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毛霉菌病继发获得性上颌骨缺损的修复重建:临床病例

Prosthetic rehabilitation of acquired maxillary defects secondary to mucormycosis: clinical cases.

作者信息

Shah Rupal J, Katyayan Manish Khan, Katyayan Preeti Agarwal, Chauhan Vishal

机构信息

Professor and Head, Department of Prosthodontics, Government Dental College and Hospital, Ahmedabad, Gujarat, India.

Assistant Professor, Department of Dentistry, GMERS Medical College Gandhinagar, Gujarat, India.

出版信息

J Contemp Dent Pract. 2014 Mar 1;15(2):242-9. doi: 10.5005/jp-journals-10024-1522.

Abstract

Maxillary necrosis can occur due to bacterial infections such as osteomyelitis, viral infections, such as herpes zoster or fungal infections, such as mucormycosis, aspergillosis etc. Mucormycosis is an opportunistic fungal infection, which mainly infects immunocompromised patients. Once the maxilla is involved, surgical resection and debridement of the necrosed areas can result in extensive maxillary defects. The clinician is to face many a challenge in order to replace not only the missing teeth, but also the lost soft tissues and bone, including hard palate and alveolar ridges. The prosthesis (Obturator) lacks a bony base and the lost structures of the posterior palatal seal area compromise retention of the prosthesis. Furthermore, the post surgical soft tissues are scarred and tense, which exert strong dislodging forces. The present article describes the prosthetic rehabilitation of maxillary necrosis secondary to mucormycosis in two cases, one completely edentulous and the other partially edentulous.

摘要

上颌骨坏死可由细菌感染(如骨髓炎)、病毒感染(如带状疱疹)或真菌感染(如毛霉菌病、曲霉菌病等)引起。毛霉菌病是一种机会性真菌感染,主要感染免疫功能低下的患者。一旦上颌骨受累,对坏死区域进行手术切除和清创会导致广泛的上颌骨缺损。临床医生不仅要面对替换缺失牙齿的挑战,还要面对修复丢失的软组织和骨组织(包括硬腭和牙槽嵴)的挑战。修复体(阻塞器)缺乏骨性基底,腭后封闭区丢失的结构会影响修复体的固位。此外,术后软组织瘢痕化且紧张,会产生强大的脱位力。本文描述了两例毛霉菌病继发上颌骨坏死的修复重建病例,一例为全口无牙颌,另一例为部分牙列缺损。

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