de Araújo Nobre Miguel, Santos Diogo, Ferro Ana, Lopes Armando, Antunes Carolina Jorge, Vitor Inês
Department of Research, Development and Education, Maló Clinic, Lisbon, Portugal.
Department of Oral Surgery, Maló Clinic, Lisbon, Portugal.
Eur J Dent. 2024 Oct;18(4):1179-1186. doi: 10.1055/s-0044-1787961. Epub 2024 Jul 23.
Placing implants in fresh postextraction sites is a borderline rehabilitation procedure. The purpose of this report is to describe the pre-, per-, and postoperative procedures for maintaining long-term stability of two full-arch rehabilitations through the All-on-4 protocol, performed in the presence of challenging conditions. Two patients were referred for full-arch rehabilitation with immediate function, with both patients presenting infection in the jaws: patient 1 with an implant (position #45) inserted in a cystic cavity; patient 2 with one implant (position #24) inserted transsinus after the removal of a cyst on the base of the maxillary sinus and another implant (position #15) inserted with a dehiscence. Both patients received a preoperative dental hygiene appointment, a regenerative surgical protocol, and were enrolled in a postoperative maintenance protocol. After surgery a provisional prosthesis was provided ensuring immediate function, and 6 months after surgery, the final prosthesis was delivered. During the follow-up appointments (final follow-up at 5 and 18 years), the implants were stable, and no infection was observed for both patients. The present case report describes two full-arch rehabilitations in immediate function, supported by dental implants inserted in the presence of challenging conditions that do not represent the norm, rather are highly demanding for the clinical team, warranting caution in the interpretation of the results.
在拔牙后的新鲜创口植入种植体是一种临界性修复程序。本报告旨在描述在具有挑战性的情况下，通过All-on-4方案对两例全牙弓修复体进行长期稳定性维持的术前、术中及术后程序。两名患者因全牙弓即刻功能修复前来就诊，两名患者均存在颌骨感染：患者1有一枚种植体（45号位置）植入囊肿腔；患者2有一枚种植体（24号位置）在拔除上颌窦底部囊肿后经鼻窦植入，另一枚种植体（15号位置）植入时存在骨开裂。两名患者均接受了术前口腔卫生护理、再生性手术方案，并纳入术后维护方案。术后提供了临时修复体以确保即刻功能，术后6个月交付最终修复体。在随访预约期间（最终随访分别为5年和18年），种植体稳定，两名患者均未观察到感染。本病例报告描述了两例全牙弓即刻功能修复，由在具有挑战性的情况下植入的牙种植体支持，这些情况并非常见情况，而是对临床团队要求极高，因此在结果解读时需谨慎。
