- 期刊
前牙植體植入角度過大之補綴製作－病例報告
The Prosthodontic Fabrication of Anterior Implant Fixture with Large Angle Implantation-A Case Report
摘要
本病例為一23歲之女性，因車禍造成上顎兩顆正中門齒脫出(Avulsion)，而病患又因昏迷無法及時找到脫出之牙齒，直到病患至牙科門診就診時，已是車禍後一個月了，此時頰側齒槽骨已嚴重吸收，經GBR及植牙手術，（分別於上顎兩側正中門齒植入兩根MIS系統，直徑4.2mm，長度13mm之內六角人工牙根）後，仍無法達到令人滿意之結果。待植牙第二階段手術後，進行補綴贋復時，發現人工牙根植入角度與鄰牙長軸之角度相差達50度以上，以現有MIS之預製有角度補綴基台，均無法調整至令人滿意之結果，故本病例以傳統蠟型雕塑技術，刻製出符合病患條件之大角度個人化基台。不但植體補綴物之美觀與固著力得到改善，其補綴物之邊緣密合度亦得到令人滿意之結果，此法可應用在當人工牙根植入角度過大時，以補綴技術彌補此大角度植體之方法，希望可提供臨床醫師參考。
並列摘要
This is a case of a 23-years-old female who suffered from a vehicle accident, causing two maxillary central incisors avulsion. The patient was unconscious at the time and was unable to retrieve the lost teeth. One month after the accident, the patient came to our OPD for treatment, and oral examination indicated severe bone loss over maxillary buccal aspect. After GBR and implant surgery (two internal hexagon MIS implants system 4.2mmX13mm over maxillary central incisors area), the result still did not meet our expectation. After finishing second stage of implant surgery and undergoing prosthetic treatment, an angle greater than 500 was found between the angle of insertion of the artificial implanted root and the root axis of adjacent natural teeth. Prefabricated angulated abutment provided by MIS system was not able to reangulate the implant prosthesis to a satisfactory result. Therefore, in this case report, conventional wax-pattern technique was employed to custom-made an angulated abutment to meet the patient's demand. Not only did the implant prosthesis achieve better esthetic and retention, but the marginal fitness of the prosthesis also fulfilled an exceptional expectation. As a result, this conventional prosthetic technique was able to use for over-angulated abutments due to large high angle of insertion of implant, thus providing fellow dentists a clinical approach for such problematic implants.