Hernández-Suarez Argimiro, Oliveros-López Luis-Guillermo, Serrera-Figallo María-Ángeles, Vázquez-Pachón Celia, Torres-Lagares Daniel, Gutiérrez-Pérez José-Luis
DDS, OMS, MSc. PhD student at Dental School, University of Sevilla (Seville, Spain). Director of National Center of Oro-Maxillofacial Surgery and Implants CIBUMAXI, Caracas, Venezuela.
DDS, MOS. PhD student at Dental School. University of Sevilla, Seville, Spain.
J Clin Exp Dent. 2020 Dec 1;12(12):e1164-e1170. doi: 10.4317/jced.57675. eCollection 2020 Dec.
Maxillary atrophy may be related to mechanical, inflammatory or systemic factors, being a consequence of a reduction in the amount and quality of available bone. Several surgical techniques have been developed for the restoration of bone volume needed for placing dental implants; guided bone regeneration or three-dimensional reconstructions with autologous bone, inter alia, are techniques described in the literature which demonstrate this, all of which preceded by a proper prosthetic surgical assessment. Even when the majority of authors recommend the use of these techniques prior to placing implants, it has been shown that implants with a smaller diameter and length may be placed in severely atrophied jaws without the need for performing any surgery, offering excellent results.
Twenty-four (24) implants were placed in six patients with severe mandibular atrophy. The implants were placed in the anterior sector and on an internal oblique line. Patients were rehabilitated with a total implant-supported prosthesis, with monitoring over a 10-year period.
After a 12-month monitoring period, all the patients presented successful rehabilitation. Marginal bone loss in general (n=24 implants) was +0.11 mm ± 0.53. In the implants in zones 1 and 4 (posterior) it was +0.06 mm ± 0.48 and in implants in zones 2 and 3 (anterior), +0.14 mm ± 0.57.
Implants can be placed in the anterior zone and on an internal oblique line in patients with severe mandibular atrophy, using a diameter and length adapted to bone availability, for later prosthetic rehabilitation, offering satisfactory results since phonetic and masticatory function can be restored, as well as facial and buccal aesthetics, in a single surgical operation, with minimum morbidity. Severe atrophy, implants, bone grafts, ridge atrophy, internal oblique line.
上颌骨萎缩可能与机械、炎症或全身因素有关，是可用骨量和质量减少的结果。已经开发了几种外科技术来恢复种植牙所需的骨量；文献中描述的技术包括引导骨再生或自体骨三维重建等，所有这些技术之前都需要进行适当的修复外科评估。即使大多数作者建议在种植前使用这些技术，但已表明，直径和长度较小的种植体可以放置在严重萎缩的颌骨中，而无需进行任何手术，且效果良好。
在6例严重下颌骨萎缩患者中植入了24颗种植体。种植体植入前牙区和内斜线处。患者用全种植体支持的假体进行修复，并进行了10年的监测。
经过12个月的监测期，所有患者均成功康复。总体边缘骨吸收（n = 24颗种植体）为+0.11 mm±0.53。在第1区和第4区（后部）的种植体中，骨吸收为+0.06 mm±0.48，在第2区和第3区（前部）的种植体中，骨吸收为+0.14 mm±0.57。
对于严重下颌骨萎缩的患者，可以将种植体植入前牙区和内斜线处，使用适合骨量的直径和长度，以便后期进行修复康复，由于可以在一次外科手术中恢复语音和咀嚼功能以及面部和颊部美观，且发病率最低，因此可提供令人满意的结果。严重萎缩、种植体、骨移植、牙槽嵴萎缩、内斜线。
