OBJECTIVETo study the precise stress distribution of the apical foramen area of endodontic endosseous implant, in order to improve the prosthetics of endodontic endosseous implant.

METHODSAfter analysis of the two-dimensional endodontic endosseous implants model with finite element method, left and right areas beside the apical foramen were selected as infinite domains to calculate. D-N interactive method was used to connect the finite and infinite domains.

RESULTSUnder 45 degrees axial right oblique loading, the stress concentration occurred in both infinite domains of the apical foramen. The infinite domain nearing the load side was tension stress concentration, but the other side was compressive stress concentration. Two stress concentration points were just at the central points, which were intersections between implant and dentin. The stress reduced in all directions from these two stress concentration points, but in the ligament, the result was contrary.

CONCLUSIONSThe change of the tooth rotational center is helpful to the tooth stability and carrying capacity after restoration. In the implant area, the diameter of implant at the apical foramen of root shall not be reduced to protect root in clinical work. It is very important to preserve the tissue of periodontal ligament for endodontic endosseous implants.

OBJECTIVETo investigate the osteointegration of with self-drilling and self-tapping microscrew implants under immediate loading histomorphometrically.

METHODSThe buccal side of upper and lower jaws of three dogs was chosen as implant receipt site. Each dog accepted 8 implants (4 self-drilling and 4 self-tapping implants). Approximately 1.47-1.96 N continuous and constant forces were immediately applied between two microscrew implants with nickel-titanium coil spring for 9 weeks. Undecalcified sections of implants and surrounding tissue were studied with light microscope and fluorescent microscope.

RESULTSOsteointegration was seen in all samples and no fibrous tissue was seen between bone and implant. More original bone was seen in self-drilling group. Modeling and remodeling were more active in self-tapping group. Bone-to-implant contact values were statistically significant higher in self-drilling group [(41.7 +/- 10.7)%] than in self-tapping group [(25.9 +/- 8.0)%, P<0.01].

CONCLUSIONSImmediate loading had no influence on osteointegration in both self-drilling and self-tapping groups. The rates of bone-to-implant contact were higher in self-drilling group.

Dental Implantation, Endosseous ; methods ; Dental Implants ; Dental Prosthesis, Implant-Supported ; methods ; Humans ; Surgery, Computer-Assisted

Dental Implantation, Endosseous ; methods ; Dental Implants ; Dental Restoration Failure ; Denture, Complete, Immediate ; Humans ; Jaw, Edentulous ; surgery

Alveolar Process ; surgery ; Dental Implantation, Endosseous ; methods ; Esthetics, Dental ; Gingiva ; surgery ; Humans

When selecting implant guidance methods or judging whether the patient can be implanted, many doctors ignore or only use visual inspection to estimate a patient's mouth opening. This phenomenon often leads to failure to complete the implantation due to insufficient mouth opening or the deflection of the implant due to limited angle, resulting in the high incidence of corresponding complications. The main reason is that doctors lack accurate analysis and control of the overall geometric conditions of the intraoral surgical area, and three-dimensional position blocking of surgical instruments occurs during the operation. In the past, mouth opening was defined as the distance between the incisor edges of the upper and lower central incisors when the patient opens his mouth widely, and the implant area could be in any missing tooth position. When it is in the posterior tooth area, the specific measurement scheme of the mouth opening could not be simply equivalent to the previous measurement method in the anterior tooth area. However, how to measure quickly and conveniently the mouth opening of any surgical area to determine whether it could be implanted and meet the needs of the selected guidance method remains unclear. This paper introduces new concepts, establishes new classification and corresponding accurate measurement scheme of implant area, and establishes a decision tree of implant methods guided by the actually measured value. Results provide a quantitative basis for rational formulation and implementation of implant treatment.
Humans ; Mouth ; Dental Implantation, Endosseous/methods* ; Incisor ; Clinical Decision-Making ; Dental Implants

Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.
Dental Implantation, Endosseous/methods* ; Dental Implants ; Esthetics, Dental ; Alveolar Ridge Augmentation/methods* ; Osseointegration ; Maxilla/surgery* ; Dental Implants, Single-Tooth

OBJECTIVETo compare the stress distribution of the staggered and straight placement of implants in the mandibular posterior region.

