Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University.
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Istanbul University.
J Craniofac Surg. 2024 Jun 1;35(4):1146-1151. doi: 10.1097/SCS.0000000000010148. Epub 2024 May 6.
OBJECTIVE: The authors aim to share their experiences in subperiosteal implant applications in atrophic jaws, which have been practiced in their clinic for about 2 years, and evaluate the complications and clinical success of the implants. MATERIAL AND METHOD: Clinical and radiologic data of 32 patients who underwent subperiosteal implantation for advanced alveolar bone loss were evaluated, but 1 patient was excluded as they smoked. Of the 31 patients included in the study, 27 were operated with the diagnosis of total tooth loss, 3 for maxillectomy and 1 for partial tooth loss. A total of 60 subperiosteal implants were placed in them. The mean follow-up period was 15 months. RESULTS: During the operation, implant-bone adaptation problems were encountered in 11 patients, implant skeletal fracture in 1 patient, and loss of primary stabilization during mini-screw fixation in 2. Although there were no complications in the early postoperative period, biological and prosthetic complications occurred in the late postoperative period. Soft tissue retraction at various levels in 12 patients (only keratinized tissue retraction in 6 and mucosal retraction exceeding keratinized tissue in 6), soft tissue infection in 5 and oroantral fistula development in 1, mini-screw loosening in 3 were the biological complications that occurred. CONCLUSIONS: Various complications may occur during or after the application of custom-made subperiosteal implants. However, these are manageable and can be reapplied in case of a possible implant loss, making it an important alternative, especially in atrophic jaws where endosseous dental implants cannot be applied.
目的:作者旨在分享他们在大约 2 年内于诊所开展的经皮下植入物应用于萎缩性颌骨的经验,并评估这些植入物的并发症和临床成功率。
材料和方法:评估了 32 名接受经皮下植入治疗晚期牙槽骨缺失的患者的临床和影像学数据,但有 1 名患者因吸烟而被排除在外。在研究中纳入的 31 名患者中,27 名患者因全口牙缺失而接受手术,3 名患者因上颌骨切除术,1 名患者因部分牙缺失而接受手术。共植入 60 枚经皮下植入物。平均随访时间为 15 个月。
结果:在手术过程中,11 名患者出现了植入物-骨适应问题,1 名患者出现了植入物骨骨折,2 名患者在微型螺钉固定时出现了初级稳定性丧失。尽管术后早期没有并发症,但在术后晚期出现了生物和修复体并发症。12 名患者(角化组织回缩 6 名,角化组织以上黏膜回缩 6 名)出现不同程度的软组织退缩,5 名患者出现软组织感染,1 名患者出现口鼻腔瘘,3 名患者出现微型螺钉松动,这是发生的生物并发症。
结论:在定制经皮下植入物的应用过程中或之后,可能会出现各种并发症。然而,这些并发症是可以管理的,如果植入物可能丢失,可以重新应用,这是一种重要的替代方法,尤其是在无法应用骨内牙科植入物的萎缩性颌骨中。
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