口腔种植学是口腔教育中较新的学科。虽然现在我们都有共识，种植⽛相关的理论知识，⽆论是治疗⽅案的规划，还是后期的随访和维护，对于每⼀个职业⽛医都⾮常重要。然⽽，在当下全球的口腔医学本科培养体系中，它的覆盖程度还远远落后于其重要性。 在此背景下，香港大学口腔医学院联合⾹港⼤学的线上教育专业团队，历时⼀年有余，设计并制作了这门为期五周的⽹络公开课，旨在传播以循证医学为基础的，客观、全⾯的⽛种植学相关知识。这门课程⾯向全球，双语教学，完全免费。学员将在20 多位全球领先的种植学专家的带领下，完成五个模块，系统地学习⽛种植学。
第一周总结
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Del curso dictado por The University of Hong Kong
口腔种植学 （Implant Dentistry）
22 calificaciones
De la lección
种植牙，生物学基础，技术工艺
什么是种植学？这一学科如何开始，又是经历了什么重大突破发展到现在的阶段？什么样的种植体更有益于我们的患者？本模块中，我们将回顾骨结合背后的基本生物学概念，以及其对临床决策的影响。
Conoce a los instructores
Nikos MattheosClinical Associate Professor in Implant Dentistry
The University of Hong Kong
Greetings from Hong Kong!
It has been an amazing start in the course
and I thank you for your enthusiasm throughout this week.
I and our course tutors have met over a thousand learners
on the discussion forum in the past few days.
I had enjoyed lively and constructive discussions
on various topics in Implant Dentistry with you,
and indeed, I have got quite a few ideas
for future research from your comments.
I know we’ve got some very quick learners in this course.
For those of you who have already post questions
and comments for Weeks 2 to 5,
or have post a mission statement (in Week 2),
solved the implant case (Weeks 2 to 5),
please stay tuned with us in the upcoming weeks.
We will continue to have even more lively discussions
when more of your online peers and instructors join
the interaction in the discussion forum.
Now as we have reached the end of Week 1,
I take the opportunity to sum up
some of the interesting topics
that were discussed in the forum.
One of the questions that consistently emerged
in this week’s discussions was about
connecting teeth with implants under the same prosthesis.
As we discussed, given the many significant functional
and anatomical differences between teeth and implants,
many people wondered if it is really a good idea
to join them under the same fixed dental prosthesis.
Let's see what the evidence says for this discussion.
We would like you to take a look
at some papers we have compiled,
which will help you better understand
the long-term survival and success rates
of different types of implant supported
or conventional fixed dental prosthesis.
This will also be discussed in more detail in Module 4.
As you can see in the first table,
the 10-year survival rate of
conventional fixed dental prostheses on teeth is around 90%,
while that of an implant supported bridge is very close.
With regards to tooth-implant supported bridge however,
the survival rate drops significantly to 77%.
This is still a high survival rate for 10 years,
but of course, not as high as in prosthesis supported
solely by either implants or natural teeth.
Furthermore, looking at the complication rates
that have been observed for the two types of reconstructions,
we see similar rates for most of the problems,
apart from the problem of the intrusion
of the abutment tooth, which is not uncommon
when we mix teeth and implants.
So, conclusively, is it a good idea
to mix teeth and implants?
Well, as the evidence shows,
it is certainly not our first option today.
Nevertheless, it remains a valid possibility,
which can be considered in special cases when the anatomy
and also the patient's needs would favor such a solution.
Another point that our learners discussed
was the sulcus around teeth and implants.
The attachment of the peri-implant tissues
and the height of the biological width
do not appear to be influenced
by the gingival biotype of the patient.
Also, as of today, no surgical technique, surface,
or device has been able to
predictably manipulate the soft tissue attachment around implants.
As you heard from Professor Ivanovski,
we have made tremendous progress in osseointegration,
by improving the implant surfaces.
But when it comes to the soft tissue attachment, guess what?
We are at the same point we were
with the first Brånemark implants.
So make a note there, those of you
who are after a cool research project,
an improvement in the soft tissue attachment
could be a significant breakthrough in implant dentistry.
Many people wondered if we could actually create
an equally shallow healthy sulcus around
implants as we have around teeth.
I think this is possible but it
greatly depends on the local anatomy.
So if we are dealing with an area of
the alveolar ridge that is relatively flat,
as it might be in the posterior maxilla or mandible,
the peri-implant sulcus can be relatively shallow,
especially around tissue level implants.
However, in the aesthetic zone,
this is where a deep sulcus is almost inevitable.
And in most cases, the better the aesthetics we achieve,
the deeper the sulcus that we will have to create.
Finally, some questions that caught our attention.
Can we create an implant coating that could
offer shock absorption like a periodontal ligament?
Or is the pattern of bone resorption
when we remove implants the same as when we remove teeth?
Excellent questions, for which
we have no answers at present.
So maybe this could be some exciting
research projects for some of you?
I’m looking forward to continue
our exciting interaction in Week 2
and thank you all for your enthusiasm and participation.
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