者 ); 第二组 - 不进行再生术 (5 名患者 ) 手术后的 3 和 6 个月, 采集骨样本 以下是评估的变量 : 新组织区域 ( 单位 ; μm² x 104), 新生成骨百分比 ( 单位 %) 我们使用无参数 U-Mann Whitney 分析法 结果 : 试验组所有的变量结果均优于对照组, 包括生成骨变量区域 (7.06 x 104 μm2 ± 1.78 vs x 104 μm2 ± 2.69(3 个月后 ) 和 x 104 μm2 ± 4.19 vs x 104 μm2 ± 5.05 (6 个月后 );p<0.001) 和新生成骨变量百分比 (6.32% ± 1.70 vs % ± 4.56 (3 个月后 ) 和 18.20% ± 5.15 vs % ± 11.8(6 个月后 );p<0.001) 总结 : 从临床和统计的角度看,MG-Osteodrive 薄膜和 MG- Reguarde 骨替代物满足所有口腔外科手术的参数, 与对照组相比,3 和 6 个月后, 它们能提高拔牙后牙槽的骨再生百分比 73

74 科学总结 : 第二部分 IMMEDIATE LOADING AND AESTHETICS IN THE ANTERIOR SECTOR. A CASE REPORT ABSTRACT Núñez Fernández, Juan Implantologia Stomatologiczna Gaceta Dental Something that is being constantly discussed of late in the world of implantology is immediate loading and aesthetics in the anterior sector ; the following case is ideal for covering both fields at once with a predictable outcome. A female patient, 27 years of age, with high aesthetic demands, visited us requesting dental treatment to fix the problem created by the agenesis of tooth 22 and the permanence of 62 in the mouth, but with great root resorption, to the point of having only mucosa insertion. This resulted in high mobility and worried the patient, since she was afraid of losing the tooth. She asks us to solve the problem, and strongly emphasises that she does not under any circumstances want to be without the tooth. In the study we must pay special attention to the space available for the placement of the implant and crown, assessing patient occlusion, mesial-distal space, thickness and depth of soft tissue and bone quantity in height and vestibular-palatal direction throughout the whole implant length that we are going to place, bearing in mind the possibility that, at this level, the bone might have a vestibular concavity. 摘要 在种植技术领域一些需要不断讨论的问题包括 前扇区的即刻负重和美容 ; 以下病例通过可预测的成果很好地涵盖了相关领域 一名女性患者,27 岁, 对美容的需求高, 前来就诊, 要求进行牙科治疗以修复齿形 22 和永久的口形 62 的发育缺损带来的问题, 但其牙根吸收性强, 只能植入黏膜 这会造成牙齿可移动性很高使患者担忧, 因为她害怕丧失牙齿 她要求我们解决该问题, 并强调不想缺失牙齿 在该研究中, 我们必须特别注意种植体和牙冠植入的可用空间, 评估患者的咬合状况 内侧远端空间 软组织的厚度和深度 高度骨数量和整个植入长度的前庭腭部方向, 我们要处理和考虑骨头可能产生前庭凹度 74

75 科学总结 : 第二部分 FIXED IMPLANT-SUPPORTED SUPERIOR FULL RESTORATION WITH GUIDED SURGERY ABSTRACT Bowen Antolín,Antonio; Nasimi, Abdul; Pascua Gómez, Maite; Arnáiz González, Francisco Javier Gaceta Dental Traditional surgical techniques for insertion of osseointegrated implants require the performance of full surgery. Recent years have seen the clinical introduction of surgical techniques that require no incisions or mucoperiosteal detachments, which have been framed within the concept of minimally invasive surgery, and among them, computer-guided surgery, perhaps being the most increasingly common clinical application. The advantages, as noted, are obvious, but we want to emphasise two aspects: first, complete planning and knowledge of the case in question, much more than when planning cases with implants and negatoscope template; and second, the reduction of common postoperative complications (pain, swelling, bruising...) in conventional techniques,making it the best choice for older patients. This is a female carrying a complete upper prosthesis for the last 10 years, who comes to see us for a restoration of the upper maxilla with a fix prosthesis. No relevant medical history. Planning is performed via assembly in the articulator and making a dental scan prosthesis. With it properly articulated, a CAT scan is performed and the image processed via the Implametric application from the DICOM radiological data obtained. Insertion of 10 implants (MG Osseous, Mozo-Grau, Valladolid, Spain) is planned and it is performed via guided surgery, using the surgical splint provided by the software supplier. After the osseointegration time has passed, the implant-supported prosthesis is inserted and the correct adjustment and articulation of the restoration are checked. 传统骨性结合种植体植入手术技术要求进行充分的手术 近些年的手术技术临床介绍中则要求无手术切口或粘骨膜的的分离, 这是微创手术的概念, 其中, 计算机辅助手术可能会逐渐成为最常见的临床应用 摘要 如前所述, 其优势是较为明显的, 但是我们想要强调两方面内容 : 第一, 完整的规划和相关的病例信息要比规划种植体和看片灯模板更重要 ; 第二, 使用常规技术减少了常见术后并发症 ( 疼痛 肿胀 瘀伤...), 这使之成为年长患者最好的选择 一位女性患者 (10 年前植入了一颗完整上颌部义齿 ) 前来就诊, 要求使用一颗固定义齿进行上颌骨的修复 没有相关病史 通过咬合器的组件和制作一颗牙扫描义齿来实现规划 经过合适的咬合, 采取 CAT 扫描, 通过获取的 DICOM 影像数据中的 Implametric 应用处理图像 规划 10 颗种植体 (MG Osseous, Mozo-Grau, 巴利亚多里德, 西班牙 ) 的植入, 采用引导手术, 手术中使用有软件供应商提供的外科夹板 骨性结合之后, 植入种植体支持义齿, 检查修复的正确调节和咬合状况 75

