Ye Lin
Dept. of Oral Implant, School and Hospital of Stomatology, Peking University, Beijing 100081, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2017 Feb 1;35(1):18-28. doi: 10.7518/hxkq.2017.01.003.
The development of clinical implant dentistry was intensively affected by dental implant design improvement and innovation, which brought about new concept, even milestone-like changes of clinical protocol. The current improvements of dental implant design and their clinical importance could be highlighted as followings: 1) The implant apical design influences the implant preliminary stability in immediate implant. The apical 3-5 mm design of implant makes implant stable in immediate implant, because this part would be screwed into alveolar bone through fresh socket, the other part of implant could not be tightly screwed in the socket because of smaller implant diameter. Implant apical form, screw design, self-taping of apical part would be essential for immediate implant. 2) The enough preliminary stability of implant makes immediate prosthesis possible. When osseointegration does not occur, the implant stability comes from a mechanical anchorage, which depends on implant form, screw thread and self-taping design. 3) Implant neck design may have influence for soft tissue recession in esthetic zone. The implant with large shoulder would not be selected for the esthetic area. The platform design may be more favorable in the area. 4) The connection design between implant and abutment is thought a very important structure in implant long-term stability. Moose taper and "tube in tube" were well documented structure design in 20-year clinical practice in Peking University. 5) In last 15 years, the plenty studies showed the platform design of implant had positive influence in implant marginal bone level. Whatever in single implant restoration or multi-implant prosthesis. 6) The digital technology makes clinical work more precise and high-tech. This would be a trend in implant dentistry. New generation of chair-side digital computer-aided design/computer-aided manufacturing makes immediate prosthesis without conventional impression possible. 7) New abutment design have changed clinical protocol greatly. The All-on-four concept and Weldone concept benefit both from the abutment innovation, which were large angulated abutment and special welding abutment materials.
临床种植牙科的发展受到牙种植体设计改进与创新的深刻影响,这带来了新的理念,甚至是临床方案的里程碑式变革。当前牙种植体设计的改进及其临床重要性可归纳如下:1)种植体根尖设计影响即刻种植时种植体的初期稳定性。种植体根尖3 - 5毫米的设计使即刻种植时种植体稳定,因为这部分会通过新鲜牙槽窝旋入牙槽骨,而种植体的其他部分由于直径较小无法紧密旋入牙槽窝。种植体根尖形态、螺纹设计以及根尖部分的自攻性对于即刻种植至关重要。2)种植体足够的初期稳定性使即刻修复成为可能。当骨结合未发生时,种植体稳定性来自机械固位,这取决于种植体形态、螺纹和自攻设计。3)种植体颈部设计可能会影响美学区域的软组织退缩。美学区域不应选择肩部较大的种植体。该区域平台设计可能更有利。4)种植体与基台之间的连接设计被认为是种植体长期稳定性的一个非常重要的结构。在北京大学20年的临床实践中,莫氏锥度和“管中管”是有充分文献记载的结构设计。5)在过去15年中,大量研究表明种植体的平台设计对种植体边缘骨水平有积极影响。无论是单颗种植体修复还是多颗种植体修复。6)数字技术使临床工作更精确、更具高科技性。这将是种植牙科的一个趋势。新一代椅旁数字计算机辅助设计/计算机辅助制造使无需传统印模即可进行即刻修复成为可能。7)新的基台设计极大地改变了临床方案。全口四颗种植概念和Weldone概念都受益于基台创新,即大角度基台和特殊焊接基台材料。