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个性化骨膜下种植体支持的闭孔器用于鼻眶脑毛霉菌病后遗症的修复:病例报告

Personalized subperiosteal implant‑supported obturator for the rehabilitation of rhino‑orbit‑cerebral mucormycosis sequela: A case report.

作者信息

Parras-Hernández Julia, Tofé-Povedano Álvaro, Herce-López Javier, Matute-García David, Martínez-Carapeto Elena, Cuadrado-Caballero Guadalupe, Rollón-Mayordomo Ángel

机构信息

Department of Oral and Maxillofacial Surgery, Reina Sofía University Hospital, 14004 Córdoba, Spain.

Department of Oral and Maxillofacial Surgery, Puerta del Mar University Hospital, 11009 Cádiz, Spain.

出版信息

Exp Ther Med. 2024 Sep 25;28(6):438. doi: 10.3892/etm.2024.12727. eCollection 2024 Dec.

Abstract

Severe atrophy of the maxilla occasionally renders it impossible to place standard endosseous implants to replace absent teeth. For such cases, personalized subperiosteal implants (PSI) are presented as a treatment alternative. Due to novel design and manufacturing technologies, PSIs are fitted closely to the bone structure of the patient, after defining the anchorage areas where the bone is of higher quality and allowing a passive dental prosthesis to be attached to restore function and aesthetics to the patient. The present case report documents a patient with severe bone defects as a sequela of rhino-orbit-cerebral mucormycosis. After a failed microvascular fibula flap reconstruction, the patient was treated with a removable implant-supported prosthesis attached to a PSI, which provided occlusion with the mandible of the patient and closed the oronasal-antral communication defect. At 18 months after treatment, the patient felt well, with no biological complications and the prosthesis was well adjusted and with good function. Consequently, we consider that in some cases such as this, a customized solution of this type can avoid complex reconstruction treatments.

摘要

上颌骨严重萎缩有时会导致无法植入标准的骨内种植体来替代缺失牙。对于此类病例,个性化骨膜下种植体(PSI)可作为一种治疗选择。由于采用了新颖的设计和制造技术,在确定骨质较高的锚固区域后,PSI能够紧密贴合患者的骨结构,并可连接被动式假牙,从而恢复患者的功能和美观。本病例报告记录了一名因鼻眶脑型毛霉菌病后遗症而存在严重骨缺损的患者。在微血管腓骨瓣重建失败后,该患者接受了附着于PSI的可摘种植体支持式假牙治疗,该假牙与患者的下颌骨实现了咬合,并封闭了口鼻窦交通缺损。治疗18个月后,患者感觉良好,无生物学并发症,假牙调整良好且功能正常。因此,我们认为在某些此类病例中,这种定制解决方案可避免复杂的重建治疗。

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本文引用的文献

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Obturators: A proposed classification and its associated techniques.阻塞器:一种建议的分类及其相关技术。
J Indian Prosthodont Soc. 2023 Apr-Jun;23(2):192-197. doi: 10.4103/jips.jips_313_22.
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COVID-19 and mucormycosis superinfection: the perfect storm.COVID-19 与毛霉菌感染:完美风暴。
Infection. 2021 Oct;49(5):833-853. doi: 10.1007/s15010-021-01670-1. Epub 2021 Jul 24.

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