Clinical efficacy,bone density,and follow-up in implant and orthodontic treatment for inclined adjacent teeth

BACKGROUND Tooth defects can cause elongation of occlusal teeth,leading to insufficient repair space.The combination of dental implant restoration and orthodontic treatment of oblique adjacent teeth has a significant therapeutic effect.AIM To explore clinical efficacy,bone density,and follow-up of implant and orthodontic treatment for patients with inclined adjacent teeth.METHODS In total,98 patients with oblique adjacent teeth were randomly assigned to implant restoration combined with orthodontic treatment(group A,n=49)or to receive implant restoration alone(group B,n=49).Changes in alveolar ridge bone density and apical bone density were observed before and after treatment in the two groups.Changes in chewing function and language function were compared between the two groups of patients.Follow-up lasted for 12 mo after repair to observe any adverse reactions in the oral cavity.RESULTS The clinical effective rates of group A and group B were 97.96%and 85.71%,respectively,with group A having a higher clinical effective rate than group B.After treatment,the bone density of the alveolar ridge and apical bone in both groups decreased compared to before treatment,while the chewing and language functions improved.The changes in various indicators in group A were more significant.After treatment,the satisfaction rate of group A(97.96%)was higher than that of group B(79.59%).The incidence of adverse reactions in group A(2.04%)was lower than that in group B(24.49%).CONCLUSION The amalgamation of implant restoration and orthodontic treatment for adjacent tilted teeth demonstrates notable clinical efficacy,diminishes alveolar bone resorption,and fosters patient functional rehabilitation while exhibiting negligible adverse reactions.

Systematic review of mini-implant displacement under orthodontic loading

A growing number of studies have reported that mini-implants do not remain in exactly the same position during treatment, although they remain stable. The aim of this review was to collect data regarding primary displacement immediately straight after loading and secondary displacement over time. A systematic review was performed to investigate primary and secondary displacement. The amount and type of displacement were recorded. A total of 27 studies were included. Sixteen in vitro studies or studies using finite element analysis addressed primary displacement, and nine clinical studies and two animal studies addressed secondary displacement. Significant primary displacement was detected （6.4-24.4 μm） for relevant orthodontic forces （0.5-2.5 N）. The mean secondary displacement ranged from 0 to 2.7 mm for entire mini-implants, The maximum values for each clinical study ranged from 1.0 to 4.1 mm for the head, 1.0 to 1.5 for the body and 1,0 to 1.92 mm for the tail part. The most frequent type of movement was controlled tipping or bodily movement. Primary displacement did not reach a clinically significant level. However, clinicians can expect relevant secondary displacement in the direction of force. Consequently, decentralized insertion within the inter-radicular space, away from force direction, might be favourable. More evidence is needed to provide quantitative recommendations.

Orthodontic treatment combined with 3D printing guide plate implant restoration for edentulism and its influence on mastication and phonic function

BACKGROUND Dentition defect,a common clinical oral disease developed in humans,not only causes masticatory dysfunction and articulation difficulties but also affects facial appearance and increases the burden on the intestinal tract.Restorative treatment is the primary option for this disease.However,traditional restorations have many drawbacks,such as mismatch with the body,low reliability,and incomplete occlusal function recovery.AIM to analyze the efficacy of orthodontics combined with 3D printing guide plate implant restoration in treating patients with dentition defects and its influence on masticatory and phonic functions.METHODS A prospective study was carried out in 86 patients with dentition defects who received implant prosthesis after orthodontic treatment in our hospital between January 2018 and January 2019.Those patients were divided into a control group and an intervention group with 43 patients in each group using a random number table.The control group received traditional implant restoration,whereas the intervention group received 3D printing guide plate implant restoration.Treatment outcomes,cosmetic appearance,dental function,implant deviation,and quality of life were compared between the two groups.RESULTS The overall response rate in the intervention group was significantly higher than that in the control group(95.35%vs 81.40%,χ^(2)=4.071,P=0.044).The number of cases with neatly trimmed cosmetic appearance(χ^(2)=4.497,P=0.034),complete coverage(χ^(2)=4.170,P=0.041),and normal occlusion(χ^(2)=5.512,P=0.019)in the intervention group was higher than that in the control group.After treatment,mastication,swallowing,and articulation were significantly improved in both groups.Masticatory(t=2.980,P=0.004),swallowing(t=2.199,P=0.031),and phonic functions(t=3.950,P=0.004)were better in the intervention group than those in the control group.The deviation value and the deviation angle(t=5.440,P=0.000)at the top(t=6.320,P=0.000)and middle parts of the implants(t=22.295,P=0.000)in the intervention group were lower than those in the control group after treatment.Functional limitations,psychosocial and physical pain and discomfort,and total scores decreased in both groups.The functional limitation(t=2.379,P=0.020),psychosocial(t=2.420,P=0.000),physical pain and discomfort(t=6.581,P=0.000),and total scores(t=2.140,P=0.035)were lower in the intervention group than those in the control group.CONCLUSION Orthodontic treatment combined with 3D printing guide plate implant restoration can significantly improve the masticatory and phonic functions,quality of life,and psychological health of patients with dentition defects.Therefore,it is highly recommended in clinic application.

