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青少年外胚层发育不良患者使用种植体支持覆盖义齿的康复治疗:一项队列研究。

Rehabilitation with implant-supported overdentures in preteens patients with ectodermal dysplasia: A cohort study.

作者信息

Montanari Marco, Grande Francesco, Lepidi Luca, Piana Gabriela, Catapano Santo

机构信息

Department of Prosthodontics, University of Ferrara, Ferrara, Italy.

Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.

出版信息

Clin Implant Dent Relat Res. 2023 Dec;25(6):1187-1196. doi: 10.1111/cid.13258. Epub 2023 Aug 22.

Abstract

INTRODUCTION

Hypohidrotic ectodermal dysplasia (HED) patients suffering of oligo-anodontia require early dental treatment to improve oral functions and reduce social impairment. The aim of this study was to evaluate the skeletal growth, implant and prosthetic survival rate, success, and complications after the rehabilitation with a maxillary denture and an implant-supported overdenture provided by a sliding bar in case of severe hypodontia/anodontia related to HED.

MATERIALS AND METHODS

This retrospective cohort study began in 2009. Nine patients over 7 years old with HED and associated oligo-anodontia who presented at the University of Bologna for dental treatment were included in the study. They were first treated with conventional dentures and then with a maxillary denture and an implant-supported overdenture with a sliding bar connected to two implants placed in the anterior mandible. The subjects treated were followed for 3-12 years. In each case, orthopanoramic and lateral cephalometric radiographic exam were taken before implant placement and annually after prosthetic load. Vertical and transverse dimensions of the mandible in the symphysis area at implant sites were taken on the lateral cephalometric radiography at the time of implant placement and after 5 years from the prosthetic loading to assess the presence or absence of an anterior mandibular growth. Biologic and mechanical complications were also recorded at every visit.

RESULTS

A mandibular vertical growth under the implant apex, at the implant neck, and a sagittal growth of the symphysis after 5 years from the prosthetic loading were observed and measured. Implant and prosthetic success and survival rates were 100% after 8.1 years (mean) follow-up period. No complications were reported except in one patient, where the repositioning of a retentive cap on the counter bar in the superstructure was necessary after 3 years from the prosthetic loading.

CONCLUSIONS

The present study suggests that the growth of the mandible near implant sites continues even after their positioning. Implants can be successfully placed and provide support for prosthetic rehabilitation in preteens patients with HED.

摘要

引言

患有少牙/无牙症的低汗型外胚层发育不良(HED)患者需要早期牙科治疗,以改善口腔功能并减少社交障碍。本研究的目的是评估在与HED相关的严重牙缺失/无牙症情况下,使用上颌义齿和由滑杆支撑的种植体支持覆盖义齿进行修复后的骨骼生长、种植体和修复体的存活率、成功率及并发症情况。

材料与方法

这项回顾性队列研究始于2009年。纳入了9名7岁以上因HED及相关少牙/无牙症到博洛尼亚大学接受牙科治疗的患者。他们首先接受传统义齿治疗,然后佩戴上颌义齿以及由连接在前下颌骨的两颗种植体的滑杆支撑的种植体支持覆盖义齿。对接受治疗的受试者进行了3至12年的随访。在每种情况下,在种植体植入前以及修复体加载后每年进行口腔全景和头颅侧位X线检查。在种植体植入时以及修复体加载5年后,在头颅侧位X线片上测量种植体部位下颌骨联合处的垂直和横向尺寸,以评估下颌前部是否存在生长情况。每次随访时还记录生物和机械并发症。

结果

在修复体加载5年后,观察并测量到种植体根尖下方、种植体颈部的下颌垂直生长以及联合处的矢状生长。经过8.1年(平均)的随访期后,种植体和修复体的成功率及存活率均为100%。除一名患者外,未报告任何并发症,该患者在修复体加载3年后需要重新调整上部结构中反杆上的固位帽位置。

结论

本研究表明,即使在种植体植入后,种植体部位附近的下颌骨仍会继续生长。种植体能够成功植入,并为患有HED的青少年患者的修复康复提供支持。

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