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使用单件式植入物对类风湿性关节炎患者进行即刻康复治疗。

Immediate rehabilitation of a rheumatoid arthritis patient with single-piece implants.

作者信息

Gaur Vivek, Singh Narender, Doshi Anita Gala, Chandrahas Bhathini

机构信息

Department of Oro-Maxillofacial Surgeon, Jaipur Dental College, Maharaj Vinayak Global University, Jaipur, India.

New Delhi, India.

出版信息

Int J Surg Case Rep. 2021 May;82:105874. doi: 10.1016/j.ijscr.2021.105874. Epub 2021 Apr 7.

Abstract

INTRODUCTION AND IMPORTANCE

The aim of this article is to report the long-term outcome of full mouth rehabilitation with single piece, smooth surface implants following immediate loading protocol on a patient suffering with RA and severe unilateral condylar resorption.

CASE PRESENTATION

Here, we present a challenging case of a patient suffering from Rheumatoid Arthritis who was stabilized and completed successfully with a 4 year follow-up period. Prosthetic management optimized the inter-occlusal relationship to maintain both function and esthetic integrity. Single piece implants are designed to engage and take support from the cortical bone low in metabolic activities thus promoting the force transmission through apical threads that are engaged in the cortical bone.

DISCUSSION

Rheumatoid Arthritis [RA] is an auto-immune inflammatory condition in which the inflamed and hypertrophic synovial membrane grows into the articulation surfaces. The Temporomandibular Joints [TM] are frequently involved in rheumatoid arthritis. According to the literature on RA, due to frequent periodontitis, decreased salivary secretion, medication, as well as decrease in bone regenerative potential, RA is often considered as a relative contraindication in the use of implants. Atrophic jaws and cases with comorbidities like osteoporosis, diabetes, rheumatoid arthritis, periodontally infected cases are restored with high success by single piece smooth surface.

CONCLUSION

To the best of our knowledge, this may be the first case of immediate functional loading by bi-cortical single piece implants.

摘要

引言与重要性

本文旨在报告一名患有类风湿关节炎(RA)且单侧髁突严重吸收的患者,在采用即刻负重方案植入单件式光滑表面种植体后进行全口修复的长期效果。

病例展示

在此,我们呈现一例具有挑战性的类风湿关节炎患者病例,该患者病情稳定,并成功完成了为期4年的随访。修复治疗优化了咬合关系,以维持功能和美学完整性。单件式种植体的设计旨在与代谢活动较低的皮质骨结合并获得支撑,从而促进通过与皮质骨结合的根尖螺纹传递力。

讨论

类风湿关节炎(RA)是一种自身免疫性炎症疾病,其中发炎和肥厚的滑膜会长入关节表面。颞下颌关节(TM)常受累于类风湿关节炎。根据关于RA的文献,由于频繁发生牙周炎、唾液分泌减少、药物治疗以及骨再生潜力降低,RA通常被视为种植体使用的相对禁忌证。萎缩性颌骨以及伴有骨质疏松、糖尿病、类风湿关节炎等合并症的病例,通过单件式光滑表面修复取得了很高的成功率。

结论

据我们所知,这可能是首例通过双皮质单件式种植体进行即刻功能负重的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0796/8079275/d17e125c944e/gr1.jpg

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