Kutlu H Burak, Goyushov Samir, Tözüm Tolga F
Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey.
J Oral Biol Craniofac Res. 2020 Apr-Jun;10(2):104-109. doi: 10.1016/j.jobcr.2020.03.005. Epub 2020 Mar 13.
Dental implant surgery is a highly reliable therapy with widespread use all over the world. However, various accidental symptoms and complications such as peri-implantitis have been reported, and occasionally necessitate implant removal. This alternative technique was performed to minimize the harmful effect of conventional resective explantation procedures. The present case concerns a 55-year-old woman who had two dental implants in the mandibular incisor regions who apparently developed severe marginal peri-implantitis. Presence of lesion was confirmed by two and three-dimensional radiographic images. Explantation was indicated because of the excessive ongoing bone loss around implants. Due to avoid serious complications such as jaw fracture, coronal resection technique (partial explantation) was suggested. After the full thickness flap was elevated, affected part of both implants were resected, and osseointegrated healthy apical parts were left in the basal bone. Wound healing was uneventful at one week follow-up. Proper locater abutments were tightened after 5 months of the partial explantation procedure, and final denture was applied in the oral cavity. The radiologic and clinical examinations showed successful outcome at 12-months follow-up. Minimally resective peri-implantitis therapy may be achieved using this non-traumatic coronal implant resection approach.
牙种植手术是一种在全球广泛应用且高度可靠的治疗方法。然而,已报告了各种意外症状和并发症,如种植体周围炎,偶尔还需要取出种植体。实施这种替代技术是为了将传统切除性取出手术的有害影响降至最低。本病例涉及一名55岁女性,其下颌切牙区有两颗牙种植体,明显发生了严重的种植体边缘性周围炎。通过二维和三维影像学图像确认了病变的存在。由于种植体周围持续的骨质过度流失,表明需要取出种植体。为避免诸如颌骨骨折等严重并发症,建议采用冠部切除术(部分取出术)。掀起全厚瓣后,切除两颗种植体的患部,将骨整合良好的健康根尖部分留在基骨中。术后一周随访时伤口愈合顺利。部分取出术后5个月拧紧合适的定位基台,并在口腔中安装最终义齿。12个月随访时的影像学和临床检查显示结果成功。使用这种非创伤性的种植体冠部切除方法可实现微创性种植体周围炎治疗。