Pfaffeneder-Mantai Florian, Meller Oliver, Schneider Benedikt, Bloch Julius, Bytyqi Ditjon, Sutter Walter, Turhani Dritan
Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria.
Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria.
Maxillofac Plast Reconstr Surg. 2022 May 24;44(1):21. doi: 10.1186/s40902-022-00351-9.
In terms of a highly atrophic maxilla, bone augmentation still remains very challenging. With the introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) for allogeneic bone blocks, a new method for the treatment of bone deficiencies was created. This case report demonstrates the successful use of two specially designed and CAD/CAM manufactured allogeneic bone blocks for a full arch reconstruction of a highly atrophic maxilla with an all-on-six concept.
We report the case of a 55-year-old male patient with a highly atrophic maxilla and severe bone volume deficiencies in horizontal and vertical lines. In order to treat the defects, the surgeon decided to use a combination of two allogeneic bone blocks and two sinus floor augmentations. The bone blocks were fabricated from the data of a cone beam computed tomography (CBCT) using CAD/CAM technology. After the insertion of the two bone blocks and a healing period of 7 months, six dental implants were placed in terms of an all-on-six concept. The loading of the implants took place after an additional healing time of 7 months with a screw-retained prosthetic construction and with a milled titanium framework with acrylic veneers.
The presented procedure shows the importance of the precise design of CAD/CAM manufactured allogeneic bone blocks for the successful treatment of a highly atrophic maxilla. Proper soft-tissue management is one of the key factors to apply this method successfully.
对于高度萎缩的上颌骨，骨增量仍然极具挑战性。随着计算机辅助设计/计算机辅助制造（CAD/CAM）异体骨块的引入，一种治疗骨缺损的新方法应运而生。本病例报告展示了成功使用两块经过特殊设计并通过CAD/CAM制造的异体骨块，采用全口六颗种植体理念对上颌骨高度萎缩进行全牙弓重建的案例。
我们报告了一例55岁男性患者，其患有高度萎缩的上颌骨，在水平和垂直方向均存在严重的骨量不足。为了治疗这些缺损，外科医生决定联合使用两块异体骨块并进行两次上颌窦底提升术。这些骨块是利用CAD/CAM技术根据锥形束计算机断层扫描（CBCT）数据制作而成。在植入两块骨块并经过7个月的愈合期后，按照全口六颗种植体理念植入了六颗牙种植体。在额外经过7个月的愈合时间后，使用螺丝固位的修复结构以及带有丙烯酸饰面的铣削钛框架对种植体进行了加载。
所展示的手术过程表明了CAD/CAM制造的异体骨块精确设计对于成功治疗高度萎缩上颌骨的重要性。恰当的软组织管理是成功应用该方法的关键因素之一。
