PDF(Pubmed)
Abstract：
This case report describes a dual full-arch rehabilitation focusing on a modified buccal incision for installation of four implants for full-arch rehabilitation of an edentulous maxilla. A modified buccal incision was performed in the subcrestal buccal region to promote direct access to the periosteum without incising the muscles in the region. For the installation of anterior implants, an 8.5 mm implant was locked in the cortical bone of the alveolar ridge and in the cortical bone of the floor of the pyriform cavity. The drilling point of the posterior implants was defined using the anterior implants as a visual reference, and the entry point could be visually estimated from the topography of the palatal surface of the maxilla. After bone leveling, the drilling enlargement sequence was carried out using drills that allowed the installation of long implants (18 mm). Straight mini-abutments were installed in the anterior implants and angled at 30º in the posterior implants. The flap was then perforated in the exact region where the mini-abutments were located. The buccal incision line was sutured with continuous 5-0 nylon suture. On the following day, aesthetic tests were carried out with teeth mounting. The patient presented minimal edema, and the lip motricity and smile width were completely preserved. The prosthesis was delivered five days after surgery. The suture was removed, and the prosthesis was installed while maintaining compression on the gingival tissue. The patient reported no pain during the prosthesis installation. The modified buccal flap enables implant placement for full-arch rehabilitation of an edentulous maxilla.
摘要：
此病例报告描述了双重全弓康复，重点是改良的颊切口，用于安装四个植入物，以对无牙上颌骨进行全弓康复。在the下颊区域进行了改良的颊切口，以促进直接进入骨膜，而不会切开该区域的肌肉。对于前植入物的安装，将8.5毫米的植入物锁定在牙槽脊的皮质骨和梨状腔底部的皮质骨中。使用前植入物作为视觉参考来定义后植入物的钻孔点。并且可以从上颌骨腭表面的地形直观地估计入口点。整骨后,使用允许安装长植入物（18毫米）的钻头进行钻孔扩大顺序。直式微型基台安装在前部植入物中，并在后部植入物中以30º倾斜。然后在微型支座所在的确切区域对皮瓣进行穿孔。颊切口线用连续5-0尼龙缝合线缝合。第二天,进行了美学测试与牙齿安装。病人出现轻微的水肿，嘴唇的运动感和微笑的宽度被完全保留下来。手术后五天交付假体。缝线被移除,并安装假体，同时保持对牙龈组织的压缩。患者报告在假体安装期间没有疼痛。改良的颊瓣可以放置植入物，以进行无牙上颌骨的全弓康复。
