Bahaa Ahmed, Bahaa AbdAllah, El-Bagoury Nada, Khaled Nora, El-Mohandes Wael A, Ibrahim Ahmed M
Oral and Maxillofacial Surgery, Royal College of Surgeons of Edinburgh, Edinburgh, GBR.
Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University, Cairo, EGY.
Cureus. 2024 Aug 26;16(8):e67879. doi: 10.7759/cureus.67879. eCollection 2024 Aug.
Background Implant-supported full-arch rehabilitation is an effective treatment for edentulous patients. It restores mastication, facial aesthetics, and psychological well-being. Patient-related outcome measures support the validity of this approach, emphasizing the importance of effective prosthodontic interventions for this patient population. This study aims to present a case series for fixed implant-supported full-arch rehabilitation using the new Carames classification (CC). Methods A total of seven patients with generalized periodontitis or non-restorable multiple teeth were indicated for extraction and replacement with a fixed full-arch implant-supported prosthesis. According to the Carames classification, most cases were categorized as CCI or CCII classes for both the upper and lower jaws. Before the surgery, screw-retained provisional complete dentures were constructed and adjusted for the vertical occlusal dimension and smile lines. After the extractions, 70 implants were immediately placed in one or both arches for the seven patients, followed by bone grafts with the dual-zone grafting technique. Multi-unit abutments were then placed and welded to a metal bar for stable fixation. The provisional denture was fitted snugly over the metal bar for immediate functional loading. After three months of healing, it was used as a biocopy to fabricate the final prosthesis. The implant loss and the peri-implant marginal tissue health status were assessed annually for three years. Statistical analysis compared the marginal bone loss as a change from the baseline over the year. Results No implant or prosthesis loss was reported over the three years. Peri-implant marginal tissue health showed promising results without bleeding and suppuration on probing and probing depths between 3 and 3.5 millimeters. Marginal bone loss was minimal over the three years, with some cases showing bone gain. Conclusion Using the Carames classification as a clinical decision support system in implant-supported full-arch rehabilitation showed promising results in peri-implant tissue health and no implant loss during three years of follow-up. The implant placement and prosthesis fabrication protocol in this study could be valuable for further research.
背景 种植体支持的全牙弓修复是无牙患者的一种有效治疗方法。它能恢复咀嚼功能、面部美观和心理健康。与患者相关的结局指标支持这种方法的有效性，强调了有效修复干预对该患者群体的重要性。本研究旨在展示一系列使用新的卡拉姆斯分类法（CC）进行固定种植体支持的全牙弓修复的病例。方法 共有7例患有广泛性牙周炎或多颗牙齿无法修复的患者被建议拔除牙齿并用固定的全牙弓种植体支持的假体进行替代。根据卡拉姆斯分类法，大多数病例的上下颌均被归类为CCI或CCII类。手术前，制作了螺丝固位的临时全口义齿，并针对垂直咬合维度和微笑线进行了调整。拔牙后，为这7例患者在一个或两个牙弓中立即植入了70颗种植体，随后采用双区植骨技术进行植骨。然后放置多单位基台并焊接到金属杆上以实现稳定固定。临时义齿紧密贴合在金属杆上以进行即刻功能加载。愈合三个月后，将其用作生物模板来制作最终假体。对种植体丢失情况和种植体周围边缘组织健康状况进行了为期三年的年度评估。统计分析比较了作为从基线起一年变化的边缘骨丢失情况。结果 三年期间未报告种植体或假体丢失。种植体周围边缘组织健康状况显示出良好结果，探诊时无出血和化脓，探诊深度在3至3.5毫米之间。三年期间边缘骨丢失极少，有些病例还出现了骨增量。结论 在种植体支持的全牙弓修复中使用卡拉姆斯分类法作为临床决策支持系统，在种植体周围组织健康方面显示出良好结果，且在三年随访期间无种植体丢失。本研究中的种植体植入和假体制作方案可能对进一步研究有价值。