Root Resorption of Central Incisor by Impacted Canine in Unusual Transposition: Orthodontics and Implant Rehabilitation: 3-Year Follow-Up

This case presents an unusual transposition of an impacted canine on the central incisor that provides a multidisciplinary approach to its resolution. The patient comes to the consultation for mobility of the central incisor. Clinically, tooth mobility was confirmed with tooth crowding and persistence of the temporary canine. Cone beam tomography (CBCT) observed the atypical position of the permanent canine that caused root resorption of the ipsilateral central incisor and the need to extract both teeth. The conservative treatment of the bone structures during the dental enucleation of the impacted canine carried out by odontosection and the immediate bone grafting of the defect projected an acceptable regeneration of the bone volume for the insertion of the implant. The orthodontic treatment managed to correct the bite, position the upper premolar in the place of the canine tooth and maintain the space to place the implant in the central incisor. The three-year follow-up shows maintenance of the peri-implant crestal bone level, the success of orthodontic treatment with recovery of the patient’s function and aesthetics.

3D打印技术在口腔医学、颌面外科修复重建中的作用与优势

背景:3D打印技术独特的优势为口腔医学的发展开拓了新的思路。目的:总结3D打印技术在口腔医学中的应用进展。方法:利用计算机检索中国知网和PubMed数据库,以“3D打印,口腔科学”为中文检索词进行分类检索,以“Three-Dimensional printing,stomatology,Dentistry,prosthodontics,oral implant,orthodontics,oral and maxillofacial surgery,dental pulp disease,periodontitis”为英文检索词进行关键词检索,经阅读初步排除与文章主题不相符的文献,根据纳入标准和排除标准,最终纳入54篇文献进行汇总。结果与结论:在口腔医学领域,3D打印技术的应用范围正迅速拓展,逐步取代传统的临床诊断和治疗方式,通过结合数字化技术和先进的材料科学,3D打印可以精确地创建三维模型,为口腔疾病治疗提供了个性化解决方案,确保医师能够在手术前进行详尽的规划和预览,提高手术的安全性。3D打印技术在定制化义齿制作、个性化种植、无托槽隐形矫治等多方面呈现出了显著优势,基于此项技术,医师可以根据患者口腔结构和需求实行精准设计与制作,为患者带来良好的治疗体验和预后效果。3D打印技术在微创牙髓治疗及牙周组织再生方面也展现出了巨大潜力,3D打印的支架和植入物可为干细胞提供适宜环境,促进牙周组织的再生和修复,但目前3D打印在再生治疗仍处于发展阶段,还需更多的研究和实践来验证其临床应用的效果和安全性。

Osteoblast Behavior on Hierarchical Micro-/Nano-Structured Titanium Surface

In the present work, osteoblast behavior on a hierarchical micro-/nano-structured titanium surface was investigated. A hi- erarchical hybrid micro-/nano-structured titanium surface topography was produced via Electrolytic Etching （EE）. MG-63 cells were cultured on disks for 2 h to 7 days. The osteoblast response to the hierarchical hybrid micro-/nano-structured titanium surface was evaluated through the osteoblast cell morphology, attachment and proliferation. For comparison, MG-63 cells were also cultured on Sandblasted and Acid-etched （SEA） as well as Machined （M） surfaces respectively. The results show signifi- cant differences in the adhesion rates and proliferation levels of MG-63 cells on EE, SLA, and M surfaces. Both adhesion rate and proliferation level on EE surface are higher than those on SLA and M surfaces. Therefore, we may expect that, comparing with SLA and M surfaces, bone growth on EE surface could be accelerated and bone formation could be promoted at an early stage, which could be applied in the clinical practices for immediate and early-stage loadings.