METHODSUsing three-dimensional finite element approach to analyze the stress distribution and variance regularity under the localized load.

RESULTSUnder vertical load, the stress peak value reduced when wide implant was placed straight (min: 3.70 MPa), but slightly increased when normal implant was placed staggered (max: 8.32 MPa); under the inclined load from buccal to lingual direction, the stress peak value reduced when the wide implant was placed in straight line (min: 12.29 MPa) or normal implant was placed staggered with buccal offset configuration (min: 15.48 MPa), but increased with lingual offset configuration (max: 23.60 MPa).

CONCLUSIONSWide implant (> or = 4 mm) with straight placement should be adopted to reduce the stress peak value and improve stress distribution, when the buccolingual diameter of the alveolar ridge in the mandibular posterior region was wide.

The use of dynamic navigation technology in edentulous jaw implant restoration can solve many problems associated with traditional edentulous jaw implant restoration. The benefits of dynamic navigation include fine positioning guidance, restoration-guided surgery, good aesthetic results, and the possibility of simultaneous conceptual design and real-time implant guidance, as well as the transition from "blind" to "direct" vision during the implantation. It can guide clinicians and adjust the plan in real time, improve the efficiency of communication between the clinician, technician, and patient throughout the process and so on. The workflow, current clinical application and challenges, accuracy analysis, and limitations of the dynamic navigation technology in the edentulous jaw are discussed in this paper, as well as an outlook on its future development, with the goal of contributing to the clinical development of dynamic navigation-guided implantology in the edentulous jaw.
Humans ; Dental Implantation, Endosseous/methods* ; Dental Implants ; Surgery, Computer-Assisted/methods* ; Esthetics, Dental ; Jaw, Edentulous/surgery* ; Technology

Objective: To evaluate the clinical efficacy of modified lateral window for maxillary sinus floor augmentation (MSFA). Methods: Fifty-five patients who visited the Stomatology Hospital Affiliated to Zhejiang University School of Medicine between June 2012 and October 2014 were enrolled in the study. Patients underwent MSFA with Bio-Oss grafts based on modified access window. During the operation the vertical height of the bony window was reduced from 6-8 mm of conventional oval window to 4-5 mm of slot-shaped window. The sinus membrane was detached completely via the lateral access and large particle Bio-Oss graft was placed in the sub-mucosal space. The implant survival, graft height, graft volume and resorption rates were measured. Intra-op and post-op complications were recorded. Results: There were 86 implants inserted. The 2-4 year cumulative survival rates were 97.67% by implant-based analysis and 96.36% by patient-based analysis. The residual bone height was (4.7±2.6) mm and bone width was (8.4±2.7) mm. The bone height of implantation site immediately after operation was (16.1±2.5) mm and it was (16.2±2.2) mm at restoration. The bone heights at 1 and 2 years after operation were (14.9±2.5) mm and (13.6±2.6) mm, respectively. The graft height was (10.6±2.8) mm and the graft volume was (1569±745) mm³ immediately after operation. The resorption rate of graft height 6 months after operation was 3.79% and that of graft volume was 7.87%. The 1-year accumulative resorption rate of graft height was 6.63% and that of graft volume was 10.89%. The 2-year accumulative resorption rate of graft height was 7.58% and that of graft volume was 15.26%. Small membrane perforation during MSFA was observed in 5 cases and all were successfully repaired by a collagen Bio-Gide membrane. Conclusion: The modified lateral technique obtains high implant survival rate, excellent graft stability and low complication rate at 2-4 year clinical follow-up, indicating that it is a safe, predictable and minimally invasive surgical method for severe atrophic maxillary posterior dentition.
Dental Implantation, Endosseous ; Follow-Up Studies ; Humans ; Maxillary Sinus ; surgery ; Sinus Floor Augmentation ; methods ; Treatment Outcome