使用兩支植體支撐下顎覆蓋式義齒，立即受力並同時提高咬合垂直高度─病例報告

Immediate Loading of Two-implant-retained Mandibular Overdenture Combined with Increasing Occlusal Vertical Dimension Simultaneously-A Case Report

鄭智文(Chih-Wen Cheng) ； 簡佳慧(Chia-Hui Chien) ； 周庭暵(Ting-Han Chou) ； 陳俊榮(Chun-Jung Chen)

《中華民國家庭牙醫學雜誌》 6卷3期 (2011/12) Pp. 34-43

https://doi.org/10.6566/JFD/2011.6(3).34

摘要

植牙支持覆蓋式義齒（implant overdenture）能增加義齒的固持力與穩定度，並改善患者的滿意度，應用於立即受力（immediate loading）的情況下，如果有良好的病例選擇，並控制好微震動（micromotion），也會有不錯的臨床效果；有關下顎覆蓋式義齒立即受力的文獻，多半是使用4支植體及桿型附連體支持，較少以2支植體來支撐。本病例報告為一男性患者因下顎全口義齒容易鬆動，希望藉由植牙來增加其下顎義齒的穩定度，臨床檢查發現患者的咬合垂直高度（occlusal vertical dimension）不足，為了縮短治療療程，治療方式使用兩支植體及桿型附連體來支持下顎覆蓋式義齒，並且在植牙手術48小時內立即裝戴受力，並同時提高義齒的咬合垂直高度，將所有所需的治療一次完成；手術後9個月的追蹤顯示植體的骨整合良好，上下顎義齒及桿型附連體也沒有發生任何機械性問題（mechanical complications），根尖片顯示並沒有明顯的植體周圍骨喪失的情況（periimplant bone loss）。（J. Family Dent. 6（3）：34－43，2011）

關鍵字

立即受力 ； 植牙支持覆蓋式義齒 ； 咬合垂直高度

並列摘要

In comparison with conventional complete dentures, implant overdentures can improve the retention, stability and the patient's general satisfaction. Under proper case selection and well control of micromotion, implant overdentures still can get a good clinical outcome even in immediate loading protocol. From the literatures about immediate loading of mandibular implant overdentures, a number of investigators have used the 4-implant design connected with a rigid bar and loaded the clip-retained overdenture within 2 to 3 days. Only a few articles reported about immediate loading of 2 implants retaining a mandibular overdenture. This case reports a fully edentulous patient who came for help due to the instability of his conventional mandibular denture. After the clinical examinations, inadequate occlusal vertical dimension was found. In order to decrease the number of patient treatment visits, the mandibular denture was modified to a 2-implant-retained overdenture, and was immediately loaded within 48 hours and increased occlusal vertical dimension simultaneously.9 months after implant placement, there was no implant mobility or mucosal inflammation, and the overdenture still functioned well without any mechanical complications. Periapical radiographs showed that there was no obvious periimplant bone loss around the dental implants. (J. Family Dent. 6(3): 34-43, 2011)

並列關鍵字

immediate loading ； implant overdenture ； occlusal vertical dimension