- 期刊
植牙之機械性併發症：植體斷裂之處理－病例報告
Mechanical Complication of Implant: Management of Implant Fracture - A Case Report
摘要
牙科骨整合植體的斷裂在臨床發生率並不高，根據文獻大概在0-3.45%，然而一旦出現植體斷裂卻是臨床上最嚴重的植體併發症之一。考量到植體治療在牙科的蓬勃發展，未來植體晚期併發症也會與日俱增。本病例為一個直徑4.1毫米標準牙科植體在三年的臨床使用後出現植體斷裂，評估後以環鋸（trephine）將植體取出，放置骨粉後重新引導骨再生，待骨頭癒合後再放置適合尺寸之植體，並修正復物設計。本文利用回顧過去臨床研究文獻和病例報告說明植體斷裂後續的臨床處理策略以及討論導致機械性失敗的可能機制和原因，進一步探討影響植體斷裂的相關因素。當愈多不利於植體斷裂的因素同時出現，則植體失敗、斷裂的風險將逐步地提高。因此，若能及早在植體斷裂前注意到臨床上可能警訊，如：植體螺絲的鬆脫、植體螺絲的扭曲、復物的瓷裂以及植體邊緣骨的喪失，或許可以協助植體免於出現斷裂的結果。一個謹慎評估的治療計劃配合合適的病例選擇亦可以減少植體斷裂的發生，並提高植牙治療的預後。
並列摘要
Fracture of dental implant is a rare but a serious phenomenon clinically. Considering that implant treatment has become more and more popular, an increase in the number of failures due to late fracture can be expected. This is a case report of a fractured standard endosseous dental implant (4.1 mm in diameter) after 3-years loading. The reviewed literature described the management options and discussed possible mechanisms of mechanical failures, as well as various factors that may result in implant fracture. The more failure-causing factors occurred, the higher risk the implants would fracture. Therefore, an early diagnosis of warning signs about implant fracture, such as screw loosening, screw bending, ceramic fracture and marginal bone loss, can avoid undesirable implant fracture. A carefully developed treatment planning and appropriate case selection can contribute to reduce the incidence of fracture.