Xing Helin, Wu Jinshuang, Zhou Lei, Yang Sefei
Department of Stomatology, Chinese People's Liberation Army General Hospital Department of Prosthodontics, Capital Medical University School of Stomatology, Beijing, P.R. China.
Medicine (Baltimore). 2017 Dec;96(48):e8812. doi: 10.1097/MD.0000000000008812.
With respect to improving the quality of oral rehabilitation, the management of keratinized mucosa is as important as bone condition for implant success. To enhance this management, a natural teeth-retained splint based on a patient-specific 3-dimensional (3D) printed mandible was used in vestibuloplasty to provide sufficient keratinized mucosa around dental implants to support long-term implant maintenance.
A 28-year-old male patient had a fracture of the anterior andible 1 year ago, and the fracture was treated with titanium.
The patient had lost mandibular incisors on both the sides and had a shallow vestibule and little keratinized mucosa.
In the first-stage implant surgery, 2 implants were inserted and the titanium fracture fixation plates and screws were removed at the same time. During second-stage implant surgery, vestibuloplasty was performed, and the natural teeth-retained splint was applied. The splint was made based upon a patient-specific 3D-printed mandible. At 30-day follow-up, the splint was modified and reset. The modified splint was removed after an additional 60 days, and the patient received prosthetic treatment.
After prosthetic treatment, successful oral rehabilitation was achieved. Within 1 year and 3 years after implant prosthesis finished, the patient exhibited a good quantity of keratinized gingiva.
The proposed splint is a simple and time-effective technique for correcting soft tissue defects in implant dentistry that ensures a good quantity of keratinized mucosa.
关于提高口腔修复质量，角化黏膜的处理对于种植成功而言与骨条件同样重要。为加强这种处理，在前庭成形术中使用了基于患者特异性三维（3D）打印下颌骨的天然牙保留夹板，以在牙种植体周围提供足够的角化黏膜来支持种植体的长期维护。
一名28岁男性患者1年前下颌前部骨折，采用钛进行治疗。
患者双侧下颌切牙缺失，前庭浅，角化黏膜少。
在第一阶段种植手术中，植入2枚种植体，同时取出钛骨折固定板和螺钉。在第二阶段种植手术中，进行前庭成形术，并应用天然牙保留夹板。该夹板基于患者特异性3D打印下颌骨制作。在30天随访时，对夹板进行修改和重新调整。再过60天后取出修改后的夹板，患者接受修复治疗。
经过修复治疗，成功实现口腔修复。在种植修复完成后的1年和3年内，患者角化牙龈量良好。
所提出的夹板是一种用于矫正种植牙科中软组织缺陷的简单且省时的技术，可确保有足够量的角化黏膜。
