Dentium種植系統(tǒng)介紹

Dentium

種植系統(tǒng)介紹

IntroductionoftheDentium

Implantsystem

臨床病例介紹

(Clinicalsituation)臨床病例介紹

(Clinicalsituation)臨床病例介紹

(Clinicalsituation)臨床病例介紹

(Clinicalsituation)臨床病例介紹

(Clinicalsituation)臨床病例介紹

(Clinicalsituation)臨床病例介紹

(Clinicalsituation)口腔種植的歷史回顧

(HistoryoftheImplant)骨膜下種植體(Subperiostealimplant)In1948byGustavdahl骨內(nèi)葉狀種植體(Endostealbladeimplant)In1967byLeonardLinkow骨內(nèi)根形種植體

(Endostealrootformimplant)In1952-1960′sbyIgvar

Branemark

(Orthopedicsurgeoninsweden)In1981long-termdata(15年臨床報(bào)告)publishedIn1982theToronto(多倫多)conferenceonosseointegrationDentalimplantisasuccessfulTxmodalityParadigmshiftinBranemarkconceptBranemark

觀念光滑表面

(Smoothsurface)皮質(zhì)骨固定，若可能

(Bicorticalanchorage,ifpossible)長(zhǎng)種植體(Longimplant)兩段式

(2-stageapproach)外六角連接(Externalhexconnection)螺絲固位修復(fù)體(Screw-retainedprosthesis)遠(yuǎn)距成骨

(Distantosteogenesis)同位骨形成

(Appositionalboneformation)Current觀念粗糙表面(Roughsurface)骨髓的重要性

(ImportancetoBonemarrow)合適長(zhǎng)度為10-12mm(longisreasonable10-12mm)一段式或兩段式(1-stageor2-stage)內(nèi)連接(Internalconnection)粘接固位修復(fù)體(Cement-retainedprosthesis)接觸成骨(Contactosteogenesis)骨形成(DenovoboneformationDenovo)ParadigmshiftinBranemarkconcept

BRANEMARK理論演化光滑表面是否最容易引發(fā)種植體周圍炎？

(IstheSmoothsurface

themostsuitablesurfacefor

peri-implantitis?)能否通過改變種植體的設(shè)計(jì)來(lái)減少邊緣骨的吸收？

(TheamountofMarginalboneloss

canbechangedby

implantdesign?)Circumferentialbonesaucerization

:1styear1-1.5mm,annually0.2mm(Albrektsson1986)

Micromovement

infixture/abutmentinterface→bacterialpenetration→boneloss(Ericsson1995JCP)StablemarginalbonelevelinMicroThread?implant

(2000,Palmer,COIR)種植體設(shè)計(jì)的最新趨勢(shì)

(Trendofthenewest

implantdesign)NobelbiocareStraumannNobelactive?Softtissuelevelimplantbonelevelimplant粗糙處理至種植體頂部(Rough

surfacetotopofimplantbody)微螺線設(shè)計(jì)(Microthreadeddesign)錐形密封設(shè)計(jì)：防止微動(dòng)(Conicalsealdesign:prevent

micromovement)錐形根形設(shè)計(jì)(Taperedrootformdesign)一段式及二段式均適用(1-stageor2-stagepossible)NobelSpeedy?Replace基臺(tái)連接方式

Abutmentconnection外連接(Externalconnection)易見螺絲松動(dòng)(Screwloosening

iseasy)基臺(tái)和種植體間存在微漏

(Microleakageexistsbetweenabutmentand

fixture)傾向螺絲固位修復(fù)體

(PreferenceofScrew-retainedprosthesis)內(nèi)連接(Internalconnection)少見螺絲松動(dòng)(Screwloosening

israre)生物密封優(yōu)秀，很少微漏(BiologicalsealingisexcellentduetolittleMicroleakage)傾向粘接固位修復(fù)體

(PreferenceofCement-retainedprosthesis)GoldretainingscrewGoldcylinderInfectionrouteAbutmentAbutmentscrewfixtureGoldretainingscrewGoldcylinderInfectionrouteAbutmentfixture種植體分類

