Hashemi Ashtiani Alireza, Moradinejad Mehrnaz, Rakhshan Vahid
Department of Prosthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Case Rep Dent. 2024 Oct 23;2024:9928608. doi: 10.1155/2024/9928608. eCollection 2024.
Systemic sclerosis (SS) is a debilitating disease that affects oral and any other tissues including skin, bone, blood vessels, and the connective tissues by excessive collagen accumulation. It is a difficult case for oral rehabilitation, let alone dental implantation. In this regard, only few studies have been conducted. This article reports a case of full-mouth implant-supported prostheses in a SS patient. After diagnosing most remaining teeth as hopeless through clinical and radiographic examinations, implant-based fixed prosthesis for both jaws was planned, considering the progressive microstomia. Hopeless teeth were extracted. In the maxilla, the areas of central incisors, canines, first premolars, and first molars were implanted. In the mandible, the areas of the lateral incisors and the right second premolar were implanted. Also, according to the surgeon's opinion, the anterior mandible needed bone grafting. After 3 months, the prosthetic treatment was started. Because in scleroderma, the limitation of mouth opening is progressive (and also in order to allow the restoration of the prosthesis in the future), screw-retained abutments were used for the posterior segment. Nevertheless, the anterior abutments were cement-retained. The patient was followed up until the present time (for 3 years). In these follow-ups, no bone resorption was observed, and the treatment was deemed successful. This report suggests that dental implants might be successful and safe for at least some cases of systemic scleredema.
系统性硬化症（SS）是一种使人衰弱的疾病，它通过胶原蛋白过度积累影响口腔及包括皮肤、骨骼、血管和结缔组织在内的任何其他组织。这对于口腔修复来说是个难题，更不用说牙种植了。在这方面，仅有少数研究。本文报告了一例系统性硬化症患者全口种植支持式修复体的病例。通过临床和影像学检查诊断出大多数余留牙预后无望后，考虑到进行性小口畸形，计划为上下颌植入种植体支持的固定修复体。拔除了预后无望的牙齿。在上颌，植入了中切牙、尖牙、第一前磨牙和第一磨牙区域。在下颌，植入了侧切牙和右第二前磨牙区域。此外，根据外科医生的意见，下颌前部需要植骨。3个月后，开始进行修复治疗。由于在硬皮病中，张口受限是进行性的（并且也是为了将来能进行修复体修复），后牙段使用了螺丝固位基台。然而，前牙基台采用了粘结固位。对该患者一直随访至今（3年）。在这些随访中，未观察到骨吸收，治疗被认为是成功了。本报告表明，对于至少部分系统性硬化症病例，牙种植可能是成功且安全的。
