Becelli Roberto, Morello Roberto, Renzi Giancarlo, Dominici Chiara
Second Faculty of Medicine and Surgery of La Sapienza University of Rome, at Sant'Andrea Hospital in Rome - Department of Maxillo-Facial Surgery, Rome, Italy.
J Craniofac Surg. 2007 Nov;18(6):1327-30. doi: 10.1097/scs.0b013e3180a772ff.
Clinical manifestations of oligodontia consist in agenesia of multiple teeth eventually with deciduous retained teeth, atrophy of alveolar ridge, aberrations of teeth dimension, and shape, with consequent aesthetic and functional defects. The first choice treatment is based on a team collaboration of maxillo-facial surgeon, orthodontist, and prosthodontist, and is conditioned by various clinical parameters as number and site of lacking teeth, age and dental development of patients, eventual alveolar ridge atrophy. Treatment planning should be individualized for each patient. In our experience, based on 8 consecutive patients at the end of dental growth affected by oligodontia, endo-osseous fixtures positioning was carried out in consideration of long-lasting stability and optimal aesthetical characteristics. In 5 patients rehabilitative preprosthetic surgical procedures were performed, consisting in 2 sinus lift with immediate positioning of 3 fixtures in both cases, 4 heterologous bone graft in postextractive sites with retained ankylotic deciduous teeth and 1 positioning of reabsorbable biomembrane. A temporary removable denture was positioned immediately after surgery in order to obtain a prompt aesthetical and psychosocial restore. Osseointegration ratio as observed at 8.5 years follow-up was analyzed according to surgical variables and differences in prosthetic rehabilitation (fixtures supporting single crown versus multiple crowns). Successful osteointegration was observed at 8.5 years mean follow-up in 58 fixtures, corresponding to a 96.6% ratio. Failure of integration was encountered in fixtures immediately positioned in postextractive sites having a mild grade of bone atrophy, supporting single crown. A rate of success of 100% was observed in cases of immediate or delayed positioning in postextractive or traditional sites.Fixtures positioning in patients affected by isolated oligodontia, without malformative syndromes, and at the end of dental development, is subject to the same recommendations for patients with lacking permanent teeth not caused by agenesia.
少牙症的临床表现包括多颗牙齿缺失，最终伴有乳牙滞留、牙槽嵴萎缩、牙齿大小和形状异常，从而导致美观和功能缺陷。首选治疗方法基于颌面外科医生、正畸医生和修复医生的团队协作，并受多种临床参数的制约，如缺牙的数量和部位、患者的年龄和牙齿发育情况、最终的牙槽嵴萎缩情况。治疗计划应针对每位患者进行个体化制定。根据我们的经验，基于8例牙生长结束时受少牙症影响的连续患者，考虑到长期稳定性和最佳美学特征进行了骨内种植体定位。在5例患者中进行了修复前外科手术，包括2例上颌窦提升术，术中均立即植入3颗种植体；4例在拔除乳牙后进行异体骨移植，乳牙为滞留的强直性乳牙；1例植入可吸收生物膜。术后立即佩戴临时可摘义齿，以实现快速的美观和心理社会恢复。根据手术变量和修复体康复差异（种植体支持单冠与多冠）分析了8.5年随访时观察到的骨整合率。在平均8.5年的随访中，58颗种植体成功骨整合，对应率为96.6%。在轻度骨萎缩的拔牙后部位立即植入支持单冠的种植体时，出现了种植体整合失败的情况。在拔牙后或传统部位立即或延迟植入种植体的情况下，成功率为100%。对于孤立性少牙症患者，无畸形综合征且牙发育结束时，种植体定位遵循与非先天性恒牙缺失患者相同的建议。
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