(ClassificationoftheDentalImplant)種植體設(shè)計(jì)（Implant

design）埋入式&非埋入式

(SubmergedVSnon-submerged)螺栓固位&非螺栓固位

(ScrewVSnon-screw(cylinder,fin))平頂&錐形密封

(FlattopVSconicalseal(ExternalVsInternal))種植修復(fù)體組成

(MaterialsofImplantbody)種植體支撐的修復(fù)體(Implant-supportedprosthesis)基臺(tái)(Abutment)種植體(Implantbody(Fixture))

PureTitanium(Grade1-4)Titaniumalloy(Ti6Al4V):

intensificationofmechanicalstrength,narrowimplant種植體表面處理

(Implantsurface)光滑表面(Smooth(machined)surface)表面粗糙化(Roughsurface)鈦漿涂層表面處理(Titaniumplasmaspraying(TPS))高速噴涂熔融的鈦金屬液滴(ProjectionofTitaniumparticle)噴砂表面處理(Grit-blasting)Alumina(Al2O3):+acidetching>SLATitaniumoxide:AstraTiOblast?Calciumphosphate:可吸收性研磨介質(zhì)表面處理

（RBM(resorbableblastmedia)）酸蝕表面處理(Acid-etching)HCl,H2SO4,HNO3Fluoride:AstraOsseoSpeed?電化學(xué)氧化表面處理(Anodizing:thickoxidelayer)羥基磷灰石涂層表面處理(HAcoating)TPSSLATiOblastAnodizingHAcoating*Evidence-basedpractice骨整合的速度和質(zhì)量與種植體的表面性質(zhì)有關(guān)(Therate&qualityofosseointegrationarerelatedtosurfaceproperties.)表面粗糙的鈦制種植體與骨的結(jié)合能力比表面光滑的鈦制種植體大得多(Titaniumimplantswithroughenedsurfaceshavegratercontactwithbonethantitaniumimplantswithsmoothersurfaces.)鈦制種植體的表面粗糙程度可以影響骨整合的速度及生物力學(xué)固位(ThesurfaceroughnessofTiimplantsaffecttherateofosseointegration&biomechanicalfixation.)適度的粗糙(1~2um)顯示出更強(qiáng)的骨反應(yīng)，并可有效防止種植體周圍炎。(Amoderateroughnessof1-2μmshowstrongerboneresponseandpreventperi-implantitis.)骨結(jié)合(Osseointegration)自體骨-種植體間沒有結(jié)締組織層連接

(Directbone-implantcontactwithoutaninterveningconnectivetissuelayer)這種生物固定被認(rèn)為是種植體支持修復(fù)體和修復(fù)體長(zhǎng)期穩(wěn)定的前提條件

(Thisbiologicfixationisconsideredtobeaprerequisiteforimplant-supportedprosthesesandlong-termsuccess)Dentium植體系統(tǒng)的設(shè)計(jì)理念高度拋光表面可以有效阻止微生物的侵入(Bacteriaresistanthighpolishedsurface)平行部分:平均應(yīng)力分布(ParallelPortion:Evenstressdistribution)錐形部分:基臺(tái)就位處和松質(zhì)骨中更穩(wěn)定(TaperPortion:Abutmenthousing&morestableinloosebonecondition)同步雙微螺紋；刺激皮質(zhì)骨Synchronizeddoublemicro-thread;Corticalbonestimulation生物學(xué)螺紋(BiologicalThread;Richbonehousingdesign)大顆粒噴砂及酸蝕(S.L.A.surface)圓形末端：防止穿孔(Roundend;lessperforationtendency)內(nèi)連接，錐形密封連接(Conicalsealdesigninternalconnection)Dentium植體系統(tǒng)的特點(diǎn)最佳的固位螺線(微螺線)(Optimalfixationthread(Microthread))錐形設(shè)計(jì)(Tapereddesign)大顆粒噴砂酸蝕表面處理

