病例报告表

Doctor Peng Dong, the expert of tooth implantation in Peking University International Hospital and president of Beijing Hedu Stomatological Clinic Co., Ltd

Medical Case Report

性别/年龄: 女/ 37岁
初诊: 09/01/2014	植牙: 24/05/2018
辅助措施: 26/10/2017	最终修复: 11/10/2018
第1次复诊: 18/10/2018
患者主诉: 上颌牙齿松动，影响进食求诊。
特殊事项: 即刻种植+即刻负重+上颌窦外提升术+GBR

病例概要

上颌牙齿牙槽骨吸收明显，根尖周大面积暗影，根吸收达根长1/3~1/2，诊断侵袭性牙周炎，经上颌窦外提升术后，拔除患牙，即刻植入C-Tech种植体，型号：EL-3509、EL-4309、EL-5109，共8颗，后期氧化锆烤瓷冠桥修复。

治疗计划

上颌牙槽骨宽度理想，骨高度不足，双侧上颌窦外提升术后2个月，拔除患牙，即刻植入C-Tech种植体EL-3509、EL-4309、EL-5109，共8颗，同期植骨后，植体支持的固定临时义齿修复。

治疗内容

1、常规消毒铺巾。上颌术区局部浸润麻醉。
2、行右上7远中斜行切口+右上7牙槽嵴顶近远中向切口+右上6543沟内切口+右上2~左上1牙槽嵴顶近远中向切+左上234沟内切口+左上5~7牙槽嵴顶近远中向切口，左上8沟内切口，翻瓣，暴露骨面，钳除右上6543和左上234清创，咬骨钳+大球钻降低平整骨面。
3、右上1定点，级差备洞+骨挤压至3.0*11mm，植入C-Tech种植体EL-3509+EL-4504P peek基台，扭力45N，边缘骨高度M1.5D1.5B1.5L1。右上3和左上1、3 定点，级差备洞+骨挤压至3.0*1 1mm，植入C-Tech种植体EL-3509+EL-4504P peek基台，左上1扭力45N，边缘骨高度M 2.5D2B1.5L2。左上3扭力45N，边缘骨高度M 1.5D1.5B-1.5L1.5。右上3扭力45N，边缘骨高度M 2D1.5B2L1.5。右上4定点，级差备洞至3.8*11mm，植入C-Tech种植体EL-4309+EL-4504P peek基台，扭力45N，边缘骨高度M1.5D2B1.5L1.5。左上4定点，级差备洞至3.8*11mm，植入C-Tech种植体EL-4309，扭力10N，边缘骨高度M1.5D-8B1.5L1.5。左右上6定点，级差备洞至3.8*11mm，各植入C-Tech种植体EL-5109+覆盖螺丝，左上6扭力25N，边缘骨高度M1D1B1.5L0.5。右上6扭力45N，边缘骨高度M1.5D1.5B1.5L1.5。将骨粉Bio-Oss分别置于右上3、1和左上1、3、4骨缺损出及唇侧骨板处，覆盖Bio-Gide于植骨处，及右上6拔牙处，拉拢并间断缝合关闭创口。
4、利用右上4、3、1和左上1、3放置临时基台，制作上颌即刻义齿，调颌，抛光。
5、九个月后取模，更换修复基台，粘接固定，氧化锆烤瓷冠桥永久修复。

Advantages of guided surgery, predictability in small spaces

by Doctor Henriette Lerner, HL-DENTCLINIC DR. STOM. MEDIC. In this case, the patient has a genesis of the two upper lateral incisors. Having created the space with the help of the orthodontic specialist, we first proceed with a Digital Smile Design and then with the digital planning of the two implants in comparison with the new aesthetics.了解更多

Guided surgery in the jaw and mandible

by Doctor Henriette Lerner, HL-DENTCLINIC DR. STOM. MEDIC. In this case, it is necessary to use all the digital tools available – detection of joint movements, digital smile design and guided surgery, with the aim of having predictability and accuracy. For the future aesthetic part and function, the evaluation took place before the surgery.了解更多

Guided surgery with bone graft

by Doctor Henriette Lerner, HL-DENTCLINIC DR. STOM. MEDIC. In this case it is shown how it is still possible to work in guided surgery and consequently perform bone grafts where necessary. The advantage in a difficult case like this is to design the dental implants with a surgical guide, in order to maintain their correct positioning. Finally, the aesthetic project was evaluated prior to surgery.了解更多

Slide Casi clinici