A Custom Manipulator for Dental Implantation Through Model-Based Design

This paper presents a Model-Based Design(MBD)approach for the design and control of a customized manipulator intended for drilling and position-ing of dental implants accurately with minimal human intervention.While performing an intra-oral surgery for a prolonged duration within a limited oral cavity,the tremor of dentist's hand is inevitable.As a result,wielding the drilling tool and inserting the dental implants safely in accurate position and orientation is highly challenging even for experienced dentists.Therefore,we introduce a customized manipulator that is designed ergonomically by taking in to account the dental chair specifications and anthropomorphic data such that it can be readily mounted onto the existing dental chair.The manipulator can be used to drill holes for dental inserts and position them with improved accuracy and safety.Further-more,a thorough multi-body motion analysis of the manipulator was carried out by creating a virtual prototype of the manipulator and simulating its controlled movements in various scenarios.The overall design was prepared and validated in simulation using Solid works,MATLAB and Simulink through Model Based Design(MBD)approach.The motion simulation results indicate that the manipulator could be built as a prototype readily.

全程护理在复杂牙列缺损患者种植联合正畸护理中的应用效果分析

目的:分析全程护理在复杂牙列缺损患者种植联合正畸护理中的应用效果。方法:选取2020年3月—2021年6月广西医科大学附属口腔医院收治的复杂牙列缺损患者82例作为研究对象,采用随机数字表法分为观察组与对照组,各41例。对照组实施常规护理,观察组在对照组基础上实施全程护理。比较两组护理效果。结果:观察组治疗依从率高于对照组,差异有统计学意义(P=0.034)。观察组不良反应总发生率低于对照组,差异有统计学意义(P=0.043)。观察组护理满意度高于对照组,差异有统计学意义(P=0.043)。结论:全程护理模式联合系统化健康教育应用于复杂牙列缺损患者种植联合正畸治疗中的效果较好,能够提高治疗依从性,降低不良反应发生率,患者满意度高。

微螺钉支抗治疗对口腔正畸患者牙龈指标及牙根周组织的影响分析

目的分析微螺钉支抗治疗对口腔正畸患者牙龈指标及牙根周组织的影响。方法选取100例口腔正畸患者,随机分为对照组(50例)与研究组(50例)。对照组选择非种植体支抗治疗,研究组则选择微螺钉支抗治疗。比较两组的临床疗效、牙龈指标[牙菌斑指数(PLI)、牙龈指数(GI)以及龈沟出血指数(SBI)]、牙根周组织损伤情况。结果研究组的总有效率96.0%显著高于对照组的82.0%(P<0.05)。相比于治疗前,两组治疗后的PLI、GI及SBI均明显下降(P<0.05);且研究组治疗后的PLI(1.28±0.25)分、GI(1.06±0.11)分、SBI(1.15±0.14)分均明显低于对照组的(1.87±0.34)、(1.43±0.14)、(1.68±0.15)分(P<0.05)。研究组的牙根周组织受损率24.0%显著高于对照组的8.0%(P<0.05)。结论选择微螺钉支抗治疗口腔正畸患者能取得显著疗效,能对牙龈情况进行显著改善,但是却会在一定程度上影响、损伤牙根周组织,所以在实际的临床治疗中应严格遵循相关的规范开展各项操作,以减少操作失误。

