种植修复资料

1、一体式基台一体式基台One-piece AbutmentOne-piece Abutment分体式基台分体式基台Two-piece AbutmentTwo-piece Abutment内部：六角内部：六角The interior: HEX -shapedThe interior: HEX -shapedCombiDual 临床图片 (Clinic side)技工室图片 (Lab. Side)二期手术(Second surgery)取印模(Impression )制备工作模型，选择基台(Manufacturing models Choose Abutment )咬合记录(Bonnet for j

2、aw Relation record)定位辅件(Positioning Jig)咬合记录 (Jaw relation record)最终修复体(Delivery of prosthesis)Mounting 制作修复体(Fabrication of prosthesis)临床图片 (Clinic side)技工室图片 (Lab. Side)一体式基台 (Combi Ab.)分体式基台 (Dual Ab.)分体式可研磨基台 (Dual milling Ab.)直接可铸造基台 (Dereact casing Ab.)角度基台 (Angled Ab.)螺栓固位型基台 (Screw Ab.)临时基台

3、(Temporary Ab.)基底 (Cylinder)一体式一体式 ( (CombiCombi) )分体式分体式 ( (Dual)Dual)植入位置理想时 (When the position of implant is ideal)可在椅旁选择基台 (Choosing abutment from Chairside)基台水平取模 (Abutment level impression)口内需要的准备视情况而定 (Preparation required inside the mouth depending on the situation)螺丝不易松动 (Little bit of scre

4、w loosening due to cold welding)重新修复困难 (Difficult retrieval)诊疗时间长 (Long chairtime)基台水平及种植体水平取模均适用 (Abutment & fixture level impression all possible)一般选用种植体水平取模方式 (Generally operate fixture level impression)可在模型上选择基台 (Choosing abutment from master model)需要定位辅件 (Positioning Jig required)据患者情况选择六角或

5、非六角基台 (Decide on Hexed or Non-Hexed according to the patients preference)容易修补 (Easy to prosthetic repair , for retrieval is allowed)诊疗时间短 (Short Chairtime!) 封闭式封闭式 ( (Transfer type) Transfer type) 开窗式开窗式 ( (Pick-up type)Pick-up type)Impression materials : Elastic silicone rubber ( Regular body )美学需求

6、 (Esthetic requirement)种植角度 (Implant angulation)种植位置 (Implant location)植入深度(穿龈高度) (Fixture installation depth (Gingival Height)牙弓间距离 (Interarch distance)修复类型 (Prosthesis type)牙医和技工的喜好 (Dentist & Dental technicians preference) Direct casting Ab.+ porcelain Dual Ab. Dual milling Ab. Angled Ab. Dir

7、ect casting Ab. Screw Ab. Combi Ab. analog Angled , Dual AbComport capLab. analogImpression coping 也可用于即刻负重或者临时冠 (Immediate loading or provisional crown, also allowed when manufacturing) Conventional Technique : Put cord and impression possible 1. 1. 去除愈合基台去除愈合基台 (Remove Healing Ab)2. 2. 据牙龈高度及牙齿间据牙

8、龈高度及牙齿间 距选择适当型号的一距选择适当型号的一 体式基台体式基台 (Condsidering gingival depth and the width of the tooth, choose and equip Combi Ab)3. 3. 据颌间距离适当切削据颌间距离适当切削 使用使用 (Consider Interarch space and remove Ab.)取印模，安插方式取印模，安插方式 (Impression Snap on Technique)1. 选择基台替代体 (Choose Lab . Analog)2. 将基台替代体连接在转移帽上 (Combine with

9、Impression coping)3. 制备工作模型 (Manufacture master model)4. 制备牙冠 (Manufacture crown) Reduction Jig required to remove Ab. In the mouth Hexed Non-HexedDing (2003) Ding (2003) : 六角和非六角与螺丝松动无直接关联 (Hexed and Non-Hexed dont affect screw loosening much) 六角仅作为基台就位的参考 (Hex is just used as Index of Abutment pos

10、itioning)简单简单 & & 容易容易 ( (Simple & Easy)Simple & Easy)椅旁时间少，和传统治疗相似 (Only a small amount of Chair time used, and must be similar to Conventional treatment)可在技工室选择和调整基台，对患者来说比较方便 (Choosing and adjusting Abutment in the Lab is convenient for the patient.)REC) 种植体水平封闭式取模 (Fixture level

11、impression by transfer type) 分体式非六角基台 (Non-Hexed Dual Abutment)可修补性可修补性 ( (RetrievabilityRetrievability) )选择粘接材料 (Choosing cement materials) 对颊舌粘膜无刺激 (Leave a notch within the range thats not stimulated on the tongue or cheek for hook or ejection) ZPC或聚羧酸水门汀 (ZPC or Polycarboxylate cement)结合粘接固位和螺丝固

12、位的修复方法 (Combine the method of cementation and screwing (SCRC)REC) 分体式基台：修复体合面备洞，方便取下并修补修复体 (Dual Abutment : With making a hole on occlusion after restoration, remove and repair prosthesis.) Use Positioning Jig to transfer the Abutment Model to the oral cavity then tighten it (2530N.cm). Re-tighten a

