Pavanelli Angélica Letícia Reis, de Avila Erica Dorigatti, Barros-Filho Luiz Antônio Borelli, Mollo Junior Francisco de Assis, Cirelli Joni Augusto, Borelli Barros Luiz Antônio, de Molon Rafael Scaf
Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara Sao Paulo, Brazil.
Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araraquara Sao Paulo, Brazil.
Case Rep Dent. 2021 Mar 31;2021:6637500. doi: 10.1155/2021/6637500. eCollection 2021.
Rehabilitation of atrophic maxilla with dental implants is still a challenge in clinical practice especially in cases of alveolar bone resorption due to peri-implantitis and pneumatization of the maxillary sinuses. Several surgical approaches have been employed to reconstruct the lost tissues allowing the proper tridimensional position of the implants. In this context, the aim of this case report is to describe a surgical and prosthetic approach to fully rehabilitate the atrophic maxilla with dental implants. The patient presented with unsatisfactory functional and esthetical implant-supported prosthesis with some of the implants already lost by peri-implantitis. The remaining three implants were also affected by peri-implantitis. Reversal prosthetic planning was performed, and a provisional prosthesis was fabricated and anchored in two short implants. Sinus floor augmentation procedure and onlay bone graft were then accomplished. After a healing period of 8 months, digital-guided surgery approach was performed to place the implants. Finally, a definitive prosthesis was installed. One-year follow-up has revealed stabilization of the bone tissue level, successful osseointegration, and a pleasant esthetic and functional result. A proper diagnosis and careful planning play an important role to enhance precision and to achieve patient esthetic and functional outcomes.
利用牙种植体修复萎缩性上颌骨在临床实践中仍然是一项挑战，尤其是在因种植体周围炎和上颌窦气化导致牙槽骨吸收的情况下。已经采用了几种手术方法来重建缺失的组织，以使种植体获得合适的三维位置。在此背景下，本病例报告的目的是描述一种通过牙种植体完全修复萎缩性上颌骨的手术和修复方法。患者的种植体支持义齿在功能和美学方面均不理想，部分种植体已因种植体周围炎而丢失。其余三颗种植体也受到种植体周围炎的影响。进行了逆向修复计划，并制作了临时义齿并固定在两颗短种植体上。然后完成了上颌窦底提升术和骨增量术。经过8个月的愈合期后，采用数字化引导手术方法植入种植体。最后，安装了最终义齿。一年的随访显示骨组织水平稳定、骨结合成功，并且获得了令人满意的美学和功能效果。正确的诊断和仔细的计划对于提高精确性以及实现患者的美学和功能效果起着重要作用。