76 科学总结 : 第二部分 HEMIMANDIBULAR BONE-ALVEOLAR DISTRACTION. TREATMENT FOR A POST- ONCOLOGIC PATIENT. RESTORATION de Benito-Sendín Velasco, Manuel Andrés; García García, Jorge; de Benito-Sendín Velasco, Andrés; de Benito-Sendín Velasco, José Mª; Arroyo Ramos, Candela; Mateos García; Verónica Gaceta Dental ABSTRACT Giant cell tumours are very rare; they almost always appear in patients over 20 years old. They are characterised by an osteolytic lesion, often multilocular and with sharp edges. Perforation is sometimes observed within the alveolar process in the oral cavity. Clinical case: In this article we will see the evolution of a 23-year-old patient who comes to the clinic showing mandibular swelling in the right side due to a tumour that expands both corticals invading soft tissues. Reconstruction is subsequently performed with an iliac crest graft and later graft distraction with four MGU distractors from Mozo-Grau, achieving an increase in height and width of 10.8 mm Result: Young patient who underwent oral tumour excision, leaving a minimal jaw segment for support. Distraction of the hip grafts is performed later, followed by the implant-supported restoration. With the patient at no time presenting visible aesthetic deformation. 摘要 巨大细胞的肿瘤十分少见 ; 它们几乎存在于患者体内超过 20 年之久 其特征为蚀骨性病变, 通常是多房性, 并带有锋利的边缘 有时会在口腔的牙槽突内发现穿孔 临床病例 : 在本文中, 我们将对一位 23 岁患者进行评估, 她前来就诊, 发现其右侧下颌骨肿胀, 病因为肿瘤扩张到外皮, 侵入软组织 重建术将会在随后进行, 手术会使用髂嵴移植物, 然后使用 4 个 Mozo-Grau 的 MGU 牵引器的进行移植物牵引, 使高度和宽度增加 10.8 mm 疗效 : 接受过口腔肿瘤切除的年轻患者, 留下了极少量用以支持的颌骨 之后进行髋部移植物的牵引, 然后进行种植体支持修复 患者没有出现可见的外观变形 76

77 科学总结 : 第二部分 OSTEODISTRACTION OF THE ALVEOLAR PROCESS ABSTRACT Bowen Antolín, Antonio; Álvarez, Elena; Bances del Castillo, Elena Gaceta Dental Distraction osteogenesis is a biological process by which bone is formed between two bone fragments that are separated gradually. The new tissue originates only under certain conditions, which we will mention later, and which do not alter the physiological phenomena that occur between the fragments. This active histogenesis occurs not only in the bone but also in skin, muscle, vascular and peripheral nervous tissue. Authors present two clinical cases: Case 1 (Intraoral extraosseous device) 23-year-old patient with traumatic avulsion of the anterior group in the mandible and bone loss and mandibular fracture, treated with miniplate osteosynthesis. The distraction period was performed by activating the 0.5 mm distraction device (half a turn of the activator), twice a day, to achieve an increase in height of 8 mm. Case 2 (Intraoral intraosseous device) 56-year-old patient with atrophy in the posterior sector of the lower jaw, with a height of 7 mm from the alveolar ridge to the mandibular canal. Conclusions: 1. The upper and lower jaw can be expanded in length and width by distraction osteogenesis. The soft tissues accompany them. 2. It distracts vital bone that becomes mineralised early. 3. Resorption is lower than that which occurs in overlapping or interposed grafts. 4. No morbidity of a second surgical field, since it is not necessary to obtain grafts. 5. Intraoral distraction devices have fewer complications and are more comfortable for patients than extraoral ones. 6. The osteodistraction of the deficient alveolar ridge represents an effective and reliable technique for a certain volume of bone mass in a predetermined position on which osseointegrated implants are inserted and proper prosthetic restoration is achieved. 摘要 牵引成骨术是一种生物处理法, 在逐渐分离的两块碎骨间成骨 新的组织只会在特定条件下生成, 我们待会将会提及, 而且这不会改变碎骨间的生理现象 这种活跃的组织生成不仅会在骨中发生, 也涵盖皮肤 肌肉 血管和外周神经组织 作者列举了 2 个临床病例 : 病例一 ( 口内骨外装置 ) 下颌骨前部创伤性撕脱 骨缺损和上颌骨骨折的 23 岁患者, 采用小型钛板接骨术治疗 牵引期就是开始使用 0.5 mm 牵引装置 ( 大小为激活器的一半 ), 一天两次, 能增加 8 mm 的高度. 病例二 ( 口内骨内装置 ) 下颌骨后部萎缩的 56 岁患者, 牙槽嵴到下颌管的高度为 7 mm 总结 :1. 通过牵引成骨术可使上 下颌骨的长度和宽度延伸 软组织与骨一起改变 2. 该法会牵引关键骨, 使之早期矿化 3. 其骨吸收要比重叠或插入的移植物要更低 4. 在二次手术区域没有复发, 因为它不需要去获取移植物 5. 口内牵引装置的并发症比口外装置的要少, 而且会使患者更加舒适 6. 牙槽嵴缺损的骨牵引术是一种可靠的技术, 它针对的是预定位置中的固定骨量, 植入骨性结合种植体, 并达到理想的义齿修复效果 77

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79 X 图片 :2 年和 4 年随访时的 MG Inhex 种植体 由 Alberto González 医生提供 在 48 页查看病例报告

80 图片由 Torres Lagares 医生提供 在 45 页查看研究