PDF(Pubmed)
Abstract：
The oral rehabilitation of MRONJ patients represents a challenging situation. Conventional dental implant insertion is not indicated because of the risk of creating a new necrotic area. This case study describes the oral rehabilitation of a 78-year-old female patient, who developed an osteonecrotic lesion in the fourth year of bisphosphonate treatment. The patient underwent a series of surgeries, including resection of the necrotic tissue on the right maxillary region and removal of conventional implants. The patient had a large maxillary defect, and no other treatment modalities such as conventional prosthetic appliances and traditional dental implant insertions were applicable. The patient had a very poor quality of life and as a rehabilitation option, two zygomatic implant insertions were planned and performed as an anchorage for maxillary fixed prosthesis. Radiographic and clinical examination after three years of follow-up indicated that healing was achieved, and healthy tissues formed around zygomatic implants. The patient did not suffer from any additional necrotic tissues or other complications in the oral cavity. According to the results of this case report, zygomatic implantation after resective surgery might be considered as a promising alternative for MRONJ patients with large defects when other treatment alternatives fail or are not applicable.
摘要：
MRONJ患者的口腔康复是一个具有挑战性的情况。由于产生新的坏死区域的风险,不指示常规的牙植入物插入。本案例研究描述了一名78岁女性患者的口腔康复，在双膦酸盐治疗的第四年出现骨坏死病变。病人接受了一系列手术,包括切除右侧上颌骨区域的坏死组织和去除常规植入物。病人有一个巨大的上颌骨缺损,并且没有其他治疗方式，例如传统的假肢矫正器和传统的牙种植体插入。病人的生活质量很差，作为康复选择，计划插入两次zy骨植入物，并将其作为上颌固定假体的锚固。经过三年的随访，影像学和临床检查表明愈合。和健康的组织形成在颧骨植入物周围。患者在口腔中没有任何额外的坏死组织或其他并发症。根据这个病例报告的结果,当其他治疗方法失败或不适用时，切除手术后的the骨植入可能被认为是具有较大缺陷的MRONJ患者的有希望的替代方法。