(SandblastingwithLargegrit&Acidetching)surface最適合皮質(zhì)骨周圍條件的雙螺線設(shè)計(jì)，確保了優(yōu)秀的初期穩(wěn)定性。(ExcellentinitialstabilityduetoDoublethreadFormthefittestcondition

aroundCorticalbone.)UpperPart(Top):上部：優(yōu)秀的初期穩(wěn)定性(Excellentinitialstability)MiddlePart(Central):中部：連接種植體的頂部及底部，可平均分不應(yīng)力(Connectingtheupperandlowerparts,evenstressdistribution

tofixturebody)LowerPart(Bottom):下部：底平，無(wú)自功作用，減少誤傷。fixturesinksuptothemiddlepartwithoutdrilling,providingoperationconvenience.Earlyosseointegrationduetorapidattachmentandproliferationofosteoblast

earlyosseointegrationDentium植體系統(tǒng)的特點(diǎn)生物學(xué)連接(Biologicconnection)種植體和基臺(tái)間的錐形密封和冷壓接(ConicalSealing&ColdWeldingbetweenfixture&Abutments)內(nèi)連接結(jié)構(gòu)形成更好的應(yīng)力條件(StructureoftheInternalconnectionformsbetterconditionforstress.)皮質(zhì)骨里更好的應(yīng)力分散效果(Greater

distributionaleffectofforce

aroundCorticalbone)防止螺絲松動(dòng)(PreventionofScrewloosening)不同直徑的基臺(tái)可以互換

(Abutmentisexchangeable(4.5.5.5.6.5),regardlessofdiameter.)連接間距小于1um(MarginalOpeningislessthan1m)基臺(tái)和種植體間的冷壓接(ColdWeldingAbutment&Fixture)種植體和基臺(tái)連接后成斜面的種植體頸部連接點(diǎn)(ConnectingpointofbevelatFixtureNeck,whencombiningFixtureandAbutment)上部和下部間的缺口可以防止骨組織向下破壞(Gapbetweentheupperandlowerpartspreventsbonedestructiontowardsalowertissue.)足夠數(shù)量的上部軟組織保護(hù)下部骨組織(Enoughquantityofuppersofttissue

protectslowerbonetissue.)有助于和鄰近種植體形成鄰接骨(Helptoform

anInterproximalBonewithadjacent

Fixture.)減少邊緣骨吸收

(Marginalbonelossisless.)-????Load-Distribution?????????-ScrewLoosening

??

Fracture?????/???????-ConicalSealing????????????Bacteria???BoneResorption???.EffectivenessofLoad-Distribution修復(fù)體的應(yīng)力分散效應(yīng)使骨破壞最小化(Load-DistributionaleffectofProsthesisminimizesbonedestruction.)錐形封閉結(jié)構(gòu)：幾乎沒有細(xì)菌性骨吸收(AlmostnoBoneresorptionbybacteriaduetoConicalSealing)基臺(tái)與種植體的完美的錐型封閉連接:自我引導(dǎo)基臺(tái)就位(InconnectingAbutmentwithFixture,

PerfectconnectionofConicalSealing:Self-GuidingofAbutment)有效地應(yīng)力分散(EffectivenessofLoad-Distribution)解決了機(jī)械性/結(jié)構(gòu)性問題，如螺絲松動(dòng)或斷裂等。(mechanical/structural

problem-solving,suchasScrewLoosening

or

Fracture,etc.)