微型种植支抗与口外弓加强支抗在口腔正畸治疗中的效果对比

目的对比口腔正畸治疗中采用微型种植支抗与口外弓加强支抗的临床效果。方法回顾性分析2018年1月-2022年12月在泰兴市人民医院进行口腔正畸治疗的患者92例,随机分为两组,对照组46例,采用口外弓加强支抗治疗;观察组46例,采用微型种植支抗治疗。比较两组治疗效果、临床指标、咬合力与咀嚼效率、不良反应。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组上、下牙槽座角、下中切牙倾角、上中切牙凸距差、尖牙间宽度与磨牙移位值均优于对照组,咬合力与咀嚼效率均高于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率较对照组更低,差异有统计学意义(P<0.05)。结论在口腔正畸治疗中应用微型种植支抗的效果较口外弓加强支抗更好,患者咀嚼功能改善更为明显,且不良反应更少。

种植钉支抗在口腔正畸领域的应用情况综述

种植钉支抗在口腔正畸领域应用广泛,而不同国家的使用情况存在差别。本文总结了相关的调查研究方法,种植钉的使用情况、优势与适应证、并发症以及影响种植钉应用的因素,结果发现:目前种植钉的使用率为43.7%~93.3%,但现有不同调查之间的标准存在差异,难以得出进一步的结论;种植钉适用于内收前牙、压低后牙等多种情况,在加强支抗的同时有利于减少对患者依从性的依赖;常见并发症有松动脱落、软组织反应和牙根损伤等;医生的年龄、性别、教育背景、治疗费用以及患者对种植钉的接受程度等因素可能影响其使用。目前尚缺少我国在种植钉支抗应用情况的相关调查研究。

微螺钉种植体支抗不同植入角度对口腔正畸患者牙槽骨吸收及并发症发生率的影响

目的探究微螺钉种植体支抗不同植入角度对口腔正畸患者牙槽骨吸收及并发症发生率的影响。方法选取2019年1月至2021年12月萍乡市人民医院口腔科收治的需内收前牙的80例正畸患者作为研究对象,根据微螺钉种植体支抗植入角度分为A组(与牙槽骨骨面成30°,26例)、B组(与牙槽骨骨面成60°,29例)和C组(与牙槽骨骨面成90°,25例)。比较两组微螺钉种植体稳定性、牙槽骨吸收情况及并发症发生率。结果施加150 g载力后,B组微螺钉种植体松动率低于A组、C组,差异有统计学意义(P<0.017)。B组牙槽骨高度与宽度吸收值均低于A组、C组,差异有统计学意义(P<0.05)。治疗期间,三组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论微螺钉种植体以与牙槽骨骨面成60°角度植入的稳定性最佳,能更好地减少牙槽骨横向及纵向吸收,同时不会增加并发症发生率,临床医师可考虑以该角度植入微螺钉种植体。

种植钉植入高度对隐形矫治远移下磨牙时应力分布的影响

目的探究种植钉不同植入高度对隐形矫治配合颌内牵引远移下磨牙时所产生的生物力分布的影响,寻找有利于保护下前牙支抗的种植钉植入位置,为临床治疗方案的设计提供参考。方法应用Mimics、Geomagic Studio 2017、SolidWorks2016、Ansys workbench建立有限元分析模型并对六种工况进行力学分析。工况一:无种植钉(对照组);工况二至工况五:种植钉植入于下颌第一磨牙和第二磨牙之间的颊侧骨皮质,距离牙槽嵴顶分别为10 mm、7 mm、4 mm、1 mm;工况六:种植钉植入于下颌升支前缘颊舌向居中,高于平面5 mm的位置。结果矢状向,种植支抗使所有牙齿均产生远中向位移;相较于对照组,种植钉组前磨牙远中位移量超过第二磨牙。垂直向,对照组(无种植钉)为类似后倾弯对下颌牙列产生的作用;种植钉组侧切牙、尖牙压低,中切牙、第一前磨牙伸长。冠状向,对照组(无种植钉)第二前磨牙、第一磨牙为舌向位移,种植钉组仅前磨牙及第一磨牙出现了舌向位移;所有牙齿中,尖牙的位移量受种植钉植入高度变化影响最大。结论种植钉植入位置越高,保护前牙支抗的效果越强。方案设计时应根据种植钉植入高度,适当使下颌牙弓缩窄,中切牙、第一前磨牙压低及侧切牙、尖牙伸长。

