{"title":"粘液瘤病例康复过程中的拓展挑战--近代针对特定患者的数字化设计种植方法。","authors":"Ankita Pathak, Mithilesh Dhamande, Bhushan Mundada, Anjali Bhoyar, Seema Sathe, Smruti Gujjelwar, Shubham Tawade, Aashish Gupta, Prasanna Sonar","doi":"10.1186/s12903-024-05099-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of maxillofacial defects is challenging due to the region's complex anatomy. During the COVID-19 era, many patients lost their maxilla and chewing efficiency as a result of Mucormycosis. In such cases, custom-designed implants offer a graftless solution for seemingly hopeless situations. This case report aims at miraculous dental transformation utilizing the Patient Specific Implant (PSI) approach.</p><p><strong>Case presentation: </strong>A 64-year-old male patient presented to the Prosthodontics Department with the chief complaint of missing teeth. He had been struggling with chewing for two years due to a post-mucormycotic maxillary jaw. A CT scan was obtained to evaluate and investigate the affected site. After a comprehensive diagnosis, the treatment of choice was a patient-specific implant decided using 3D printing technology. Reconstructing maxillofacial defects poses significant challenges due to the region's intricate anatomy, as well as its aesthetic and functional implications. The use of pre-formed alloplastic implants and autogenous grafts often leads to complications such as resorption, infection, and displacement. However, recent technological advances have made it possible to fabricate customized patient-specific implants (PSIs) through computer modeling, offering new opportunities for reconstructive surgery.</p><p><strong>Conclusion: </strong>This case report demonstrates the dental management of post-mucormycotic patients with specially designed implants, customized according to the availability and anatomy of the bone in the entire head region. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included infection, soft tissue recovery, wound separation, masticatory efficiency, stability of the prosthesis, and aesthetic outcomes. The positive outcomes observed at follow-up appointments emphasize the viability and effectiveness of patient-specific implants in addressing maxillary defects caused by post-mucormycosis.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"24 1","pages":"1383"},"PeriodicalIF":2.6000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566662/pdf/","citationCount":"0","resultStr":"{\"title\":\"Outstretching challenges for rehabilitation of a mucormycotic case-a digitally designed patient-specific implant approach in the recent era.\",\"authors\":\"Ankita Pathak, Mithilesh Dhamande, Bhushan Mundada, Anjali Bhoyar, Seema Sathe, Smruti Gujjelwar, Shubham Tawade, Aashish Gupta, Prasanna Sonar\",\"doi\":\"10.1186/s12903-024-05099-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Reconstruction of maxillofacial defects is challenging due to the region's complex anatomy. During the COVID-19 era, many patients lost their maxilla and chewing efficiency as a result of Mucormycosis. In such cases, custom-designed implants offer a graftless solution for seemingly hopeless situations. This case report aims at miraculous dental transformation utilizing the Patient Specific Implant (PSI) approach.</p><p><strong>Case presentation: </strong>A 64-year-old male patient presented to the Prosthodontics Department with the chief complaint of missing teeth. He had been struggling with chewing for two years due to a post-mucormycotic maxillary jaw. A CT scan was obtained to evaluate and investigate the affected site. After a comprehensive diagnosis, the treatment of choice was a patient-specific implant decided using 3D printing technology. Reconstructing maxillofacial defects poses significant challenges due to the region's intricate anatomy, as well as its aesthetic and functional implications. 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引用次数: 0
摘要
背景:由于颌面部的解剖结构复杂,颌面部缺损的重建具有挑战性。在 COVID-19 时代,许多患者因蘑菇菌病而失去了上颌骨和咀嚼功能。在这种情况下,定制设计的种植体为看似无望的情况提供了一种无移植的解决方案。本病例报告旨在利用患者专用种植体(PSI)方法实现奇迹般的牙齿蜕变:一位 64 岁的男性患者来到口腔修复科,主诉是牙齿缺失。由于上颌黏膜瘤后遗症,两年来他一直在为咀嚼而苦恼。他接受了 CT 扫描,以评估和检查患处。经过全面诊断后,决定采用 3D 打印技术,为患者量身定制种植体。由于颌面部的解剖结构复杂,而且对美观和功能都有影响,因此重建颌面部缺损是一项重大挑战。使用预成型的异体植入物和自体移植物往往会导致吸收、感染和移位等并发症。然而,最近的技术进步使得通过计算机建模制作定制的患者专用种植体(PSI)成为可能,为重建手术提供了新的机遇:本病例报告展示了根据整个头部区域骨质的可用性和解剖结构定制的特殊设计种植体对粘液瘤后患者的牙科治疗。在15天、30天、45天和90天的随访中,以及随后两年的每月随访中,均未出现并发症,这凸显了这种方法的成功。评估参数包括感染、软组织恢复、伤口分离、咀嚼效率、假体稳定性和美观效果。在复诊中观察到的积极结果强调了患者特异性种植体在解决粘液瘤病后引起的上颌缺损方面的可行性和有效性。
Outstretching challenges for rehabilitation of a mucormycotic case-a digitally designed patient-specific implant approach in the recent era.
Background: Reconstruction of maxillofacial defects is challenging due to the region's complex anatomy. During the COVID-19 era, many patients lost their maxilla and chewing efficiency as a result of Mucormycosis. In such cases, custom-designed implants offer a graftless solution for seemingly hopeless situations. This case report aims at miraculous dental transformation utilizing the Patient Specific Implant (PSI) approach.
Case presentation: A 64-year-old male patient presented to the Prosthodontics Department with the chief complaint of missing teeth. He had been struggling with chewing for two years due to a post-mucormycotic maxillary jaw. A CT scan was obtained to evaluate and investigate the affected site. After a comprehensive diagnosis, the treatment of choice was a patient-specific implant decided using 3D printing technology. Reconstructing maxillofacial defects poses significant challenges due to the region's intricate anatomy, as well as its aesthetic and functional implications. The use of pre-formed alloplastic implants and autogenous grafts often leads to complications such as resorption, infection, and displacement. However, recent technological advances have made it possible to fabricate customized patient-specific implants (PSIs) through computer modeling, offering new opportunities for reconstructive surgery.
Conclusion: This case report demonstrates the dental management of post-mucormycotic patients with specially designed implants, customized according to the availability and anatomy of the bone in the entire head region. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included infection, soft tissue recovery, wound separation, masticatory efficiency, stability of the prosthesis, and aesthetic outcomes. The positive outcomes observed at follow-up appointments emphasize the viability and effectiveness of patient-specific implants in addressing maxillary defects caused by post-mucormycosis.
期刊介绍:
BMC Oral Health is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology.