- 期刊
以腭黏膜移植前庭成形術合併引導骨再生術重建外傷後牙床之植體贋復病例報告
Reconstruction of the Severe Atrophic Ridge of the Mandible after Traffic Accident with Guided Bone Regeneration Combined with Palatal Mucosa Graft and Vestibuloplasty for Implant Rehabilitation-A Cas
摘要
近年來植牙贋復已經成為一項相當普遍及成功率高的手術。但是臨床上仍有許多植牙手術上的限制，例如骨組織因為年紀老化，外傷造成骨缺損，或因口腔癌大範圍手術後造成骨組織不足甚至嚴重缺損等因素增加植牙臨床上的困難度。過去文獻對年紀長者或因口腔癌大範圍手術後的植牙手術已有相當多的討論。而年輕病人因外傷造成的骨缺損修復則需要更多的考量。包括美觀上的因素，此外植牙體上所覆蓋的軟組織及植牙體周圍的牙周狀態對植牙的成功率有相當大的影響。 本篇的目的是敘述如何重建因車禍造成嚴重中顏面部創傷及下顎骨缺損而導致牙齒喪失並說明下顎前牙重建之經過。病患為一位二十一歲男性，於民國89年12月發生車禍，在本院整形外科接受手術治療後出院。病人於民國90年因下顎前區不適至本科求診，診斷為下顎前區斷骨處骨缺損(bone defect)及疤痕收縮(scar contraction)，經過骨板移除術(remove of bone plate)並再施行引導骨再生術(guided bone regeneration)及後續的前庭再造(Vestibuloplasty)及腭角質化黏膜移植手術(palatal flap with keratinized mucosa)後，於民國91年接受義齒製作，術後病人咀嚼功能恢復良好。 文中將進一步探討骨組織重建之相關臨床經驗，諸如：傳統骨組織之重建，硬組織及軟組織重建技術，假牙及植牙贋復前手術等，以達成病人咀嚼功能恢復及美觀上的目標。
並列摘要
The implant surgery for prosthetic rehabilitation becomes a safe and predominant operation lately. But the thin, sharp atrophic alveolar ridge due to trauma usually hinders oral rehabilitation with dental implants. Therefore, the dentist should rebuild the atrophic ridge by adequate technique in order to meet basic requirements of the implant surgery. Meanwhile, the augmented ridge also needs following soft tissue reconstructions for pen-implant area such as a second-stage vestibuloplasty, keratinized mucosal graft, or split thickness skin graft. This paper reported a case with atrophic alveolar ridge due to traffic accident needed bone allograft, soft tissue management, and preprosthetic surgery for proper prosthetic rehabilitation. The course and treatment of this case was fully discussed in this article. Furthermore, clinical techniques related to bone tissue reconstruction including traditional bone regeneration, hard and soft tissue reconstructions and preprosthetic surgery were also discussed for the chewing function and esthetic requirements.
延伸閱讀
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