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使用个性化种植体对新冠后毛霉菌病进行数字化引导的高级口腔修复学康复:病例报告

Digitally Guided Advanced Prosthodontic Rehabilitation for Post-COVID-19 Mucormycosis Using Patient-Specific Implants: A Case Report.

作者信息

Surana Mayuri, Tewary Shivsagar, Mishra Nilesh, Jain Vidit, Sanyal Pronob

机构信息

Department of Prosthodontics, School of Dental Sciences, Krishna Vishwa Vidyapeeth, Malkapur, IND.

Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Vishwa Vidyapeeth, Malkapur, IND.

出版信息

Cureus. 2024 Jul 17;16(7):e64729. doi: 10.7759/cureus.64729. eCollection 2024 Jul.

Abstract

This case report describes the prosthodontic rehabilitation of a middle-aged male patient who underwent bilateral low-level maxillectomy due to post-COVID-19 mucormycosis. The oronasal communication was closed using an anterior base tongue flap. Two patient-specific subperiosteal implants were placed to rehabilitate the patient's bony defect. Using a postsurgical CT scan, a virtually customized subperiosteal titanium framework was created from grade IV titanium alloy. The fabricated framework was implanted over the patient's zygomatic bone bilaterally. Six months later, the right-sided patient-specific implant was infected and had to be surgically removed. After satisfactory healing, an open-tray impression was taken to create a computer-aided design/computer-aided manufacturing titanium Hader bar. An acrylic resin overdenture was then fabricated over this bar. A clasp assembly was fabricated by direct metal laser sintering of cobalt-chromium alloy for additional retention. The metal substructures were incorporated into the overdenture prosthesis to enhance the stability and retention.. This case report unveils an innovative approach to rehabilitating severely compromised maxillary bony defects and impaired oral functioning, offering a viable alternative when traditional reconstruction methods are inadequate. Prosthodontic treatment greatly affects the aesthetics, phonetics, and mastication of the patient, improving the overall quality of life of the patient.

摘要

本病例报告描述了一名中年男性患者的口腔修复治疗过程,该患者因新冠后毛霉菌病接受了双侧低位上颌骨切除术。采用前基底舌瓣封闭口鼻通道。植入两枚定制的骨膜下种植体以修复患者的骨缺损。利用术后CT扫描,由IV级钛合金制作了一个虚拟定制的骨膜下钛框架。将制作好的框架双侧植入患者的颧骨上。六个月后,右侧定制种植体发生感染,不得不通过手术取出。在伤口顺利愈合后,制取开口托盘印模,制作了一个计算机辅助设计/计算机辅助制造的钛制哈氏杆。然后在该杆上制作了一副丙烯酸树脂覆盖义齿。通过钴铬合金直接金属激光烧结制作了一个卡环组件,以增强固位。将金属子结构纳入覆盖义齿修复体,以提高稳定性和固位力。本病例报告揭示了一种修复严重受损上颌骨缺损和口腔功能障碍的创新方法,当传统重建方法不足时提供了一种可行的替代方案。口腔修复治疗对患者的美观、语音和咀嚼功能有很大影响,提高了患者的整体生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a9b/11329327/a30304552701/cureus-0016-00000064729-i01.jpg

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