一名需要植入物的严重骨骼III类咬合不良患者缺失上颌前牙的康复

Z. H. Kassim, Abdul Latif Abdul Hamid, Nadhirah Ghazali, Puvanendran Balasingham
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摘要

年轻患者创伤性牙损伤(TDI)的处理可能从简单到复杂。在牙齿脱落的情况下,一种可靠而保守的治疗选择是种植体支持的固定义齿(i-FDP),因为这种治疗选择不需要像传统的固定桥那样准备良好的基牙。然而,植入物的放置通常是假体驱动,以允许3D功能和美学修复。如果存在严重的骨骼III类错牙合,治疗可能包括术前正畸治疗,然后进行颌骨手术纠正骨骼差异,最后进行术后正畸治疗,然后进行种植体康复。一个多学科的治疗方法在一个循序渐进的方式是必需的,以解决患者的整体治疗需要。本病例报告报告了一个年轻的成年男性患者的关节修复,正畸和口腔颌面外科治疗的骨骼III类错,谁需要康复撕脱缺失的前牙持续儿童TDI。由于骨骼关系的严重程度,需要进行Le Fort I上颌前进和双侧矢状劈开截骨术来矫正下颌骨后退,并在种植体植入前进行正畸治疗以纠正错颌和弓关系。使用i-FDP矫正错颌畸形,使缺失牙齿的功能和美观恢复。
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A Rehabilitation of Missing Maxillary Anterior Teeth in a Severe Skeletal Class III Malocclusion Patient Requiring Implants
Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion, treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic rehabilitation of the missing teeth using an i-FDP.
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