种植修复资料

一体式基台One-pieceAbutment分体式基台Two-pieceAbutment内部：六角Theinterior:HEX-shapedCombiDual临床图片(Clinicside)技工室图片(Lab.Side)二期手术(Secondsurgery)取印模(Impression)制备工作模型，选择基台(ManufacturingmodelsChooseAbutment)咬合记录(BonnetforjawRelationrecord)定位辅件(PositioningJig)咬合记录(Jawrelationrecord)最终修复体(Deliveryofprosthesis)Mounting制作修复体(Fabricationofprosthesis)临床图片(Clinicside)技工室图片(Lab.Side)一体式基台(CombiAb.)分体式基台(DualAb.)分体式可研磨基台(DualmillingAb.)直接可铸造基台(DereactcasingAb.)角度基台(AngledAb.)螺栓固位型基台(ScrewAb.)临时基台(TemporaryAb.)基底(Cylinder)一体式(Combi)分体式(Dual)植入位置理想时(Whenthepositionofimplantisideal)可在椅旁选择基台(ChoosingabutmentfromChairside)基台水平取模(Abutmentlevelimpression)口内需要的准备视情况而定(Preparationrequiredinsidethemouthdependingonthesituation)螺丝不易松动(Littlebitofscrewlooseningduetocoldwelding)重新修复困难(Difficultretrieval)诊疗时间长(Longchairtime)基台水平及种植体水平取模均适用(Abutment&fixturelevelimpressionallpossible)一般选用种植体水平取模方式(Generallyoperatefixturelevelimpression)可在模型上选择基台(Choosingabutmentfrommastermodel)需要定位辅件(PositioningJigrequired)据患者情况选择六角或非六角基台(DecideonHexedorNon-Hexedaccordingtothepatient’spreference)容易修补(Easytoprostheticrepair,forretrievalisallowed)诊疗时间短(ShortChairtime!!!)封闭式(Transfertype)开窗式(Pick-uptype)Impressionmaterials:Elasticsiliconerubber(Regularbody)美学需求(Estheticrequirement)种植角度(Implantangulation)种植位置(Implantlocation)植入深度(穿龈高度)(Fixtureinstallationdepth(GingivalHeight))牙弓间距离(Interarchdistance)修复类型(Prosthesistype)牙医和技工的喜好(Dentist&Dentaltechnician'spreference)DirectcastingAb.+porcelainDualAb.DualmillingAb.AngledAb.DirectcastingAb.ScrewAb.CombiAb.analogAngled,DualAbComportcapLab.analogImpressioncoping☆也可用于即刻负重或者临时冠(Immediateloadingorprovisionalcrown,alsoallowedwhenmanufacturing)☆ConventionalTechnique:Putcordandimpressionpossible1.去除愈合基台(RemoveHealingAb)2.据牙龈高度及牙齿间距选择适当型号的一体式基台(Condsideringgingivaldepthandthewidthofthetooth,chooseandequipCombiAb)3.据颌间距离适当切削使用(ConsiderInterarchspaceandremoveAb.)取印模，安插方式(ImpressionSnaponTechnique)1.选择基台替代体(ChooseLab.Analog)2.将基台替代体连接在转移帽上(CombinewithImpressioncoping)3.制备工作模型(Manufacturemastermodel)4.制备牙冠(Manufacturecrown)☆ReductionJigrequiredtoremoveAb.InthemouthHexedNon-HexedDing(2003):六角和非六角与螺丝松动无直接关联(HexedandNon-Hexeddon’taffectscrewlooseningmuch)六角仅作为基台就位的参考(HexisjustusedasIndexofAbutmentpositioning)简单&容易(Simple&Easy)椅旁时间少，和传统治疗相似(OnlyasmallamountofChairtimeused,andmustbesimilartoConventionaltreatment)可在技工室选择和调整基台，对患者来说比较方便(ChoosingandadjustingAbutmentintheLabisconvenientforthepatient.)REC)种植体水平封闭式取模(Fixturelevelimpressionbytransfertype)分体式非六角基台(Non-HexedDualAbutment)可修补性(Retrievability)选择粘接材料(Choosingcementmaterials)对颊舌粘膜无刺激(Leaveanotchwithintherangethat’snotstimulatedonthetongueorcheekforhookorejection)ZPC或聚羧酸水门汀(ZPCorPolycarboxylatecement)结合粘接固位和螺丝固位的修复方法(Combinethemethodofcementationandscrewing(SCRC))REC)分体式基台：修复体合面备洞，方便取下并修补修复体(DualAbutment:Withmakingaholeonocclusionafterrestoration,removeandrepairprosthesis.)☆UsePositioningJigtotransfertheAbutmentModeltotheoralcavitythentightenit(25~30N.cm).Re-tightenafter15minutes.☆Whenequippedinthemouthandwhenreboundingbygingivaltissue,holdfor10~15minutes分体式可研磨基台(DualmillingAb.)•SimilartoDualAb.•CreatePathmodificationandoptionalmarginbymilling角度基台(AngledAb.(15°))•Wheninstalledpathisunfavorable临时基台(TemporaryAb.)•Whenimmediateloading•Afterprovisionalcrownismanufacturedwhengingivalcontouring直接可铸造基台(DirectcastingAb.)•ManufactureofIndividualizedabutmentpossible*螺栓固位型基台(ScrewAbutment)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(Cement-retainedprosthesisreducesstressonalveolarcrestbyinducingittoalongaxisofimplant.)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-retainedprosthesisisgivenforceonocclusalscrewholeforproperverticalocclusalloadingonprosthesis.)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的2/3(Screwholediameterisabout3mm;itoccupies30%ofocclusalsurfaceonposteriorareaor50%offunctionalareabecauseitisfunctionalareaon2/3ofentireocclusalsurface.)几乎所有的咬合面螺丝孔都位于长轴上，即咬合接触区上(Almostallpositionofocclusalscrewholeislocatedonlongaxis,whereocclusalcontactoccurs.)螺丝孔须用树脂覆盖并适当进行调合(Andthenocclusaladjustmentisachievedonscrewholecoveredwithcompositeresin.)咬合面材料折断(Fractureofocclusalmaterial)应力集中在螺丝孔上(concentratestressonscrewhole)修复体就位困难(Access)患者开口度有限，螺丝难于就位，且容易误咽(Itisdifficulttoaccesswithalimitedmouthopeningpatient.Andonecaneasilyswallowscrewwhilehandlinginstrument.)疲劳(Fatigue)应力作用在修复体支持结构上，甚至会引起种植体断裂(weightingstressonprostheticsupportingstructureevenbringsaboutfractureofimplant.)螺丝松动(Screwloosening)Accordingtoseveralreport,50%ofscrewsofprosthesisonupperdentitionisloosenedatleast1timewithin1yearafterloading.Dependingonsingleimplantstudy,65%ofscrewslooseningoccurswithin3yearsafterloading.☆Rec)cement-retainedprosthesis后牙区咬合面材料(Occlusalmaterialofposteriorarea)烤瓷？树脂？→金属(Porcelain?,Resin?→Metalocclusion)树脂和烤瓷容易碎裂(Fibrousandhardfood;easilyporcelainandresinchippingorfracture.)须考虑功能紊乱(夜磨牙，紧咬牙)(parafunction(Bruxism,Clenching)mustconsidered)*Zirconiumcore+porcelain咬合面形态(Occlusalform)侧方不能有剪切力(Shearstrengthmustnotbeoccurredbylateralforce)大小和天然牙相似或者略小(Similartonaturalsizeoralittlesmallerthan