de Avila Erica Dorigatti, de Molon Rafael Scaf, de Barros-Filho Luiz Antônio Borelli, de Andrade Marcelo Ferrarezi, Mollo Francisco de Assis, de Barros Luiz Antônio Borelli
Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Universidade Estadual Paulista, UNESP, Rua Humaitá 1680, 14801-903 Araraquara, SP, Brazil.
Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Universidade Estadual Paulista, UNESP, Rua Humaitá 1680, 14801-903 Araraquara, SP, Brazil.
Case Rep Dent. 2014;2014:702630. doi: 10.1155/2014/702630. Epub 2014 May 14.
When dental implants are malpositioned in relation to the adjacent teeth and alveolar bone or in an excessive buccal or lingual position, the final prosthesis rehabilitation impairs the peri-implant health of the gingival tissues and the aesthetics of the patient. Thus, the purpose of this case was to report and discuss a multidisciplinary protocol for the treatment of a compromised maxillary tooth in a patient with an abscess in his right central incisor due to an excessive buccal implant position. The patient presented with an implant-supported provisional restoration on his right maxillary central incisor and a traumatic injury in his left central incisor. The treatment protocol consisted in (i) abutment substitution to compensate the incorrect angulation of the implant, (ii) clinical crown lengthening, (iii) atraumatic extraction of the left central incisor, and (iv) immediate implant placement. Finally, (v) a custom abutment was fabricated to obtain a harmonious gingival contour around the prosthetic crown. In conclusion, when implants are incorrectly positioned in relation to the adjacent teeth, associated with soft-tissue defects, the challenge to create a harmonious mucogingival contours may be achieved with an interdisciplinary approach and with the placement of an appropriate custom abutment.
当牙种植体相对于相邻牙齿和牙槽骨位置不当，或处于过度颊侧或舌侧位置时，最终的修复体康复会损害种植体周围牙龈组织的健康以及患者的美观。因此，本病例的目的是报告并讨论一种多学科治疗方案，用于治疗一名因种植体过度颊侧位置导致右上中切牙脓肿的患者的上颌受损牙齿。该患者右上颌中切牙有种植体支持的临时修复体，左中切牙有创伤性损伤。治疗方案包括：（i）更换基台以补偿种植体不正确的角度；（ii）临床牙冠延长术；（iii）无创拔除左中切牙；（iv）立即植入种植体。最后，（v）制作定制基台以在修复冠周围获得和谐的牙龈轮廓。总之，当种植体相对于相邻牙齿位置不正确并伴有软组织缺损时，通过跨学科方法和放置合适的定制基台，可以应对创造和谐的膜龈轮廓这一挑战。
