- 期刊
下顎齒冠外彈性附連體覆蓋式義齒之全口重建：病例報告
Full Mouth Rehabilitation by a Mandibular Overdenture with Extra-Coronal Resilient Attachments: A Case Report
摘要
無牙患者裝戴傳統全口義齒常因固位性(retention)與穩定性(stability)不佳，病人並不十分滿意。牙科種植體(dental implant)已被廣泛應用在口腔功能的重建，也應用在全口覆蓋式義齒(overdenture)且是一種效果良好的治療方式。回顧近年的文獻，下顎覆蓋式義齒的成功率頗高，所使用的植體系統不同，植體數也不同。 本病例報告為一全口無牙的患者，下顎左側齒槽嵴嚴重吸收且缺乏角化黏膜。提出三個治療計劃供病患選擇。計畫A：上下顎全口傳統義齒。優點為價格便宜。缺點為下顎固位性及穩定性不良。計畫B：上顎：四支植體加齒冠外彈性附連體覆蓋式義齒(extra-coronal resilient attachment overdenture)。下顎：四支植體加齒冠外彈性附連體覆蓋式義齒。優點為固位及穩定夠。缺點為費用高。計畫C：上顎：傳統全口義齒。下顎：二支植體加齒冠外彈性附連體覆蓋式義齒。兼有固位及價格較便宜之優點。病人選擇計劃C。在33與43植入(TiUnite) Brånemark植體，以前庭加深、舌側溝槽加深加游離齒齦移植片(free gingival graft)，復原牙峭的高度，使義齒有固位性。之後製作覆蓋式義齒，使用齒冠外彈性附連體，上顎製作全口義齒。
並列摘要
Edentulous patients wearing complete dentures often have the problems of lacking stability and retention. Dental implants have been extensively used in the rehabilitation of oral function, and have been a treatment modality with good results when combined with overdentures. The recent literature has shown a high success rate for mandibular overdentures, with the use of a variety of implant systems and a varying numbers of implants. This report presents a case of fully edentulism with severe resorbed ridge and lack of keratinized mucosa over mandibular left alveolar ridge area. We offered three treatment options for the patient. Plan A was the fabrication of maxillary and mandibular complete dentures. The advantage was less expensive, and the disadvantage was poor retention and stability for the mandibular denture. Plan B was the four implants supporting overdentures with extra-coronal resilient attachments for the maxillary and mandibular arches. The advantage was good stability and retention, and the disadvantage was higher cost. Plan C was the fabrication of maxillary complete denture and mandibular overdenture with extra-coronal resilient attachments supported by two implants. The advantage was better retention and less expensive. The patient chose plan C. The treatment included placement of two Brånemark implants in 33 and 43 areas after vestibular deepening and free gingival grafting to restore the ridge height and provide better retention for the denture. The prostheses reconstruction included the mandibular implant-retained overdenture with extra-coronal resilient attachments, and the maxillary complete denture.