J.Wolff’slaw有利的應(yīng)力條件是使靠近植入種植體的骨組織保持正常狀態(tài)，這樣就不會(huì)發(fā)生周圍邊緣骨組織吸收(Whenbeneficialstressconditionisformedtokeepanormalstateofbonetissuecloseinstalled

implant,resorptionofsurroundingmarginalbonetissuedoesnotoccur.)Dentium植體系統(tǒng)的特點(diǎn)基臺(tái)肩臺(tái)邊緣下有TiN覆蓋層(TiNcoatingundershouldermarginofAbutment最佳的固位螺紋(Optimalfixationscrew)

TiN覆蓋層可以防止鈦?zhàn)匀谎趸?/p>

(PreventnaturalTi-oxidizationbyTiNcoating)增強(qiáng)磨損抗性金黃色改善美學(xué)效果(Increaseresistancetoabrasionand

improveaesthetics

withgoldcolor.)更好的軟組織和種植體反應(yīng)

(Betterreactionofsofttissueand

Fixture.)1.微螺紋具有最佳的應(yīng)力分散效果(Positivemicrothreadbringsbettereffecttooptimalstresscondition.)2.雙微螺紋使種植體具有優(yōu)秀的初期

穩(wěn)定性

(DoubleMicrothreadsimproveexcellentinitialstability.)Dentium植體系統(tǒng)的特點(diǎn)基臺(tái)螺絲(Abutmentscrew)切削刃(Cuttingedge)平坦根端(Flatend)?螺絲：適用所有不同直徑的種植體(Singlescrewsizefitsalldifferentfixturesizes.)?六角扳手：適用于所有六角插槽(Singlehexscrewdriverfitshexscrewheadsocket.)?3葉狀自攻設(shè)計(jì)：使骨破壞最小化(3bladesselftappingdesignminimizesbonedestruction.)?錐形的根尖部形狀使植入更容易(Taperedapicalshapepromoteseasierpenetration.)?平坦末端設(shè)計(jì)減少骨穿孔的風(fēng)險(xiǎn)(Theflatenddesignreducesboneperforationrisk.)Dentium植體系統(tǒng)的特點(diǎn)生物學(xué)螺紋(Biologicthread)抗菌的高度拋光表面(BacteriaResistantHighPolishSurface)?容納更多骨量設(shè)計(jì)形成額外的骨填充空間(Therichbonehousingdesigncreatesextrabonefillingspaces.)?銳利的邊緣使植入更便捷(Thesharperedgepenetratesandengagestothebonereadily.)?錐形斜面平臺(tái)設(shè)計(jì)，使得一期和二期手術(shù)不需要骨成形程序(Thetaperedbevelplatformdesignmakestheboneprofilingprocedureunnecessaryat1st,2ndsurgery.)Dentium植體系統(tǒng)的特點(diǎn)Implantium系列所有種類的基臺(tái)在所有種植體上均適用(AllAbutmentscanbeconnectedtoallFixtures)一體式基臺(tái)(CombiAbutment)分體式基臺(tái)(DualAbutment)角度基臺(tái)(AngledAbutment)直接可鑄造基臺(tái)(Direct-CastingAbutment)螺栓固位型基臺(tái)(ScrewAbutment)Implantium系列一期手術(shù)便于齦瓣覆蓋和暴露風(fēng)險(xiǎn)最小化(Easyflapcoverage&Minimumexposureduring1stsurgery)覆蓋螺釘安裝到種植體上后，不僅更容易縫合軟組織，看上去也更漂亮(PuttingtheCoverscrewontheFixture,itbecomeseasiertonotonlysutureasofttissue,butalsomakeitlookbetter.)齦瓣無(wú)張力縫合，種植體不會(huì)被暴露(FixtureexposureisimprobableduetoTensionfreeflapclosure.)二期手術(shù)：換安愈合基臺(tái)，操作簡(jiǎn)單(Simpleinstallationofhealingabutmentduring2ndsurgery)在種植體頂部做<1cm的切口，用扳手卸下覆蓋螺絲，這樣更容易連接愈合基臺(tái)(Aftertheincisionlessthan1cmonthetopofFixture,

detachtheCoverscrew

withadriversothatitbecomeseasiertoattachthe

HealingAbutment.)最小的切口，最小的傷害帶給病人最小的創(chuàng)傷

(Minimizingtheincision,lessdamageoffersapatientMinimalTrauma.)0.8mm1.1mmBenefitsofImplantium

Implantium