台北荣民总医院8月7日,(台北荣总牙科部口腔颚面外科 高寿延主任)
「人工植牙」就是利用手术的方式先将精密制造的钛金属牙根植入上下颚骨缺牙区,等待伤口愈合而且植入的人造牙根与周围的骨质密接整合后再以此牙根为牙桥桥墩之底座进行假牙的制作。一般传统的人工植牙是分成二阶段式,也就是先手术,隔几个月骨质密合后再作假牙,当然某些情况下条件配合理想,也可进行单一阶段植牙,提早进行假牙制作。人工植牙的好处是既可免于制作一般假牙时必须磨小邻近正常牙的困扰,又可减少牙床骨的吸收,好处可多着呢!
自然的严重骨吸收、严重车祸外伤后以及口腔肿瘤手术切除部分颚骨之患者牙床骨软硬组织条件不良,他们的口腔环境常有牙床高度不足及软组织条件不良的情形出现; 经过适当筛选高度合作的患者仍然可以用精巧的手术方式来重建牙床以改善口腔环境,有如『逢山开路,遇水架桥』,经过治疗后,最后患者还是有机会获得人工植牙、赝复重建之机会。
人工植牙是一新兴的必须以手术植入人工牙根配合假牙制作的方式,也是一种高级又昂贵的治疗。其成功的要件在于正确的诊断与治疗,及患者充分的配合。人工牙根在口腔中一如自己的牙齿,在植入后更须小心细腻的清洁与照顾才得以保留的长久。根据我们以往的经验也陆续发表了十余篇刊登在国内外知名期刊有关人工植牙的文章及手术技术上的改良,相信未来此项技术能造福更多牙床骨软硬组织不良的患者。
注: 赵 女士为一位七十岁患者,其牙床骨严重萎缩,造成咀嚼不易,但是在接受了人工植牙及软组织的处理之后获得相当大的改善,不仅在咀嚼、消化方面有显著成效,而且心情愉快许多,体重也因此恢复上升。
作者: 高寿延 台北荣民总医院口腔颚面外科主任, 阳明大学牙医系教授, 哈佛大学博士,长庚大学医务管理研究所硕士
TEL: 28757572, E-mail: sykao@vghtpe.gov.tw
参考文献:
1. Kao SY, Yeung TC, Chou IC, Chang CS: Reconstruction of the severely resorbed class-IV atrophic edentulous ridge of maxilla and mandible for implant restoration - a case report. J Oral Implantol 18: 128-132, 2002.
2. Kao SY, Yeung TC, Hung KF, Chou IC, Wu CH, Chang CS: Transpositioned flap vestibuloplasty combined with implant surgery in the severely resorbed atrphic edentulous ridge. J Oral Implantol 28(4):194-199, 2002
3. Kao SY, Yeung TC, Lo WL, Wu CH, Lui MT , Richard Chang CS: Rehabilitation of Dental Implants for the Post-irradiated and Marginally Resected Mandible in an Oral Cancer Patient. Chin Med J 65: 548-552, 2002. (IM)
4. 吴智伟, 杨子彰, 高寿延: 病例报告--一位车祸外伤患者经硬组织与软组织重建后之植体赝复手术. 中华牙医学会讯: 17-18, 2003十二月号.
5. Wu CW, Yeung TC, Lui MT , Chang CS, Kao SY: Reconstruction of the severe atrophic ridge of the mandible after traffic accident with guided bone regeneration combined with palatal mucosa graft and vestibuloplasty for implant rehabilitation –a case report. Chin J Oral Maxillofac Surg 15: 99-107, September 2004.
6. Wu CW, Hung KF, Yeung TC, Kao SY: A method using vestibulo-sulcoplasty simultaneously combining spilt-thickness skin graft and palatal keratinized mucosa graft for rehabilitation of peri-implant tissue in the severely atrophic edentulous ridge secondary to oral cancer surgery. J Oral Implantol 31(4):186-191, 2005. IM
7. Kao SY, Fong HJ, Chou SJ, Wu JH, Tu HF, Yeung TC: Segmental osteotomy to reposition multiple osseointegrated dental implants in the anterior maxilla in a trauma patient. Dental Traumatlolgy 21:1-4, 2005. SCI
8. Kao SY, Fong HJ, Lui MT , Yeung TC, Hung KF, Wu CH, Yu EH, Wu HT, Chang CS: Implant rehabilitation of severely traumatized anterior alveolar ridge. Asian J Oral Maxillofacial Surg 17(4):240-246, 2005. IM
9. Kao SY, Jenny Fong HJ, Chou IC, Yeung TC: Using distraction osteogenesis for repositioning the dental implant retained premaxilla in conjunct with autogenous bone graft and mucosa graft vestibuloplasty in a trauma patient – report of a case. J Oral Maxillofac Surg 64:794-798, 2006. SCI
12. Ta-Wei Chen, Haw-sheng Chang, Kam-Wing Leung, Shou-Yen Kao: Novel Surgical Approach to Elevate the Floor of the Maxillary Sinus Without Bone Grafting to Rehabilitate Dental Implants: Clinical and Radiographic Evaluation. J Oral Maxillofac Surg(submmitted)
