霍萨姆·纳萨尔
无牙颌患者的传统标准是制作上颌和下颌全口义齿。使用牙种植体来支撑和保留活动或固定假体可以消除许多报道的传统全口义齿的问题。在放置多个种植体以保留和支撑固定假体方面始终存在一些限制。牙槽嵴的严重吸收、上颌窦增大和不利的颌关系可能会限制足够数量的牙种植体的放置。患者不愿意进行手术来改变骨骼，并且经济限制有时会妨碍放置足够数量的牙种植体来支撑固定修复体，因此需要对无牙颌患者采取不同的方法。种植体支持的覆盖义齿可以成为那些受损患者的最佳治疗选择，具有以下优点；出色的固位力、额外的支撑和稳定性、改善的咀嚼和功能、最少的种植体数量以及更轻松的手术过程。将现有的假牙改造成新的假牙可以带来附加值。然而，出现了一些问题，例如上牙弓和下牙弓应使用多少颗牙种植体来支撑和保留覆盖义齿？种植牙是否需要夹板固定？理想的附件是什么？这种方法中最常见的早期和晚期并发症是什么？如何维护覆盖义齿？本演讲将回答这些问题，并给出制作种植覆盖义齿时需要记住和考虑的十个黄金技巧。
拔牙后，周围的牙槽骨（作为关键的牙齿支撑结构）会不可避免地发生重塑，导致明显的骨吸收。拔牙后部位的骨质改变会影响理想的口腔康复。牙科植骨仍然是促进骨缺损愈合的关键组成部分。在此基础上，证实与自然愈合相比，牙槽嵴保留技术可显着减少牙槽骨嵴的垂直和水平收缩。本研究的目的是比较新型异种移植物 BonePlus+B 和 Bio-Oss 的疗效。这项随机临床试验由同一颌骨接受至少 2 次单牙根拔除术的患者组成。7名患者（4名女性，3名男性），平均年龄40±5.2岁，贡献了 16 个拔牙槽，随机移植有 Boneplus+B (n=9) 或 Bio-Oss (n=7)。5个月后，采集骨样本用于组织学和组织形态计量学分析。所有数据均使用 Mann-Whitney U 检验分析进行分析，P 值设置为 0.05。两个研究组之间在牙槽窝保留成功率方面没有统计学上的显着差异（P 值
Human saliva is a fluid with many biological functions essential for the maintenance of oral health. Salivary flow and composition influences calculus formation and periodontal disease. Salivary calcium, magnesium due to its affinity to be readily taken up by plaque, is an important factor not only with regard to the onset of periodontitis but also significantly with regard to dental health. They are one of the most intensely studied potential markers for periodontal disease in saliva. Cross-sectional and longitudinal studies have provided strong evidence that smoking is a significant risk factor for periodontal disease. All of the surveys have reported increased quantities of calculus in smokers. It has long been known that smoking causes a marked increase in salivary flow rate as a simple reflex effect and this could explain the tendency of smokers to accumulate increased amounts of calculus. There is some evidence that smoking also increases the mineralizing potential of saliva. An elevated level of salivary calcium in smokers is related to a greater degree of bone loss and lower mineral density of bones than in non-smokers. Smokers have comparatively higher oral pH than non-smokers. Therefore, there is a great possibility for this pH to extract calcium from the scales deposited on the teeth (or even from their teeth) of these individuals which might result in the elevated levels of salivary calcium, magnesium level
To estimate, analyze, compare and to correlate the variation in salivary calcium, magnesium levels and pH in periodontally healthy subjects and that of chronic periodontitis of smoker and non-smoker subjects. The restoration of endodontically-treated teeth (ETT) has been widely and controversially discussed in the dental literature, most of which recommends cuspal coverage of ETT to protect against potential tooth fracture. The main goal of conservative dentistry in managing ETT is to achieve minimally invasive preparation with maximal cuspal coverage. The “endocrown” follows this rationale. In addition, proximal caries with deep cervical margins are particularly complex to manage clinically. Moreover, there are various clinical approaches to such challenges, such as placing a base of composite resin to coronally displace proximal margins underneath indirect bonded restorations as known as deep margin elevation (DME) or coronal margin relocation. The ideal treatment of ETT has been controversially discussed in the literature. Based on current evidence, endocrowns can be considered as a reliable treatment option for moderately mutilated ETT. The achieved adhesive monoblock system reduces the need for macro-retentive geometry and provides an efficient outcome and better esthetics. Furthermore, the DME technique represents another useful treatment approach for patients with financial restrictions and those with higher risk of negative outcomes involving more invasive surgical procedures. Thus, it could be used in clinical situations with deep subgingival cervical margin where isolation with a rubber dam remains possible.
本研究是在 ETT 上进行的冠内冠修复的临床病例报告，伴有广泛的冠状破坏。结合本文介绍的临床程序，一些宫颈边缘较深的 ETT 通过 DME 技术直接复合树脂修复体进行治疗。