使用钽牙种植体对口咽恶性肿瘤进行手术治疗后的种植修复学康复治疗
Implant Prosthodontic Rehabilitation after Surgical Treatment for an Oropharyngeal Malignant Tumour Using Tantalum Dental Implants.
作者信息
Vuletić Marko, Pelivan Ivica, Gabrić Dragana
机构信息
Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
出版信息
Case Rep Dent. 2021 Apr 22;2021:5585181. doi: 10.1155/2021/5585181. eCollection 2021.
Oropharyngeal cancer (OPC) represents a significant portion of head and neck cancers. In most cases, it is localised in the soft palate, lingual and palatine tonsils, base of the tongue, and the surrounding tissues. Alcohol and tobacco exposure are well-known evidence-based risk factors for developing OPC; however, over the last decade, there has been a rapid increase in OPC linked to human papillomavirus (HPV). Dental implant therapy faces many challenges related to immediate and long-term success, and patients who are rehabilitated with implant prosthodontic therapy often have numerous comorbidities. Tantalum is a rare transitional metal element which has high corrosion resistance and is extremely inert. Porous tantalum trabecular metal (PTTM) has high volumetric porosity, a low modulus of elasticity, and very high friction. PTTM implant surface enhancement allows "osseoincorporation," which means the neovascularisation and formation of new bone directly onto the implant. A 65-year-old patient presented to the Department of Oral Surgery of Clinical Hospital Centre Zagreb after resection of the mandible due to OPC had oral rehabilitation. Three Zimmer Biomet Trabecular Metal™ implants (4.1 × 10 mm) were inserted in the area of lower left first incisor, lower left second premolar, and lower right second premolar, and after four months, a new upper partial denture and the bar-retained mandibular overdenture were made. Implant prosthodontic rehabilitation of head and neck cancer patients is usually challenging in terms of achieving an improvement in its main aim, quality of life; however, today it is a safe and reliable therapy. Although radiation therapy may negatively affect the patient's oral condition and influence the short- and long-term success of the implant, the presented case report showed that the excellent properties of PTTM-enhanced dental implants may give great basis for future comparative researches of using these implants in the treatment of oncologic patients.
口咽癌(OPC)占头颈癌的很大一部分。在大多数情况下,它位于软腭、舌扁桃体和腭扁桃体、舌根及周围组织。酒精和烟草暴露是公认的基于证据的OPC发病风险因素;然而,在过去十年中,与人乳头瘤病毒(HPV)相关的OPC迅速增加。牙种植治疗面临许多与即刻和长期成功相关的挑战,接受种植修复治疗的患者通常有多种合并症。钽是一种稀有过渡金属元素,具有高耐腐蚀性且极为惰性。多孔钽小梁金属(PTTM)具有高体积孔隙率、低弹性模量和非常高的摩擦力。PTTM种植体表面增强可实现“骨结合”,即新血管形成和新骨直接在种植体上形成。一名65岁患者因OPC切除下颌骨后到萨格勒布临床医院中心口腔外科进行口腔修复。在下颌左第一前牙、左第二前磨牙和右第二前磨牙区域植入了3枚 Zimmer Biomet 小梁金属™种植体(4.1×10毫米),四个月后制作了新的上颌局部义齿和杆卡式下颌覆盖义齿。对头颈癌患者进行种植修复治疗通常在实现其主要目标即改善生活质量方面具有挑战性;然而,如今它是一种安全可靠的治疗方法。尽管放射治疗可能会对患者的口腔状况产生负面影响并影响种植体的短期和长期成功率,但本病例报告表明,PTTM增强型牙种植体的优异性能可为未来在肿瘤患者治疗中使用这些种植体的比较研究提供很好的基础。
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