Kluenter Tim, Stoilov Milan
Department of Oral, Maxillofacial and Plastic Surgery, Medical Faculty, University of Bonn, Bonn, Germany.
Department of Prosthodontics, Preclinical Education and Dental Materials Science, Medical Faculty, University of Bonn, Bonn, Germany.
Case Rep Dent. 2023 Dec 23;2023:6681076. doi: 10.1155/2023/6681076. eCollection 2023.
Lichen sclerosus is a rare condition that occurs in the genital area or on the extraoral skin but can also manifest orally (oral lichen sclerosus (OLS)). The condition is associated with atrophy, scarring, and functional limitations of the tissues. In the present case, an extremely pronounced variant is described, and the oral rehabilitation of the patient is presented. . The edentulous patient showed a progressive course with severely restricted mouth opening and persistent pain. Conventional dental treatment was therefore impossible. To address this issue, two implants were placed in each jaw at the position of the lateral incisors. After osseointegration and exposure of the implants, provisional bridges made of polymethyl-methacrylate were fitted to test the new jaw relation. After a successful provisional phase, an FDP in the sense of an extreme short dental arch (ESDA) has been inserted.
The experimental treatment of the patient with only a total of four implants and the ESDA concept represented a satisfactory therapy for the patient. The patient regained her chewing ability, which significantly increased her oral health-related quality of life (OHRQoL). Still, it should be noted that this is a high-risk and experimental prosthetic treatment.
硬化性苔藓是一种罕见的疾病,发生于生殖器区域或口腔外皮肤,但也可在口腔内表现(口腔硬化性苔藓(OLS))。该疾病与组织的萎缩、瘢痕形成及功能受限有关。在本病例中,描述了一种极为显著的变异型,并展示了该患者的口腔修复情况。这位无牙患者病情呈进行性发展,伴有严重的张口受限和持续性疼痛。因此,常规牙科治疗无法进行。为解决这一问题,在双侧上颌侧切牙位置各植入两枚种植体。种植体骨结合及暴露后,安装由聚甲基丙烯酸甲酯制成的临时桥体以测试新的颌关系。在临时阶段成功后,植入了极端短牙弓(ESDA)意义上的固定局部义齿。
仅使用总共四枚种植体对该患者进行的实验性治疗以及ESDA概念对患者而言是一种令人满意的治疗方法。患者恢复了咀嚼能力,这显著提高了她的口腔健康相关生活质量(OHRQoL)。不过,应当指出的是,这是一种高风险的实验性修复治疗。