Prosthetic and Surgical Managements of Peri-implantitis at the Flap Reconstruction Site

元データ 2008-07-01 日本補綴歯科学会

概要

Patient: A 70-year-old edentulous woman with a flap reconstruction presented Kyushu University Dental Hospital for a masticatory dysfunction because of insufficient retention and stability with her complete denture. She had received 5 implants in the mandible for an implant-supported fixed prosthesis. Although an implant-supported fixed prosthesis could provide improved stability and function, the fixed prosthesis and lack of keratinized mucosa led to the difficulty of cleaning. To improve oral hygiene, an implant-supported overdenture was fabricated after free gingival graft from palate. However, a failure in the graft union and the subgingival plaque resulted in peri-implantitis. The patient received open flap debridement and was treated with antibiotics. Although the patient had used this prosthesis with a slight inflammation for 5 years, a deep pocket was observed around the implant. As a treatment of peri-implantitis, abrasive debridement with beta-TCP was performed. Up to the present, the patient healed uneventfully.Discussion: The implant-supported prosthesis is an alternative to the conventional removable denture and is used to provide predictable retention, stability and function in a flap reconstruction patient. However, we should consider the patients cleaning ability and the condition of soft tissue around implants.Conclusion: Prosthodontic treatment planning is a complex process that involves various factors such as the surgical factors, occlusion, superstructure and oral hygiene. If we make a plan in the light of these factors, implant-supported prosthesis must offer better function, comfort and predictable result to the patients.

著者

KOYANO Kiyoshi Department of Removable Prosthodontics, Faculty of Dental Science, Kyushu University
Koyano Kiyoshi Department Of Oral Rehabilitation Faculty Of Dental Science Kyushu University
Ayukawa Yasunori Department Of Oral Rehabilitation Faculty Of Dental Science Kyushu University
OGINO Yoichiro Department of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
TORIYA Kohei Department of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
Ogino Yoichiro Department Of Oral Rehabilitation Faculty Of Dental Science Kyushu University
Toriya Kohei Department Of Oral Rehabilitation Faculty Of Dental Science Kyushu University
Ayukawa Yasunori Section Of Implant And Rehabilitative Dentistry Division Of Oral Rehabilitation Faculty Of Dental Science Kyushu University
Koyano Kiyoshi Section Of Implant And Rehabilitative Dentistry Division Of Oral Rehabilitation Faculty Of Dental Science Kyushu University

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