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Slide Casi clinici

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: 男/ 47岁  
初诊: 02/07/2015 植牙: 08/08/2015 / 18/09
辅助措施:08/08/2015 / 18/09 最终修复: 18/06/2016
第1次复诊: 29/06/2016  
患者主诉: 上颌牙松动严重,要求治疗。
特殊事项:即刻种植+即刻负重+GBR

病例概要

上颌:右上8、2和左上1、2、8Ⅱ~Ⅲ°松动,右上5、4、3和左上3、4、5不同程度牙龈萎缩,Ⅰ~Ⅱ°松动。同时拔除后,即刻植入C-Tech种植体,型号为:EL-3511/EL-4311/EL5111,共8颗。
下颌:右下3、4、5和左下4、5不同程度牙龈萎缩,Ⅰ~Ⅱ°松动,同时拔除后,即刻植入C-Tech种植体,型号为:EL-4311/EL5109/EL5111,共6颗。
后期氧化锆全冠桥修复。

治疗计划

上颌2、3、5、6牙槽骨宽度和骨高度理想,拔除患牙后,即刻植入C-Tech种植体EL-3511/EL-4311/EL-5111,共8颗,植体支持固定临时义齿修复。
一个月后种植下颌
下颌3、4、6牙槽骨宽度和骨高度理想,拔除患牙后,即刻植入C-Tech种植体EL-4311/EL5109/EL5111,共6颗,植体支持固定临时义齿修复。

治疗内容

上颌种植手术

1、常规消毒铺巾。微痛局部浸润麻醉上颌全牙列。暂时保留右上8。

2、左上7至右上7沿牙槽嵴顶切口,右上5、4、3、2和左上3、4、5沟内切口,翻瓣。拔除患牙。骨钳去除牙槽间隔,大球钻平整骨面。

3、左右上6定点,级差备洞至4.7*13,均植入C-Tech种植体5.1*11mm,左上6扭力不足。右上5、3、2和左上2、3、5定点,级差备洞,左右上2至2.8*13mm,均植入C-Tech种植体EL-3511。级差备洞,左右上3、5至3.7*13mm,均植入C-Tech
种植体EL-4311。利用右上6 5 3 2和左上2 3 5 植体,安装peek临时基台,左上6+封闭螺丝,骨粉Bio-Oss覆盖左上6牙槽嵴顶及右上3~4骨间隙,盖骨膜Bio-Gide。严密缝合。

4、利用上颌总义齿及右上6 5 3 2和左上2 3 5 植体制作临时义齿。调颌。

下颌种植手术

左1、常规消毒铺巾。无痛推麻仪局部浸润麻醉下颌全牙列。

2、左下7~右下7牙槽嵴顶近远中水平切口,右下5、4、3和左下4、5沟内切口,分龈翻瓣,拔除患牙,咬骨钳去除薄锐牙槽嵴顶边缘,球钻平整股骨面。

3、左下6定点,先锋钻达工作长度,扩孔钻逐级备洞至4.7*12mm,植入C-Tech种植体EL-5111+peek基台Φ4.5H3,扭力60N,边缘骨高度M1D1B0.5L0.5。右下3、4和左下3、4,级差备洞3.7*13mm,植入C-Tech种植体EL-4311, 左下4+封闭螺丝,扭力20N,边缘骨高度M2D2B1L2。左下3+peek基台Φ4.5H3,扭力60N,边缘骨高度M0.5D0.5B0.5L0.5。右下3+peek基台Φ4.5H3,扭力60N,边缘骨高度M1.5D1.5B0.5L1。
右下4+封闭螺丝,扭力20N,边缘骨高度M1.5D1.5B1L1.5。右下6定点,级差备洞至4.7*11mm,植入C-Tech种植体EL-5109+peek基台Φ4.5H3,扭力为:60N,边缘骨高度M-0.5D-1B0L-0.5。左下3、4和右下4、6 植入骨粉Bio-Oss,+骨膜Bio-Gide,严密缝合,压迫止血。

4、利用 右下3、6和左下3、6做基台,行下颌即刻过度义齿。调颌。

5、十个月后取模,更换修复基台,粘接固定,氧化锆烤瓷冠永久修复。

臨床病例

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

Full arch case: immediate implant placement with guided surgery and immediate loading

Catarina G. Rodrigues, DDS, MSc - Manuel D. Marques, DDS A 57-year-old woman presented to a private practice with the chief complaint being “I'm self-conscious about the appearance of my teeth. Also, I’ve lost most of my teeth and I cannot eat well because of that”. The clinical and radiographic examination revealed the absence of all teeth except the central incisors and right lateral incisor in the upper. In the lower, partial edentulism, severe bone loss, and multiple periapical inf了解更多

使用引导手术和一次性概念的3单元桥接种植修复

Catarina G. Rodrigues, DDS, MSc - Manuel D. Marques, DDS 患者男性、30岁。24号、25号和26号牙齿缺失,牙周情况良好、咬合空间尚可。c 治疗计划:24号、26号牙位植入两颗种植体,种植桥修复。 在数字化导板的引导下,植入两颗西泰克美学种植体。 西泰克美学植体、斜肩台加平台转移、保证美学效果,多种螺纹增加初期稳定性。 选择戴入两颗穿龈高度为3的最新的西泰克“ONETIM了解更多

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