种植

null内窥镜在口腔种植中的应用进展内窥镜在口腔种植中的应用进展内 容内 容内窥镜在口腔中的应用 1内窥镜在口腔种植中的应用 2问与展望3 4内窥镜在口腔中的应用内窥镜在口腔中的应用颞下领关节疾病唾液腺疾病 神经疾病1986年Sanders [1]报道治疗性颞下颌关节内窥镜， 国内于1987年华西医科大学首先开始采用1991诊断性涎腺镜和治疗性涎腺内窥镜镜相继问世， 为涎腺主导管疾病的诊断和治疗提供了新的方法Jannetta等[2]在70年代推广桥小脑角的微血管减压术，在 直视或显微镜下寻找压迫点并减压，成功率为85％左右内窥镜在口腔中的应用内窥镜在口腔中的应用颔面部骨折 种植外科1997年，Saunders等[3]首次报道了经上颌窦开窗术在内镜下行 眶底壁骨折的探查和复位术．术中可明确骨折的部位、形态、 大小和缺损边缘骨质的稳定性2000年，Wilffang等[4]对上颌窦底高度余留4—8mm的患者行 内镜下上颌窦底增高术，内镜由上颌窦开口进入，自体骨或生 物材料从牙槽嵴填入，同期种植体植入。与传统的上颌窦开窗 进路植骨相比．内镜辅助术并发上颌窦炎的几率明显下降，大 大增加了种植成率。[1]Clark GT．Sanders JB，Bnflolami CN Advance in diagnostic and surgical arthroscopy of the tempemmandibular joint [M] Philadelphia W.B．Saunders 1993：5一14． [2]Engelke W;Deckwer I Endoscopically controlled sinus floor augmentation. A preliminary report 1997 [3]Brunt LM;Jones DS;Wu JS Experimental development of an endoscopic approach to neck explorati and parathyroidectomy [外文期刊] 1997(05) [4]Wiltfang J．Mosgau SS.Marten HA，et.Endoscopic and ultrasonography evaluation of the maxillary sinus after combined sinus floor augmentation alld implant insenion[M]Oral Surg Oral Med Oral Pathol Oral Radial Ended．2000，89(3)．288—291内窥镜在口腔种植中的应用内窥镜在口腔种植中的应用在口腔颌面外科和口腔种植外科内窥镜已被使用，但它从来没有在常规种植牙程序中使用。直到去年，才有医生在常规的种植牙程序中使用口腔内窥镜。 优点：可以同时进行可视化和冲洗，这是手术成功的关键因素内镜辅助植入可确保适当的质量和密度的骨植入种植体中，延长口腔种植体的耐用性。这种方法的准确性的高，不造成压力坏死。低创伤，种植体具有良好的稳定性和较高的成功率内窥镜在口腔种植中的应用内窥镜在口腔种植中的应用Endoscopic Approach to Dental ImplantologyResultsObjective Endoscopic Approach to Dental Implantology [M] Journal of Oral and Maxillofacial Surgery Volume: 69, Issue: 1, January, 2012, pp. 186-191 Nellie, Oded; Moshonov, Joshua; Zagury, Ami; Michaeli, Eli; Casap, Nardy Objective www.themegallery.comLOGO Objective To describe an innovative miniature visualization surgical endoscope and endoscopic techniques applicable to dental implant procedures Materials and MethodsMaterials and MethodsWe describe the newly introduced Modular Implant Endoscope (Israel). The device was tested in 56 procedures, such as routine dental implants procedures (34), closed sinus lift procedures (18), and implant preparation site surgery (4) by 4 experienced clinicians, and their preliminary observations are outlined. The new modular implant endoscope accurately identified all micro anatomical and pathological structures, and simplified dental implant proceduresResultsResultsBone qualitysinus liftingThe deviceThe deviceSialo Technology, IsraelApplication techniquesApplication techniquesIntraoperative view of the usage of the endoscope during routine implant surgeryInsertion of the endoscope cannula into the drill socket for immediate inspection.The endoscope in conjunction with the low-speed engine during surgery.Implant site preparationImplant site preparationIn immediate implant placement: endoscopic evaluation of socket condition can be performed in real-time. The irrigation procedure allows observing the cavity walls of the immersed bleeding alveolar socket under variable magnification. Cortical and cancellous bone structures can be differentiated in situ, and pathologies are detectable even with capillary bleeding.Implant site preparationImplant site preparationIn late implantations: a pilot hole is drilled into the recipient site and expanded using progressively wider drills. Before each drill is used, endoscopic observation assures that anatomical structures, like the inferior alveolar nerve, maxillary sinus, are avoided.Bone qualityBone qualityThe fundamental cause for differences in the survival of dental implants is bone quality. Currently, the assessment of bone quality