- 期刊
四根顴骨植體重建嚴重萎縮上顎骨－半年追蹤病例報告
Rehabilitation of Severely Atrophic Maxilla by Using Quad-zygomatic Implants- A 6-month Follow-up Case Report
摘要
顴骨植體配合前牙標準植體是近代牙科臨床上作為嚴重萎縮上顎重建的選擇。然而，若是上顎前區齒槽骨也嚴重萎縮，則可能受限於齒槽骨高度而無法植入標準植體。本病例報告提出以上顎四根顴骨植體術式配合固定式植體支持式贋復物，重建嚴重齒槽骨萎縮患者之咀嚼功能及顏面美觀。患者為61歲男性，患有嚴重牙周病，上下顎齒槽骨嚴重萎縮。若以傳統活動式贋復物重建則無法獲得良好穩定度。若以植牙重建則需大範圍植骨手術，因此本病例以四根顴骨植體術式配合固定式植體支持式贋復物來達到全口重建的目的。患者術後恢復顏面美觀，贋復物正常行使咬合功能，軟組織無異常狀況，亦無面頰麻痹或上顎竇感染狀況發生，並已追蹤半年。因此運用四根顴骨植體全口重建能立即性恢復病人咬合功能與顏面美觀，更能作為漫長植骨治療的替代方式，也能提供先天或後天疾患全口重建的新選擇。
並列摘要
Rehabilitation of extremely atrophic maxilla by insertion of zygomatic implants and anterior standard implants is an alternative option in modem dentistry. However, the alveolar bone height creates an anatomic limitation for placing standard implants while premaxilla is severely resorbed. The purpose of this case report is to propose the reconstruction of chewing function and facial esthetic by using quad zygomatic implants and implant-supported fixed prostheses in severely resorbed maxilla. The patient was a 61 year-old man with severe chronic periodontitis and had extremely atrophic jaws. Both of the atrophic alveolar ridges cannot provide good stability to removable prostheses, and necessitate reconstructing with dental implants and a large amount of bone augmentation. Hence, we performed the procedure without bone graft by insertion of four zygomatic implants and restored with implant-supported fixed prosthesis. Afterward, the patient got a high quality of life, including esthetic and functional complete fixed prosthesis. He has been followed up for six months without soft tissue abnormalities, sinus infection or paralysis. Oral rehabilitation with quad zygomatic implants and implant-supported fixed prostheses can immediately ameliorate facial appearance and resume occlusal function. The treatment concepts have evolved as an alternative for multiple bone augmentation procedures, and also can be considered as a viable treatment option for those with congenital or acquired disorders involved the maxilla.