正畸微植体动态植入过程有限元数值仿真

目的 建立自攻型正畸微植体动态植入模型,研究微植体动态植入过程中周围骨应力分布情况。方法 基于CBCT数据重建口腔三维模型;利用ABAQUS软件建立微植体和种植区域骨组织的有限元模型;使用三维动态有限元方法,对微植体受40 N轴向推进力、0.5 r/s恒定转速植入骨内的过程进行仿真分析。结果 成功建立了自攻型正畸微植体动态植入过程的三维有限元模型、结果可视化展示了微植体动态植入过程;结果发现植入阶段和螺纹位置对骨应力分布影响明显且不同骨质应力状态差异明显:在植入过程中,皮质骨最大应力为167 MPa,稳定阶段最大应力为50 MPa;松质骨最大应力为30 MPa。结论 植入阶段和螺纹位置对骨应力分布影响明显;皮质骨和松质骨应力差异明显。可以利用应力特征判断骨质类型,通过种植体周围的骨应力分布情况判断颌骨是否处于合适的种植状态。

混合现实技术在口腔正畸学教学中的应用效果评价

随着5G和混合现实技术(Mixed Reality,MR)的发展,MR被广泛应用于医疗和医疗教学等相关领域。为了探索MR教学对口腔正畸临床中微支抗钉植入术相关内容教学效果的影响。本研究按照随机原则,将124名安徽省口腔医院正畸科学生分为实验组(MR教学组)和对照组(传统教学组)。实验组通过接受正畸微支抗钉植入术MR教学,体验模拟真实诊疗过程中的手术操作;对照组采用传统临床见习的手术带教方式。研究结果显示,理论成绩方面,实验组学生的微支抗钉植入术与对照组没有显著差异;实践技能方面,实验组学生明显优于对照组。教学问卷调查结果显示,学生对MR教学系统的欢迎程度和使用满意度分别为98.39%(62人)和95.16%(62人)。MR实验教学平台与传统临床见习的带教方式相比,MR技术能够显著提升学生对微支抗钉植入术临床操作流程的熟练度,有助于正畸临床学习兴趣的培养及教学质量的提升。

正畸联合骨水平种植体修复在牙列缺损中的应用效果评价

目的:评价正畸联合骨水平种植体修复在牙列缺损中的应用效果。方法 :回顾分析2020年1月—2022年1月因牙列缺损就诊的88例下颌后牙区单牙种植患者的资料,其中,骨水平种植体修复44例(对照组),正畸联合骨水平种植体修复44例(试验组)。比较2组种植体植入成功率、种植体牙周健康情况、咀嚼功能、种植体稳定情况、术后并发症及患者满意度。采用SPSS 18.0软件包对数据进行统计学分析。结果:2组植入3个月、6个月的成功率相比,差异无统计学意义(P>0.05),试验组植入12个月的成功率显著高于对照组(P<0.05)。试验组植入12个月的龈沟出血指数(gingival sulci bleeding index,SBI)、探诊深度(probing depth,PD)显著低于对照组(P<0.05),2组植入12个月的骨吸收量相比,差异无统计学意义(P>0.05)。2组治疗后最大力咬合时咬肌、颞肌肌电活动显著高于治疗前(P<0.05),试验组治疗后最大力咬合时咬肌、颞肌肌电活动显著高于对照组(P<0.05)。2组6个月、12个月时的种植体稳定系数显著高于3个月(P<0.05),2组12个月时的种植体稳定系数显著高于6个月(P<0.05),试验组6个月、12个月时的种植体稳定系数显著高于对照组(P<0.05)。2组总并发症发生率相比,差异无统计学意义(P>0.05)。试验组患者满意度显著高于对照组(P<0.05)。结论:正畸联合骨水平种植体修复牙列缺损可提高种植成功率及咀嚼效能,改善种植体牙周健康情况,提升患者满意度。

