Barrero Carlos, Border Michael B, Bencharit Sompop
Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
Open Dent J. 2011;5:122-5. doi: 10.2174/1874210601105010122. Epub 2011 Jul 26.
Subperiosteal implants used to be prescribed to partially and fully edentulous patients to restore occlusion and esthetics prior to the emergence of the more successful endosseous implants that are used today. Because subperiosteal implants had a high incidence of failure, difficulty of placement, and post-operative complications, the use of subperiosteal implants declined significantly. However, some subperiostal implants placed 20-30 years ago still survive. Little information is available in the literature on how to treat patients whose subperiosteal implants still remain. This clinical case report thereby describes a treatment for a patient with a maxillary subperiosteal implant placed 23 years ago. The patient was offered a treatment option that included surgical implant removal, bone grafting and placement of endosseous implants to support a new maxillary overdenture. This treatment plan was not feasible due to the financial constraints of the patient and the complexity of the treatment. The patient chose a more conservative treatment plan, preserving the existing implant. The existing maxillary subperiosteal implant was restored with MICRO ERA attachments and a maxillary implant-retained overdenture was fabricated. The patient was satisfied with the esthetics and functional aspects of the treatment. No further peri-implant bone loss or other complications were found after a six-month recall. This clinical report suggests an alternative treatment plan for patients with existing subperiosteal implants that wish to avoid complex surgical procedures.
在如今使用的更成功的骨内种植体出现之前,曾给部分或全部牙列缺失的患者使用骨膜下种植体来恢复咬合和美观。由于骨膜下种植体失败率高、植入困难且术后并发症多,其使用量大幅下降。然而,一些20至30年前植入的骨膜下种植体仍留存。文献中关于如何治疗骨膜下种植体仍留存的患者的信息很少。因此,本临床病例报告描述了一名23年前植入上颌骨膜下种植体患者的治疗情况。为该患者提供了一个治疗方案,包括手术取出种植体、植骨以及植入骨内种植体以支持新的上颌覆盖义齿。由于患者的经济限制和治疗的复杂性,该治疗方案不可行。患者选择了更保守的治疗方案,保留现有种植体。用MICRO ERA附件修复现有的上颌骨膜下种植体,并制作了上颌种植体支持的覆盖义齿。患者对治疗的美观和功能方面感到满意。六个月复查后未发现进一步的种植体周围骨丢失或其他并发症。本临床报告为希望避免复杂手术的现有骨膜下种植体患者提出了一种替代治疗方案。