背景:种植体周围炎在临床实践中提出了重大挑战,需要有效的治疗策略。该病例报告提出了治疗种植体周围炎的综合治疗方法,专注于切除手术,包括植入成形术和长期维持。
方法:我们描述了一例50岁女性种植体周围炎影响上颌全弓种植体支持康复的病例。治疗策略包括切除手术与植入成形术,一个新的上颌覆盖义齿,以及每年三到四次的定期维护护理时间表。在10年的随访期内进行了临床和影像学评估。
结果:治疗后,所有上颌骨植入物均未显示超过4mm的探测深度,探查或化脓时没有出血,最小的斑块积累,没有进一步的骨质流失.植入成形术的切除手术似乎有效地提供了粘膜下净化,并创造了有利于口腔卫生的粘膜上植入物表面。尽管有定期维护,一些下颌骨植入物在随访期间出现骨丢失,并采用与上颌骨植入物相同的方法进行治疗.
结论:综合治疗方法取得了良好的长期临床和影像学结果,强调联合策略在治疗种植体周围炎方面的有效性。然而,在新的植入物中复发或种植体周围炎的可能性,即使经过十年的成功治疗和严格的维护,强调了持续的重要性,勤勉关怀和定期评估,以及时诊断和解决这些问题。
结论:为什么这个病例是新信息?种植体周围炎治疗的长期有效性,特别是涉及植入成形术,仍然记录不足。该病例提供了10年随访的见解,以了解治疗种植体周围炎的综合方法的有效性。此外,这些发现说明了新的种植体周围炎发展的潜力,无论持续的种植体周围的健康和严格的维护。这一发现强调了持续监测对表现出种植体周围炎的新植入物的早期诊断和治疗的关键作用。成功处理此病例的关键是什么?此病例的成功取决于综合治疗方法,该方法结合了与植入成形术相关的手术干预以去除植入线,从而创造更光滑的表面,对斑块积累的保留较少。这种方法的一个关键方面也是假体组件的重新设计,以提高卫生可达性,连续监测,和一致的维护保养。在这种情况下,成功的主要限制是什么?尽管患者一贯坚持维护计划。此外,对植入物特性的关键评估,特别是他们对机械故障的敏感性,在进行植入成形术时是最重要的。此外,使患者的期望与治疗的现实美学和功能结果相一致通常具有挑战性.
结论:种植体周围炎,一种影响种植牙的炎症性疾病,治疗相当具有挑战性。该病例报告描述了患有这种疾病的50岁妇女如何成功治疗和维持10年以上。该方法包括一种称为切除手术的手术方法,其中涉及重塑骨缺损(骨成形术)和平滑植入物表面(植入成形术)。此外,她安装了一个新的上义齿,每年定期随访三到四次。十年后,她的上部植入物稳定,没有感染或进一步骨质流失的迹象,它们很容易保持清洁。在这段时间里,她的一些下部植入物确实经历了进行性骨丢失的炎症,但是他们使用与她的上植入物相同的外科手术进行管理。这份为期10年的病例报告强调了切除手术治疗种植体周围炎的积极和稳定的临床结果,以及跨学科方法和定期检查维护的重要性。早期诊断,以及长期种植周围炎的管理。
BACKGROUND: Peri-implantitis poses significant challenges in clinical practice, necessitating effective therapeutic strategies. This case report presents a comprehensive treatment approach for managing peri-implantitis, focusing on resective surgery, including implantoplasty and long-term maintenance.
METHODS: We describe the case of a 50-year-old female patient with peri-implantitis affecting a maxillary full-arch implant-supported rehabilitation. The treatment strategy involved resective surgery with implantoplasty, a new maxillary overdenture, and a regular maintenance care schedule of three to four visits per year. Clinical and radiographic assessments were performed over a 10-year follow-up period.
RESULTS: Post-treatment, all maxillary implants demonstrated no probing depths exceeding 4 mm, absence of bleeding on probing or suppuration, minimal plaque accumulation, and no further bone loss. Resective surgery with implantoplasty seems to have effectively provided submucosal decontamination and created a supra-mucosal implant surface conducive to oral hygiene. Despite regular maintenance, some mandibular implants exhibited bone loss during the follow-up period and were managed using the same approach as for the maxillary implants.
CONCLUSIONS: The comprehensive treatment approach yielded favorable long-term clinical and radiographic outcomes, underscoring the effectiveness of the combined strategies in managing peri-implantitis. Nevertheless, the potential for recurrence or the development of peri-implantitis in new implants, even after a decade of successful treatment and strict maintenance, highlights the importance of ongoing, diligent care and regular evaluations to promptly diagnose and address these issues.
CONCLUSIONS: Why is this case new information? The long-term effectiveness of peri-implantitis treatments, particularly involving implantoplasty, remains under-documented. This case provides insights from a 10-year follow-up on the efficacy of a comprehensive approach for managing peri-implantitis. Furthermore, these findings illustrate the potential for new peri-implantitis to develop, regardless of sustained peri-implant health and rigorous maintenance. This finding highlights the critical role of continuous monitoring for the early diagnosis and treatment of new implants exhibiting peri-implantitis. What are the keys to the successful management of this case? The success of this case hinged on a comprehensive treatment approach that combines surgical intervention associated with implantoplasty to remove implant threads, thereby creating smoother surfaces, less retentive for plaque accumulation. A critical aspect of this approach was also the redesign of prosthetic components to improve hygiene accessibility, continuous monitoring, and consistent maintenance care. What are the primary limitations to success in this case? The primary challenge in achieving success in this case was the prevention of new implants with peri-implantitis, despite the patient\'s consistent adherence to the maintenance program. Moreover, a critical evaluation of implant characteristics, particularly their susceptibility to mechanical failures, is paramount when performing implantoplasty. Furthermore, aligning patient expectations with the realistic esthetic and functional outcomes of the treatment is often challenging.
CONCLUSIONS: Peri-implantitis, an inflammatory disease affecting dental implants, is quite challenging to treat. This case report describes how a 50-year-old woman with this condition was successfully treated and maintained over 10 years. The approach included a surgical method called resective surgery, which involved reshaping the bone defect (osteoplasty) and smoothing the implant surface (implantoplasty). Additionally, she was fitted with a new upper denture and had regular follow-up visits three to four times a year. After ten years, her upper implants were stable with no signs of infection or further bone loss, and they were easy to keep clean. Some of her lower implants did experience inflammation with progressive bone loss during this time, but they were managed using the same surgical procedure as for her upper implants. This 10-year case report highlights positive and stable clinical results after resective surgery for treating peri-implantitis and the importance of an interdisciplinary approach and regular check-ups for maintenance, early diagnosis, and management of peri-implantitis over the long term.