Wang Shuang, Duan Siyi, Chen Rui, Wang Zijian, Tang Yulong
Graduate School, China Medical University, Shenyang, China.
Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China.
Front Oral Health. 2024 May 7;5:1369494. doi: 10.3389/froh.2024.1369494. eCollection 2024.
This article reports on four rare cases involving multiple trauma-induced adjacent missing anterior teeth in the maxillary or mandibular region. These cases were successfully treated using a 4-axial implant-based alternative insert and an immediate loading protocol.
This series of cases was summarized by retrospective study that 4 patients who received a total of 20 immediately loaded implants. These patients had suffered from trauma-induced loss of 8-9 adjacent anterior teeth. The 4-axial-implants were inserted with the assistance of digital pioneer drill guides. The surgical procedure involved alveolar bone trimming or ultrasonic osteotomy, eliminating the need for traditional large-area bone augmentation. Pre- and post-operative CBCT was matched using DTX Studio Implant software, the deviation of implant between actual position and preoperative design was measured and compared using SPSS software package.
The average follow-up duration 48 months after implant prostheses, the cumulative retention rate of the implants was 100%, the marginal bone loss averaged 0.53 mm (SD 0.15 mm), and buccal plate bone loss averaged 0.62 mm (SD 0.41 mm).
This retrospective clinical report demonstrates the successful treatment of several patients with multiple adjacent maxillary or mandibular anterior teeth using four implant-supported screws to fix the frame and employing immediate loading. The approach resulted in long-term stable clinical outcomes. Moreover, the method not only shortens the period of edentulism but also facilitates easy disassembly, maintenance, and cleaning. Consequently, it emerges as a highly favorable clinical option for patients suffering from extensive tooth loss.
本文报告4例上颌或下颌区域因多处创伤导致相邻前牙缺失的罕见病例。这些病例采用基于4轴种植体的替代植入物和即刻加载方案成功治疗。
通过回顾性研究总结该系列病例，4例患者共植入20颗即刻加载种植体。这些患者因创伤导致8 - 9颗相邻前牙缺失。4轴种植体在数字先锋钻导板辅助下植入。手术过程包括牙槽骨修整或超声截骨，无需传统的大面积骨增量。使用DTX Studio Implant软件对上、下颌骨CBCT图像进行配准，采用SPSS软件包测量并比较种植体实际位置与术前设计的偏差。
种植修复后平均随访48个月，种植体累计留存率为100%，边缘骨吸收平均为0.53 mm（标准差0.15 mm），颊侧骨板吸收平均为0.62 mm（标准差0.41 mm）。
本回顾性临床报告表明，使用4颗种植体支持的螺钉固定牙桥并采用即刻加载，成功治疗了多例上颌或下颌相邻前牙缺失患者。该方法取得了长期稳定的临床效果。此外，该方法不仅缩短了无牙期，还便于拆卸、维护和清洁。因此，对于患有大面积牙齿缺失的患者而言，它是一种非常理想的临床选择。
