Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
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Flapless implant surgery on atrophied alveolar ridge in a patient with growth disorder

성장 장애를 가진 부분 무치악 환자에서 위축된 골에 무피판 임플란트 수술 증례

  • Lee, Du-Hyeong (Department of Prosthodontics, School of Dentistry, Kyungpook National University)
  • 이두형 (경북대학교 치과대학 치과보철학교실)
  • Received : 2014.02.24
  • Accepted : 2014.04.24
  • Published : 2014.06.30
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Abstract

The growth disorder influences craniofacial development and early loss of permanent teeth. This case reports the importance of computerized tomography (CT) and surgical guide to identify horizontal bone loss, adjacent teeth and to guide drills when placing implants in a short stature patient. The patient has idiopathic short stature and the 3rd grade of intellectual disability. To recover posterior mandibular teeth, implant treatment was planned. CT images showed that the adjacent teeth were located markedly to the buccal side. A CT-based surgical guide was fabricated and implants was placed using flapless surgery. Bone dehiscence and fenestration may happen when the surgical guide was fabricated just based on adjacent clinical crowns. Thus, it is essential to analysis bone and teeth and to make surgical guide through CT, especially in atrophied bone on grow disorder patients. Furthermore, systematic researches are recommended to elucidate the relationship between growth disorder and tooth malposition.

성장장애는 두개안면부의 골격성장과 영구치의 조기상실에 영향을 미친다. 본 증례는 성장장애 환자에서 치아를 조기 상실한 부위에 무피판 술식으로 임플란트를 식립 시 컴퓨터 단층촬영(CT)을 통한 인접치아의 확인과 임플란트 가이드의 필요성을 살펴보았다. 특발성 저신장과 3급 정신지체의 20세의 여환에서 구치의 회복을 위해 임플란트 고정성 보철을 계획하였다. CT 영상에서 인접치가 심하게 협측으로 위치되어 있었고, 이를 반영하여 가이드를 제작후 임플란트를 식립하였다. 이상 위치된 인접치를 기준으로 임플란트를 식립할 경우 협측 골의 천공이 발생할 수 있다. 그러므로 성장장애 환자에서 치아 조기 상실부에 임플란트를 식립 시 CT를 통한 치아의 위치 확인과 가이드의 제작이 요구된다.

Keywords

References

  1. Wit JM, Clayton PE, Rogol AD, Savage MO, Saenger PH, Cohen P. Idiopathic short stature: definition, epidemiology, and diagnostic evaluation. Growth Horm IGF Res 2008;18:89-110. https://doi.org/10.1016/j.ghir.2007.11.004
  2. Pedicelli S, Peschiaroli E, Violi E, Cianfarani S. Controversies in the definition and treatment of idiopathic short stature (ISS). J Clin Res Pediatr Endocrinol 2009;1:105-15.
  3. van Erum R, Mulier M, Carels C, de Zegher F. Short stature of prenatal origin: craniofacial growth and dental maturation. Eur J Orthod 1998;20:417-25. https://doi.org/10.1093/ejo/20.4.417
  4. Kjellberg H, Beiring M, Albertsson Wikland K. Craniofacial morphology, dental occlusion, tooth eruption, and dental maturity in boys of short stature with or without growth hormone deficiency. Eur J Oral Sci 2000;108:359-67. https://doi.org/10.1034/j.1600-0722.2000.108005359.x
  5. Bazopoulou-Kyrkanidou E, Dacou-Voutetakis C, Nassi H, Tosios K, Kyrkanides S, Damoli M. Microdontia, hypodontia, short bulbous roots and root canals with strabismus, short stature, and borderline mentality. Oral Surg Oral Med Oral Pathol 1992;74:93-5. https://doi.org/10.1016/0030-4220(92)90221-B
  6. Gardner DG, Girgis SS. Taurodontism, short roots, and external resorption, associated with short stature and a small head. Oral Surg Oral Med Oral Pathol 1977;44:271-3. https://doi.org/10.1016/0030-4220(77)90279-1
  7. Oh TJ, Shotwell J, Billy E, Byun HY, Wang HL. Flapless implant surgery in the esthetic region: advantages and precautions. Int J Periodontics Restorative Dent 2007;27:27-33.
  8. Campelo LD, Camara JR. Flapless implant surgery: A 10-year clinical retrospective analysis. Int J Oral Maxillofac Implants 2002;17:271-6.
  9. Ozan O, Turkyilmaz I, Yilmaz B. A preliminary report of patients treated with early loaded implants using computerized tomography-guided surgical stents: flapless versus conventional flapped surgery. J Oral Rehabil 2007;34:835-40. https://doi.org/10.1111/j.1365-2842.2007.01772.x
  10. Wyatt CC, Pharoah MJ. Imaging techniques and image interpretation for dental implant treatment. Int J Prosthodont 1998;11:442-52.
  11. Stumpel LJ 3rd. Cast-based guided implant placement: a novel technique. J Prosthet Dent 2008;100:61-9. https://doi.org/10.1016/S0022-3913(08)60140-7
  12. Nanda A, Jain V. Simplistic partially limiting surgical guide for flapless implant placement: a case report. J Oral Implantol 2012;38:639-41. https://doi.org/10.1563/AAID-JOI-D-10-00123
  13. Iplikcioglu H, Akca K, Cehreli MC. The use of computerized tomography for diagnosis and treatment planning in implant dentistry. J Oral Implantol 2002;28:29-36. https://doi.org/10.1563/1548-1336(2002)028<0029:TUOCTF>2.3.CO;2
  14. Katsoulis J, Pazera P, Mericske-Stern R. Prosthetically driven, computer-guided implant planning for the edentulous maxilla: a model study. Clin Implant Dent Relat Res 2009;11:238-45. https://doi.org/10.1111/j.1708-8208.2008.00110.x
  15. Katz RV, Neely AL, Morse DE. The epidemiology of oral diseases in older adults. Copenhagen; Munksgaard; 1996. p. 263-301.
  16. Carr AB, McGivney GP, Brown DT, McCracken WL. McCracken's removable partial prosthodontics. 12th ed. St. Louis; Mosby; 2010. p. 1-18.
  17. Carlsson GE, Thilander H, Hedegard B. Changes in contour of the maxillary alveolar process after extractions with or without insertion of an under immediate full denture. Acta Odontol Scand 1967;25:21-43. https://doi.org/10.3109/00016356709072521
  18. Pietrokovski J, Massler M. Alveolar ridge resorption following tooth extraction. J Prosthet Dent 1967;17:21-7. https://doi.org/10.1016/0022-3913(67)90046-7
  19. Ostler MS, Kokich VG. Alveolar ridge changes in patients congenitally missing mandibular second premolars. J Prosthet Dent 1994;71:144-9. https://doi.org/10.1016/0022-3913(94)90022-1
  20. Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 4th ed. St. Louis; Mosby; 2006. p. 379-88.