In 't Veld Matthijs, Schulten Engelbert A J M, Neveling Ulf, Jan Jager Derk H, Leusink Frank K J
Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam, The Netherlands.
Camlog Vertriebs GmbH, DEDICAM Guide Department, Wimsheim, Germany.
J Oral Implantol. 2022 Apr 1;48(2):139-146. doi: 10.1563/aaid-joi-D-20-00420.
Patients with Sjögren syndrome (SS) experience difficulties in wearing conventional dentures. After removal of all teeth, the oral rehabilitation is challenging and time consuming using conventional treatment protocols. Although implant-retained overdentures are beneficial for this specific patient group, the average total oral rehabilitation time (TORT) usually takes at least 9 months and needs to be reduced to increase patients' quality of life (QoL). In this paper, we report on a new treatment concept for immediate implant-based oral rehabilitation in a 77-year-old patient with partial edentulous SS. Because of persistent pain, discomfort, and retention problems with the conventional prosthetic devices, full clearance of the remaining mandibular dentition and immediate oral rehabilitation with an implant-retained overdenture were suggested. The treatment protocol included virtual surgical planning (VSP), combining a guided bone reduction of the mandibular alveolar process, immediate dental implant placement, and restoration using a prefabricated bar and placement of the overdenture. This method demands the use of ionizing 3D imaging optionally combined with an optical dental scan or a conventional impression. Furthermore, one needs to gain experience using VSP software. This novel treatment concept for immediate implant-based oral rehabilitation using VSP proved to be feasible and safe in a patient with SS, resulting in a significantly reduced TORT and improved QoL. Further research is needed to what extent this treatment concept could be beneficial to other patient groups, such as patients with head and neck cancer.
干燥综合征（SS）患者佩戴传统假牙存在困难。拔除所有牙齿后，采用传统治疗方案进行口腔修复具有挑战性且耗时。尽管种植体支持的覆盖义齿对这一特定患者群体有益，但平均总口腔修复时间（TORT）通常至少需要9个月，需要缩短以提高患者的生活质量（QoL）。在本文中，我们报告了一名77岁部分牙列缺失的SS患者基于即刻种植的口腔修复新治疗理念。由于传统修复装置持续存在疼痛、不适和固位问题，建议拔除剩余下颌牙列并即刻采用种植体支持的覆盖义齿进行口腔修复。治疗方案包括虚拟手术规划（VSP），结合下颌牙槽突引导性骨减量、即刻牙种植体植入，以及使用预制杆和覆盖义齿进行修复。该方法需要使用电离3D成像，可选择性地结合光学牙科扫描或传统印模。此外，需要积累使用VSP软件的经验。事实证明，这种基于VSP的即刻种植口腔修复新治疗理念在一名SS患者中是可行且安全的，显著缩短了TORT并改善了QoL。还需要进一步研究这种治疗理念对其他患者群体（如头颈癌患者）的有益程度。
