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“压迫性坏死”——早期种植失败的一个值得关注的原因?病例报告及文献综述

"Compression Necrosis" - A Cause of Concern for Early Implant Failure? Case Report and Review of Literature.

作者信息

Ramesh Roshni, Sasi Anoop, Mohamed Shahana C, Joseph Sonia P

机构信息

Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India.

出版信息

Clin Cosmet Investig Dent. 2024 Mar 7;16:43-52. doi: 10.2147/CCIDE.S453798. eCollection 2024.

Abstract

PURPOSE

Compression necrosis refers to bone tissue damage that can occur when excessive pressure or force is applied to surrounding bone during implant placement. This pressure can compromise blood supply to the bone, leading to necrosis. Compression necrosis is a concern, because it can affect the stability and long-term success of dental implant.

PATIENTS AND METHODS

This case report highlights a case of early bone loss and implant failure possibly due to compression necrosis. Clinical data, photographs, radiographs, blood examination report and histology were presented to document the early failure of an implant placed in the mandibular left posterior region of a 33-year-old female patient.

RESULTS

Radiograph taken six weeks after implant placement showed severe angular defect. Therefore, the implant was surgically removed. Histological examination of the area showed bony trabeculae with an absence of osteoblastic riming, suggestive of necrotic bone.

CONCLUSION

Using excessive torque values when placing implants in dense bones can increase the risk of implant failure due to bone over compression. Dental professionals must follow the manufacturer's instructions and employ quality surgical techniques during implant placement into dense cortical bone to minimise risks.

摘要

目的

压迫性坏死是指在种植体植入过程中,当对周围骨骼施加过大压力或力量时可能发生的骨组织损伤。这种压力会损害骨骼的血液供应,导致坏死。压迫性坏死是一个值得关注的问题,因为它会影响牙种植体的稳定性和长期成功率。

患者和方法

本病例报告重点介绍了一例可能因压迫性坏死导致早期骨丢失和种植体失败的病例。展示了临床数据、照片、X光片、血液检查报告和组织学检查结果,以记录一名33岁女性患者下颌左后区域植入种植体的早期失败情况。

结果

种植体植入六周后拍摄的X光片显示严重的角形缺损。因此,通过手术取出了种植体。对该区域的组织学检查显示骨小梁缺乏成骨细胞包绕,提示骨坏死。

结论

在致密骨中植入种植体时使用过大的扭矩值会增加因骨过度受压导致种植体失败的风险。牙科专业人员在将种植体植入致密皮质骨时必须遵循制造商的说明并采用高质量的手术技术,以将风险降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7da/10926919/567ee1028c06/CCIDE-16-43-g0001.jpg

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