A Case of Oral Rehabilitation Using a Bone Graft and Implant Overdenture for a Severe Ridge Defect

When implant placement in the existing bone is not possible, bone regeneration is an essential procedure for long-term functional and esthetic stability of the implant. This clinical report describes implant treatment using a bone graft and implant overdenture (IOD) for a severe bone defect.The pati...

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Published inJournal of Japanese Society of Oral Implantology Vol. 37; no. 2; pp. 164 - 170
Main Authors OHKUBO, Chikahiro, KURIHARA, Daisuke, SUZUKI, Yasunori, KOKUBO, Yuji, NAKAOKA, Kazutoshi
Format Journal Article
LanguageJapanese
Published Japanese Society of Oral Implantology 30.06.2024
公益社団法人 日本口腔インプラント学会
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ISSN0914-6695
2187-9117
DOI10.11237/jsoi.37.164

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Abstract When implant placement in the existing bone is not possible, bone regeneration is an essential procedure for long-term functional and esthetic stability of the implant. This clinical report describes implant treatment using a bone graft and implant overdenture (IOD) for a severe bone defect.The patient was a 25-year-old man with the chief complaint of swelling of the left buccal region. CT images showed a unilocular radiolucent lesion extending from the maxillary anterior region to the maxillary sinus. The lesion included an impacted tooth and root resorption of 21 to 24 was observed. A biopsy suggested that it was a glandular odontogenic cyst (GOC). Cystectomy was performed with root canal filling and apicoectomy of 21 to 24. Nine months later, tooth extraction of 21 to 24 was performed because of increased mobility, and an immediate denture was inserted. Reconstruction of the alveolar ridge using particulate cancellous bone and marrow (PCBM) was carried out with a titanium mesh tray. Nine months after the PCBM graft, 3 dental implants were placed into the reconstructed bone. After confirming the osseointegration, an implant-supported prosthesis was fabricated. A telescopic system was selected as the retainer for cleanability. The patientʼs satisfaction was improved by the IOD. As of 6 years after IOD placement, implant loss, bone resorption, decrease of retention force, and denture breakage have not been observed.
AbstractList When implant placement in the existing bone is not possible, bone regeneration is an essential procedure for long-term functional and esthetic stability of the implant. This clinical report describes implant treatment using a bone graft and implant overdenture (IOD) for a severe bone defect.The patient was a 25-year-old man with the chief complaint of swelling of the left buccal region. CT images showed a unilocular radiolucent lesion extending from the maxillary anterior region to the maxillary sinus. The lesion included an impacted tooth and root resorption of 21 to 24 was observed. A biopsy suggested that it was a glandular odontogenic cyst (GOC). Cystectomy was performed with root canal filling and apicoectomy of 21 to 24. Nine months later, tooth extraction of 21 to 24 was performed because of increased mobility, and an immediate denture was inserted. Reconstruction of the alveolar ridge using particulate cancellous bone and marrow (PCBM) was carried out with a titanium mesh tray. Nine months after the PCBM graft, 3 dental implants were placed into the reconstructed bone. After confirming the osseointegration, an implant-supported prosthesis was fabricated. A telescopic system was selected as the retainer for cleanability. The patientʼs satisfaction was improved by the IOD. As of 6 years after IOD placement, implant loss, bone resorption, decrease of retention force, and denture breakage have not been observed.