微种植体支抗在青少年口腔正畸治疗中的疗效及对患者咀嚼功能和咬合力的影响

目的:探讨微种植体支抗在青少年口腔正畸治疗中的疗效,以及对患者咀嚼功能及咬合力的影响。方法:选取2018年1月-2021年1月笔者医院收治的68例行口腔正畸的青少年患者纳入研究,按照随机数字表法分为对照组和观察组,各34例。对照组患者采用传统正畸口外弓支抗,观察组患者采用微种植体支抗,两组矫治周期为18个月。比较两组疗效、正畸效果(两组磨牙移位、上中切牙凸距差以及上中切牙倾角差)、咀嚼效率及咬合力,采用自制满意度调查问卷评估两组满意度。结果:观察组治疗有效率高于对照组(P<0.05);观察组磨牙移位距离小于对照组,而上中切牙凸距差、上中切牙倾角差均大于对照组(P<0.05);治疗后两组咀嚼效率以及咬合力均提高,且观察组高于对照组(P<0.05);观察组外形、舒适度、咬合功能和便捷性等满意度评分均高于对照组(P<0.05)。结论:青少年口腔正畸治疗采用微种植体支抗正畸效果显著,可有效提高咀嚼功能、增大咬合力,患者满意度较高。

无托槽隐形矫治联合种植修复治疗错[牙合]畸形伴牙列缺损的修复效果及对咀嚼功能的影响

目的:探究无托槽隐形矫治联合种植修复治疗错[牙合]畸形伴牙列缺损的修复情况及对咀嚼功能的影响。方法:采用随机数字表法将2020年7月-2022年7月笔者医院就诊的60例错[牙合]畸形伴牙列缺损患者分为两组,每组30例。对照组给予传统直丝弓矫治技术联合种植修复,观察组给予无托槽隐形矫治联合种植修复。比较两组的种植修复效果及治疗前后牙周健康指标、牙周美观度,采用种植体稳定系数判定种植体稳定性,分析联合治疗对患者咀嚼功能的影响。结果:两组的种植修复成功率比较差异无统计学意义(P>0.05);观察组倾斜牙扶正时间及转位牙扭正时间短于对照组,治疗后咀嚼效率高于对照组(P<0.05);观察组治疗后龈沟出血指数、菌斑指数评分低于对照组,红色美学指数、白色美学指数和ISQ治疗后3个月的评分均高于对照组(P<0.05);两组并发症发生率对比差异无统计学意义(P>0.05)。结论:对错[牙合]畸形伴牙列缺损患者给予无托槽隐形矫治联合种植修复治疗,可改善患者的咀嚼功能及牙周健康状况,提高牙周美观度及种植体稳定性。

成人特发性髁突吸收的关节-正畸联合保守治疗1例

特发性髁突吸收(ICR)是一类罕见、原因不明的颞下颌关节(TMJ)破坏性疾病,以髁突渐进性吸收为特征,主要见于年轻女性。该病进展慢、病程长,常继发严重的牙颌面畸形。文章报告1例非手术治疗的单侧特发性髁突吸收患者,获得兼顾美学、功能、稳定的治疗效果。

影响正畸钛合金微种植钉稳定性的相关因素分析

目的研究与正畸钛合金微种植钉稳定性相关的因素。方法收集2020年至2021年因正畸治疗需要植入的微种植钉共1271颗,分别对年龄、性别、微种植钉植入部位(上颌、下颌、颊侧、腭侧、前牙、后牙)、微种植钉的品牌、微种植钉的长度、微种植钉的直径、口腔卫生情况、植入手术医师职称级别(初级、中级、高级)等信息进行研究。采用SPSS 26.0软件对数据作统计学分析。结果1271颗钛合金微种植钉,松动脱落69颗,占比5.43%。单因素分析结果显示,年龄、上颌下颌、前牙后牙、口腔卫生对微种植钉脱落存在显著影响(P<0.05);而性别、微种植钉植入部位(颊侧、腭侧)、微种植钉的品牌、微种植钉的长度、微种植钉的直径、植入手术医师职称级别等对微种植钉脱落无明显影响(P>0.05)。Logistic回归分析结果显示,前牙后牙、上颌下颌、口腔卫生为微种植钉脱落的独立影响因素,而年龄、性别、微种植钉的植入部位、微种植钉的品牌、长度、直径以及手术医师的职称级别不是微种植钉脱落的独立影响因素。结论患者的年龄、植入点位于上颌或下颌、植入点位于前牙或后牙、患者的口腔卫生情况与微种植钉支抗稳定性有关,而与其他因素相关性不明显。