- 期刊
以四支顴骨植體重建上顎骨缺損且癒合不良的唇腭裂患者咬合－病例報告
Rehabilitation with Quad Zygomatic Implants for Severe Atrophy and Malunion of Maxilla in the Cleft Patient-A Case Report
摘要
唇腭裂是常見的先天顱顏面異常，常伴隨有先天缺牙、咬合不正以及大範圍上顎骨缺損發生。進行咬合重建治療時，常因不適合補骨手術而無法進行傳統植牙重建治療。此時，顴骨植牙提供一個良好的治療方案，顴骨植牙不僅可以避免補骨手術的需要，也提供更佳的植體穩定度。一名41歲女性，過去曾接受唇腭裂修補手術以及勒福氏第一型上顎截骨手術改善唇腭裂與上顎後縮咬合問題，近期因上顎全口嚴重牙周病於門診尋求上顎咬合重建治療。口內檢查發現，除了有嚴重上顎骨缺損外，同時因為之前接受上顎截骨手術後，上顎骨有部分骨頭癒合不良，造成雙側齒槽骨無法穩定承受咬合力量。經過與患者討論後，患者決定以四支顴骨植體作為咬合重建的方式，減少因需要大範圍補骨等待的時間。本文提出唇腭裂患者進行上顎全口重建治療時可能遇到的困境，並提出以顴骨植體作為治療方案的預後，提供臨床醫師參考。
並列摘要
Cleft lip and palate is a common congenital craniofacial abnormality, which is often accompanied by congenital missing teeth, malocclusion and maxillary bony defect. Traditional dental implant with bony grafting is often time consuming for these patients. At this time, zygomatic implants provide an another opinion, which can not only avoid the need for long-term bone grafting surgery, but also provide better occlusal stability. A 41-year-old female, who had been through cleft lip and palate repair and Le Fort I osteotomy of the maxilla came to our OPD to seek for maxillary prosthetic rehabilitation owing to severe periodontitis. With the severe maxillary defect presented and the failure of healing after orthognathic surgery, both side of the alveolar bone couldn't bear the occlusal force stably. After discussing with the patient, we decided to reconstruct the occlusion by all-on-4^(TM) technique with 4 zygomatic implants. In this case report, we present some difficulties of full mouth prosthetic rehabilitation when treating patients with cleft lip and palate, and also the result of using zygomatic implants as a clinical reference.