Mäntynen Pilvi, Laurila Marisa, Strausz Tommi, Mauno Jari, Leikola Junnu, Suojanen Juho
Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland.
Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland.
Dent J (Basel). 2023 Sep 11;11(9):212. doi: 10.3390/dj11090212.
This patient series reports the outcomes of CAD/CAM prosthetic reconstructions in patients with cleft lip and palate (n = 9, aged 27 to 76) who have experienced significant failure with conventional restorative and fixed prosthodontic treatments. The objective of the protocol is to establish a functional and patient-friendly prosthetic structure for individuals with unilateral/bilateral cleft lip and palate (UCLP/BCLP) while minimising the requirement for specialised follow-up care in the cleft unit. The study data were obtained from a retrospective cohort at Helsinki University Hospital. Prosthetic reconstructions were performed using CAD/CAM bar structures by the Atlantis 2in1 system or Createch removable telescope structures, supported by four to eight maxillary dental implants. Out of the nine patients, seven experienced no complications. One prosthesis fracture occurred after 16 months due to a design error in the original framework, and one patient experienced failure of osseointegration in a dental fixture (specifically, one fixture out of the eight maxillary implants in this patient). In total, 56 implants were successfully placed. The maxillary dentition of elderly patients with cleft lip and palate often poses challenges due to periodontal and reconstructive issues. An implant-supported CAD/CAM bar with a removable telescope suprastructure offers an easily maintained and functional solution for dental rehabilitation.
本患者系列报告了唇腭裂患者（n = 9，年龄27至76岁）采用CAD/CAM修复重建的结果，这些患者在传统修复和固定义齿修复治疗中遭遇了显著失败。该方案的目标是为单侧/双侧唇腭裂（UCLP/BCLP）患者建立一个功能良好且对患者友好的修复结构，同时尽量减少腭裂治疗单元的专业随访需求。研究数据来自赫尔辛基大学医院的一项回顾性队列研究。使用Atlantis 2in1系统的CAD/CAM杆结构或Createch可摘套筒冠结构进行修复重建，由4至8颗上颌牙种植体支持。9名患者中，7名未出现并发症。1例因原框架设计错误在16个月后发生假体骨折，1例患者的1颗牙种植体（具体而言，该患者上颌8颗种植体中的1颗）发生骨结合失败。总共成功植入了56颗种植体。唇腭裂老年患者的上颌牙列常因牙周和重建问题带来挑战。带有可摘套筒冠上部结构的种植体支持CAD/CAM杆为牙齿修复提供了一种易于维护且功能良好的解决方案。