is based on radiographic evaluation and on the subjective sensation of resistance experienced by the surgeon when preparing the implant site. Thus, additional qualitative objective methods for evaluating bone quality are needed, and indeed, endoscopic observation of the site can determine the quality of bone density.Bone qualityBone qualitysinus liftingsinus liftingC, D, Intraoperative endoscopic view during closed sinus elevation: Insertion of collagen sponge under the sinus membranethe endoscope can assist in sinus lifting interventionsinus liftingsinus liftingA, Endoscopic closed sinus elevation: Intraoperative endoscopic view, note the intact sinus membrane after the endoscopic procedure B, Endoscopic demonstration of sinus membrane perforations (yellow arrow）Overall evaluationOverall evaluationIn general, a significant improvement in all tested aspects, including handling and flexibility, and verification of findings that were not detected radiological were obtained with the endoscope. The endoscope proved superior to conventional optical aid, Its working canal facilitated specific application of medication and irrigation solutions Discussion Discussion the new Modular Dental Implant Endoscope that we have used accurately identified all microstructures and facilitated simplified dental implantation procedure. The endoscope should be considered not only for intraoperative observation and assessment of bone density, but also for active assistance during the procedures of implantation. Endoscopic Visualization of Anatomic Structures as a Support Tool in Oral Surgery and Implantology Endoscopic Visualization of Anatomic Structures as a Support Tool in Oral Surgery and Implantology Objective： The aim of the present report was to present the application of endoscopes for the visualization of oral structures, which might enable the surgeon to enhance the quality of minimally invasive procedures in the oral cavity Materials and Methods：Endoscopy was performed in patients undergoing various intraoral procedures Results: endoscopic visualization of critical intraosseous structures contributes to improve the quality and to reduce the invasiveness of dent alveolar interventions Endoscopic Visualization of Anatomic Structures as a Support Tool in Oral Surgery and Implantology , [M]Journal of Oral and Maxillofacial Surgery ，Volume: 69, Issue: 1, January, 2012, pp. 186-191 Beltran, V ; Fuentes, R 3; Engelke, Wpost extraction alveolar controlpost extraction alveolar controlSex： female Age ： 20-year-old Condition：an extraction site (right central incisor) was considered for immediate implantation. SE: The extension of the vestibular wall defect could be clearly visualized In this case, the prognosis for immediate implantation was questionable B, Bony wall, ST: Soft tissue. Arrows indicate the border of the osseous wallexposure of the inferior alveolarexposure of the inferior alveolarSex： male Age ： 19-year-old Condition：After removal of a left inferior third molar, the alveolar nerve was visible To confirm its position and intactness, micro-endoscopic imaging was performed. IE: immersion endoscope was used in the depth of the extraction socket in direct contact with the alveolar wall under continuous irrigationFIGURE 4. Immersion endoscopy of the inferior alveolar nerve. Arrows indicate the osseous border of the open nerve canal.问题与展望问题与展望内窥镜准确性高，对周围组织损伤小、并发症少、术后恢复时间缩短．它改变了许多传统手术的概念．增加了许多解剖困难部位的手术机会。 但内窥镜设备昂贵、术者需特别训练。而且口腔颌面部的内镜辅助技术起步较晚，应用于临床的病例数也较少。尚需改良设备、增加经验。 nullwww.themegallery.com