When implant placement in the existing bone is not possible, bone regeneration is an essential procedure for long-term functional and esthetic stability of the implant. This clinical report describes implant treatment using a bone graft and implant overdenture (IOD) for a severe bone defect.The patient was a 25-year-old man with the chief complaint of swelling of the left buccal region. CT images showed a unilocular radiolucent lesion extending from the maxillary anterior region to the maxillary sinus. The lesion included an impacted tooth and root resorption of 21 to 24 was observed. A biopsy suggested that it was a glandular odontogenic cyst (GOC). Cystectomy was performed with root canal filling and apicoectomy of 21 to 24. Nine months later, tooth extraction of 21 to 24 was performed because of increased mobility, and an immediate denture was inserted. Reconstruction of the alveolar ridge using particulate cancellous bone and marrow (PCBM) was carried out with a titanium mesh tray. Nine months after the PCBM graft, 3 dental implants were placed into the reconstructed bone. After confirming the osseointegration, an implant-supported prosthesis was fabricated. A telescopic system was selected as the retainer for cleanability. The patientʼs satisfaction was improved by the IOD. As of 6 years after IOD placement, implant loss, bone resorption, decrease of retention force, and denture breakage have not been observed. 高度な顎堤欠損を有する症例に対し,骨幅と骨高径を回復させる自家骨移植とインプラントによる咬合回復は有用である.今回,腺性歯原性囊胞摘出後の顎堤欠損部に海綿骨骨髄細片(PCBM)移植と患者可撤式コーヌステレスコープを適応したインプラントオーバーデンチャー(IOD)により咬合回復した症例を報告する.患者は25歳の男性,左側頰部の膨隆を主訴として来院した.上顎左側中切歯から第一小臼歯は動揺度1であった.上顎左側埋伏過剰歯を含む境界明瞭なエックス線透過像を認め,上顎左側中切歯から第一小臼歯に歯根吸収が認められた.上顎に認められた腺性歯原性囊胞を摘出し,埋伏過剰歯を抜去した9か月後,上顎左側中切歯から第一小臼歯を抜去した.二次的に顎堤欠損部をPCBMにて再建後,3本のインプラント体を埋入した.顎堤吸収が大きく,十分なリップサポートが確保できず審美回復が困難なことや機能時にカンチレバーとなり力学的にも不利になりやすく,清掃性も著しく低下することから,インプラント上部構造はIODを選択した.IODの支台装置は二次固定が可能なコーヌステレスコープを選択し,剛性の高い可撤性上部構造を装着することで,複数のインプラントを強固に連結した.IOD装着後,囊胞の再発やインプラント周囲炎は確認されなかった.また,IODの破損や維持力の低下はなく,機能的・審美的に患者の満足が得られている.
Author OHKUBO, Chikahiro
KURIHARA, Daisuke
SUZUKI, Yasunori
KOKUBO, Yuji
NAKAOKA, Kazutoshi
Author_FL KOKUBO Yuji
鈴木 恭典
大久保 力廣
KURIHARA Daisuke
NAKAOKA Kazutoshi
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References 4) Kaplan I, Anavi Y, Hirshberg A. Glandular odontogenic cyst:a challenge in diagnosis and treatment. Oral Dis 2008;14;575-581.
9) 濱田良樹,山田浩之,熊谷賢一,ほか.カスタムメイド・チタンメッシュトレーと自家腸骨/脛骨海綿骨骨髄細片による下顎骨再建の臨床的有用性.口腔腫瘍 2014;26:78-88
5) Rammer M, Montanzen A, Lane SL, et al. Glandular odontogenic cyst:report of a case and review of the literature. Oral Surg Oral Med Oral Pathol 1997;84:54-57.
3) 岡本喜之,川田賢介,岩井俊憲,ほか.右側下顎智歯部に発生した腺性歯原性囊胞の1例.日口外誌 2006;52:11-14
2) Kramer IR, Pindborg JJ, Shear M. The WHO Histological typing of odontogenic tumors. Cancer 1992;70:2988-2994.
8) 飯野光喜.顎裂への新鮮自家腸骨海綿骨細片移植術の実際.幸地省子編.口唇裂口蓋裂治療.東京:西村書店,33-186,2008
6) 山近重生,中川洋一,寺田知加,ほか.術後12年で再発を認めた下顎骨体部腺性歯原性囊胞の1例.日口外誌 2006;52:527-531
7) 熊谷賢一,山田浩之,濱田良樹,ほか.自家腸骨海綿骨細片移植による即時顎堤再建後にインプラント治療を施行した歯原性線維腫の1例.日口診誌 2015;28:221-225
1) Gardner DG, Kessler HP, Morency R, et al. The glandular odontogenic cyst:an apparent entity. J Oral Pathol 1988;17:359-366.
References_xml – reference: 8) 飯野光喜.顎裂への新鮮自家腸骨海綿骨細片移植術の実際.幸地省子編.口唇裂口蓋裂治療.東京:西村書店,33-186,2008.
– reference: 5) Rammer M, Montanzen A, Lane SL, et al. Glandular odontogenic cyst:report of a case and review of the literature. Oral Surg Oral Med Oral Pathol 1997;84:54-57.
– reference: 7) 熊谷賢一,山田浩之,濱田良樹,ほか.自家腸骨海綿骨細片移植による即時顎堤再建後にインプラント治療を施行した歯原性線維腫の1例.日口診誌 2015;28:221-225.
– reference: 1) Gardner DG, Kessler HP, Morency R, et al. The glandular odontogenic cyst:an apparent entity. J Oral Pathol 1988;17:359-366.
– reference: 4) Kaplan I, Anavi Y, Hirshberg A. Glandular odontogenic cyst:a challenge in diagnosis and treatment. Oral Dis 2008;14;575-581.
– reference: 6) 山近重生,中川洋一,寺田知加,ほか.術後12年で再発を認めた下顎骨体部腺性歯原性囊胞の1例.日口外誌 2006;52:527-531.
– reference: 3) 岡本喜之,川田賢介,岩井俊憲,ほか.右側下顎智歯部に発生した腺性歯原性囊胞の1例.日口外誌 2006;52:11-14.
– reference: 9) 濱田良樹,山田浩之,熊谷賢一,ほか.カスタムメイド・チタンメッシュトレーと自家腸骨/脛骨海綿骨骨髄細片による下顎骨再建の臨床的有用性.口腔腫瘍 2014;26:78-88.
– reference: 2) Kramer IR, Pindborg JJ, Shear M. The WHO Histological typing of odontogenic tumors. Cancer 1992;70:2988-2994.
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Snippet When implant placement in the existing bone is not possible, bone regeneration is an essential procedure for long-term functional and esthetic stability of the...
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SubjectTerms glandular odontogenic cyst
implant overdenture
particulate cancellous bone and marrow
telescopic system
インプラントオーバーデンチャー
コーヌステレスコープ
海綿骨骨髄細片移植
腺性歯原性囊胞
Title A Case of Oral Rehabilitation Using a Bone Graft and Implant Overdenture for a Severe Ridge Defect
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