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全身麻醉下口腔鳞状细胞癌治疗后患者的全口数字化牙齿修复:病例报告

Full-Mouth Digital Dental Rehabilitation Under General Anesthesia in a Post-Treatment Intraoral Squamous Cell Carcinoma Patient: A Case Report.

作者信息

Batisse Cindy, El Osta Nada, Cousson Pierre-Yves

机构信息

Department of Prosthodontics, UFR d'Odontologie, Clinical Odontology Research Center (CROC), University of Clermont Auvergne, F-63000 Clermont-Ferrand, France.

CHU Clermont-Ferrand, Odontology Department, F-63000 Clermont-Ferrand, France.

出版信息

Healthcare (Basel). 2025 Apr 19;13(8):940. doi: 10.3390/healthcare13080940.

Abstract

The treatment of head and neck cancer primarily involves surgical tumor removal combined with radiotherapy and/or chemotherapy. It often leads to significant side effects, impacting the anatomical structures of the oral cavity and resulting in major functional, esthetic, and socio-relational alterations. This clinical report aims to demonstrate the effectiveness of a hospital-based approach incorporating general anesthesia (GA) and computer-aided design and manufacturing (CAD/CAM) technology in the oral rehabilitation of a 58-year-old woman in remission from intraoral squamous cell carcinoma of the mandibular symphysis. The patient presented with oral pain, radiation-induced caries, reduced occlusal vertical dimension, and severely compromised teeth. The treatment plan included the removal of two non-restorable teeth, root canal treatment for the remaining teeth, and the placement of ceramic crowns and a partial removable prosthesis. Due to the complexity of the case and the patient's limitations, the treatment was performed under GA, allowing for a staged approach. Digital technologies, including intraoral scanning and CAD-CAM, enhanced precision and patient comfort. This approach facilitated tooth preservation and minimized the number of extractions while achieving satisfactory functional and esthetic outcomes. The case highlights the value of GA and digital techniques in managing special-needs patients with a history of irradiated head and neck cancer.

摘要

头颈癌的治疗主要包括手术切除肿瘤,并结合放疗和/或化疗。这通常会导致显著的副作用,影响口腔的解剖结构,并造成主要的功能、美观和社会关系改变。本临床报告旨在证明一种基于医院的方法的有效性,该方法结合全身麻醉(GA)和计算机辅助设计与制造(CAD/CAM)技术,用于一名58岁处于下颌骨联合部口腔鳞状细胞癌缓解期女性的口腔修复。患者表现为口腔疼痛、放射性龋齿、咬合垂直距离减小以及牙齿严重受损。治疗方案包括拔除两颗无法修复的牙齿,对其余牙齿进行根管治疗,以及安装陶瓷冠和局部可摘义齿。由于病例的复杂性和患者的局限性,治疗在全身麻醉下进行,采用分阶段方法。包括口腔内扫描和CAD-CAM在内的数字技术提高了精度并提升了患者舒适度。这种方法有助于保留牙齿,减少拔牙数量,同时实现了令人满意的功能和美观效果。该病例突出了全身麻醉和数字技术在管理有头颈癌放疗史的特殊需求患者中的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a195/12026995/0422868a4a20/healthcare-13-00940-g001.jpg

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