13、fter 15 minutes. When equipped in the mouth and When equipped in the mouth and when rebounding by gingival tissue, when rebounding by gingival tissue, hold for 1015 minuteshold for 1015 minutes分体式可研磨基台(Dual milling Ab.) Similar to Dual Ab. Create Path modification and optional margin by milling角度基台

14、(Angled Ab. (15) When installed path is unfavorable 临时基台 (Temporary Ab.) When immediate loading After provisional crown is manufactured when gingival contouring直接可铸造基台 (Direct casting Ab.) Manufacture of Individualized abutment possible * 螺栓固位型基台 (Screw Abutment)l通过诱导应力沿种植体长轴传导，粘接固位修复体可以减少作用在牙槽嵴上的应力

15、 (Cement-retained prosthesis reduces stress on alveolar crest by inducing it to a long axis of implant.)l适当的垂直合力作用在修复体上时，螺栓固位型修复体力量作用在螺丝孔合方。(Screw-retained prosthesis is given force on occlusal screw hole for proper vertical occlusal loading on prosthesis.)l螺丝孔的直径约为3mm，占后牙咬合面的30%，功能区的50%，因为功能区占整个咬合面

16、的2/3 (Screw hole diameter is about 3mm; it occupies 30% of occlusal surface on posterior area or 50% of functional area because it is functional area on 2/3 of entire occlusal surface. )l几乎所有的咬合面螺丝孔都位于长轴上，即咬合接触区上 (Almost all position of occlusal screw hole is located on long axis, where occlusal con

17、tact occurs.)l螺丝孔须用树脂覆盖并适当进行调合 (And then occlusal adjustment is achieved on screw hole covered with composite resin. )咬合面材料折断咬合面材料折断 ( (Fracture of Fracture of occlusalocclusal material) material) 应力集中在螺丝孔上 (concentrate stress on screw hole) 修复体就位困难修复体就位困难( (Access)Access) 患者开口度有限，螺丝难于就位，且容易误咽 (It i

18、s difficult to access with a limited mouth opening patient. And one can easily swallow screw while handling instrument.)疲劳疲劳 ( (Fatigue)Fatigue) 应力作用在修复体支持结构上，甚至会引起种植体断裂 (weighting stress on prosthetic supporting structure even brings about fracture of implant.)螺丝螺丝松动松动 ( (Screw loosening)Screw loos

19、ening)According to several report, 50% of screws of prosthesis on upper dentition is loosened at least 1 time within 1 year after loading. Depending on single implant study, 65% of screws loosening occurs within 3 years after loading. Rec) cement-retained prosthesis后牙区咬合面材料 (Occlusal material of pos

20、terior area) 烤瓷？树脂？ 金属 (Porcelain ?, Resin? Metal occlusion)树脂和烤瓷容易碎裂 (Fibrous and hard food; easily porcelain and resin chipping or fracture.)须考虑功能紊乱(夜磨牙，紧咬牙) (parafunction (Bruxism, Clenching) must considered)* Zirconium core + porcelain咬合面形态 (Occlusal form)侧方不能有剪切力 (Shear strength must not be occ

21、urred by lateral force )大小和天然牙相似或者略小 (Similar to natural size or a little smaller than natural tooth.)增龄性咬合面和邻面磨损，将使天然牙向近中移位 (Natural teeth move to mesial side because of abrasion of occlusal and interproximal surface in aging.) 由于骨整合，种植体不会发生移位。因此，在邻接区容易引起食物嵌塞。为了修补邻接面，修复体需要具备可修补性。 (Implant can not b

22、e moved by osseointegration. Therefore, there easily occurs food impaction on interproximal area. So retrievability of prosthesis has to be easy in order to repair contact surface.） 理想合 (Ideal occlusion)交错保护合 (Mutually protected occlusion) 尖牙保护合 (Canine protected occlusion) 组牙功能合 (Group function occ

23、lusion)平衡合(全口义齿) ( Balanced occlusion (full denture)种植体保护合 (Implant protected occlusion)避免让种植修复体过载 (Avoid add up overforce on Implant prosthesis.)植入前 (When should implant be installed) 确定种植体数目、直径和长度 (Confirm the sufficient number of implant, and consider its diameter and length.) 最理想的种植位点和种植体散布于牙弓上

24、(Optimal implant positioning and distribution in dental arch.) 适当的角度以便分散合力 (Favorable angulation of installed implant for distribution of occlusal force.)修复前 (When should prosthesis be restorated) 正中接触位于牙冠中心附近 (Centric contact should be near the adjacent center of crown.) 比天然牙的正中接触要轻 (Slighter conta

25、ct at centric than natural tooth.) 减少种植体牙冠咬合面积，降低牙尖斜度 (Reduce occlusal surface of implant crown and inclination of cusp.) 去除非正中接触，减小侧方力 (Remove eccentric contact; Reduce lateral force.)全口缺牙 (Fully edentulous)全骨固定修复 (Fully bone anchored prosthesis) 交互保护或组牙功能合 (Mutually protected or group function occlusion)覆盖义齿修复 (Overdenture prosthesis) 平衡合 (Balanced occlusion)部分缺牙 (Partially edentulous)前牙固定修复 (Anterior fixed prosthesis) 尖牙保护或组牙功能 (Canine protected or group function)后牙固定修复 (Posterior fixed prosthesis) 尖牙保护合 (Canine protected occlusion)含尖牙的固定修复 (Fi