截除受损邻牙的牙根后，保持牙齿与种植体之间的距离：临床病例报告

IF 0.9 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Advances in Periodontics Pub Date : 2023-02-07 DOI:10.1002/cap.10236

Bradley Lander, Allison Rascon, Dennis Sourvanos, Joseph Fiorellini, Rodrigo Neiva

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引用次数: 0

摘要

背景无牙颌部位的水平牙-种植体距离有限，这给临床医生带来了挑战。本病例报告描述了截除邻近受损臼齿的牙根以保持最佳的牙-种植体间距的方法和结果一位 41 岁的女性被转诊到医院进行拔牙和种植体植入手术，以替换她的左侧上颌第二前磨牙（13 号），该前磨牙被诊断为垂直根折。13 号牙的拔除和牙嵴保留均已完成，未出现并发症。术后 4 个月的临床检查显示，受 14 号牙颊面中上根分叉程度的影响，13 号牙缺牙间隙的中-远端距离较窄（5.69 毫米）。锥形束计算机断层扫描（CBCT）分析证实，14 号牙的中颊根有根尖周病变。在治疗计划中，截除了牙髓受损的 14 号牙的颊中根，以提供空间，方便植入标准直径的种植体，同时不影响种植体或邻牙。术后 1 年的随访证实并维持了牙槽骨水平。结论本病例报告的研究结果表明，截除受损臼齿的牙根是当代种植牙治疗空间限制的另一种解决方案。还需要更多的研究来评估这种方法的可靠性和长期成功率。要点为什么本病例是新信息？有关窄直径种植体长期疗效的证据不足。临床治疗指南不足。本文介绍了一种替代方法，即通过截除邻近受损牙齿的牙根来处理中间距受限的特殊情况。成功处理这种病例的关键是什么？全面诊断和严格的病例选择多学科治疗计划循证决策本病例成功的主要限制因素是什么？非常特殊的临床应用；邻牙受损需要长期随访

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Maintaining tooth-implant distance following root amputation of a compromised adjacent tooth: A clinical case report

Background

Edentulous sites with limited horizontal tooth-implant distance pose a challenge to clinicians. This case report describes root amputation of an adjacent compromised molar to maintain an optimal tooth-implant distance

Methods and Results

A 41-year-old female was referred for extraction and implant placement to replace her left, maxillary second premolar (#13), which had been diagnosed with a vertical root fracture. Extraction and ridge preservation of #13 was completed without complication. The 4-month postsurgical clinical examination revealed a narrow mesial-distal distance (5.69 mm) of the edentulous space (#13), which was influenced by the degree of divergence of the mesial buccal root of tooth #14. Cone-beam computed tomography (CBCT) analysis verified a periapical lesion on the mesial-buccal root of tooth #14. The amputation of the endodontically compromised mesial-buccal root of #14 was treatment planned to provide space and facilitate placement of a standard diameter implant without compromising the implant or adjacent teeth. Crestal bone levels were verified and maintained at the 1 year postoperative follow-up.

Conclusion

The findings of the case report demonstrate how root amputation of a compromised molar is an alternative solution for managing spatial limitations in contemporary implant dentistry. More studies are required to assess the reliability and long-term success of this approach.

Key points

Why is this case new information?

There is insufficient evidence on the long-term efficacy of narrow-diameter implants. Clinical treatment guidelines are not sufficiently available.
This paper presents an alternative approach to managing a specific scenario where mesial-distance distance is limited using root amputation of an adjacent compromised tooth.

What are the keys to successful management of this case?