Becker William, Wong James
Department of Periodontology, University of Southern California School of Dentistry, Los Angeles, CA, USA.
Clin Implant Dent Relat Res. 2003;5(1):47-51. doi: 10.1111/j.1708-8208.2003.tb00181.x.
Immediate or early functional loading of implants in fully edentulous mandibles can enhance patient comfort and the ability to masticate within a few days after implant placement. Recently there has been evidence that this method of restoring edentulous mandibles is predictable.
The goal of this case report is to present the treatment of a patient diagnosed with a large ameloblastoma in the mandible. After removal of the tumor and mandibular reconstruction, the patient had complete anesthesia in the right mandible, with an alveolar ridge deformity.
Two years after removal of an ameloblastoma in the right mandibluar sextant, five implants were installed between the mental foramina. One implant was installed for safety reasons in the event one of the others was lost. This implant remains buried. A denture was used as a drilling guide. Abutments were attached to the implants, and impression copings were fixed to the abutments. The denture was used for the "pickup" impression. Flaps were sutured, maintaining exposure of the abutments. In the laboratory, gold cylinders were heat cured to the tissue side of the denture. The cylinders were attached to the cast with laboratory screws. The gold cylinders were heat cured to the intaglio side of the denture. Five days after implant placement, the nonmetal reinforced acrylic denture was fixed to the implants with laboratory screws. The bridge is removed annually, and the implants are examined for mobility and periapical radiographs are taken.
The patient has worn the prosthesis for 2.5 years without loss of implants and without breakage of the nonmetal reinforced denture. At 2.5 years the implants are stable, implant sites demonstrate stable crestal bone, and the patient is eating comfortably and without limitations.
Early functional loading of implants in the edentulous mandible may offer patients the option of wearing implant-supported prosthesis immediately or shortly after implant insertion.
在全口无牙的下颌骨中即刻或早期对种植体进行功能性加载，可提高患者舒适度，并能在种植体植入后几天内恢复咀嚼能力。最近有证据表明，这种修复无牙下颌骨的方法具有可预测性。
本病例报告的目的是介绍一名被诊断为下颌骨巨大成釉细胞瘤患者的治疗情况。在切除肿瘤并进行下颌骨重建后，患者右下颌骨完全麻醉，伴有牙槽嵴畸形。
在右侧下颌骨象限切除成釉细胞瘤两年后，在颏孔之间植入了五颗种植体。出于安全考虑，额外植入了一颗种植体，以防其他种植体出现问题。这颗种植体一直处于埋藏状态。使用义齿作为钻孔导向。将基台连接到种植体上，并将印模帽固定在基台上。使用义齿进行“取模”印模。缝合皮瓣，保持基台暴露。在实验室中，将金柱热固化到义齿的组织面。用实验室螺钉将金柱固定在模型上。将金柱热固化到义齿的凹面。种植体植入五天后，用实验室螺钉将非金属增强丙烯酸义齿固定到种植体上。每年拆除桥体，并检查种植体的松动情况，同时拍摄根尖片。
患者佩戴该假体已2.5年，种植体未丢失，非金属增强义齿也未破损。在2.5年时，种植体稳定，种植部位的牙槽嵴骨稳定，患者进食舒适，没有限制。
在无牙下颌骨中对种植体进行早期功能性加载，可为患者提供在种植体植入后立即或不久后佩戴种植体支持假体的选择。
