KONJENİTAL BİR OLİGONTİ VAKASININ ALL-ON-4 DENTAL İMPLANT KONSEPTİ İLE TEDAVİSİ

Yıl 2019, Cilt: 5 Sayı: 1, 1 - 11, 01.04.2019

Sercan Küçükkurt

Öz

Oligodonti; süt, kalıcı veya her iki dentisyonda
altıdan fazla dişin konjenital eksikliği ile
karakterize, nadir bir genetik hastalıktır. Genellikle
bir sendromun parçasıdır, ancak nadiren izole
olarak ortaya çıkabilir. Oligodonti hastalarında
dişlerin hiç oluşmamasına paralel olarak genellikle
alveolar kretlerde de ciddi atrofiler mevcut
olmaktadır. Dolayısıyla bu hastaların protetik
rehabilitasyonları da klinisyenler için oldukça güç
olabilmektedir. All-on-4 tedavi konsepti, anterior
bölgeye iki adet dik ve posterior bölgeye iki adet
eğimli yerleştirilen, toplam dört implant destekli,
tek parça, tüm ark protez uygulamasını içeren,
tam dişsiz çenelerin sabit protetik rehebilitasyonu
için uygulanan bir tedavi metodudur. Yapılan
çalışmalarda, posterior bölgeye eğimli yerleştirilen
implantların ileri cerrahi işlemlere gerek kalmadan,
anatomik sınırlamalara takılmadan uygulanabildiği,
biyomekanik kuvvetleri daha iyi karşıladığı,
protetik kantilever uzantıların boyutunu azalmasını
sağladığı ve ayrıca başarısızlık oranlarında dik
yerleştirilen implantlarla karşılaştırıldığında
anlamlı bir fark bulunmadığı bildirilmektedir.
Bu olgu sunumunda, maksillada sadece üç dişi
ve mandibulada sadece ön grup dişleri olan 22
yaşındaki erkek hastanın, All-on-4 dental implant
konsepti ile her iki çene için rehabilite edilmesi
sunulmaktadır. Hastanın 2 yıl izleminde herhangi
bir komplikasyon olmadığı ve fizyolojik olarak
kabul edilen periimplant kemik kayıpları dışında
kayıp yaşanmadığı görülmüştür. Bu tedavi
sayesinde tam teşhisi konulamamış bir sendrom
sebebiyle oligodontik olan hastanın fonksiyonel ve
estetik beklentileri yeterince karşılanabilmiştir.

Anahtar Kelimeler

all-on-4, all-on-four, dental implant, oligodonti

Kaynakça

• 1. Branemark PI. Vital microscopy of bone marrow in rabbit. Scand J Clin Lab Invest. 1959; 11 Supp 38: 1-82. 2. Babbush CA, Hahn JA, Krauser JT, Rosenlicht JL. Dental Implants: The Art and Science. 2nd ed: Saunders; 2010. 544 p. 3. Misch CE. Contemporary Implant Dentistry. 3rd ed: Mosby, Elsevier; 2007. 1120 p. 4. Malo P, de Araujo Nobre M, Lopes A, Ferro A, Gravito I. All-on-4(R) Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible: A 7-Year Clinical and 5-Year Radiographic Retrospective Case Series with Risk Assessment for Implant Failure and Marginal Bone Level. Clin Implant Dent Relat Res. 2015; 17 Suppl 2: e531-541. 5. Malo P, de Araujo Nobre M, Lopes A, Francischone C, Rigolizzo M. “All-on-4” immediate-function concept for completely edentulous maxillae: a clinical report on the medium (3 years) and long-term (5 years) outcomes. Clin Implant Dent Relat Res. 2012; 14 Suppl 1: e139-150. 6. Soto-Penaloza D, Zaragozi-Alonso R, Penarrocha-Diago M, Penarrocha-Diago M. The all-on-four treatment concept: Systematic review. J Clin Exp Dent. 2017; 9: e474-e488. 7. Malo P, Rangert B, Nobre M. “All-on-Four” immediate-function concept with Branemark System implants for completely edentulous mandibles: a retrospective clinical study. Clin Implant Dent Relat Res. 2003; 5 Suppl 1: 2-9. 8. Clelland NL, Gilat A, McGlumphy EA, Brantley WA. A photoelastic and strain gauge analysis of angled abutments for an implant system. Int J Oral Maxillofac Implants. 1993; 8: 541-548. 9. Bellini CM, Romeo D, Galbusera F, Agliardi E, Pietrabissa R, Zampelis A, et al. A finite element analysis of tilted versus nontilted implant configurations in the edentulous maxilla. Int J Prosthodont. 2009; 22: 155-157. 10. Baggi L, Pastore S, Di Girolamo M, Vairo G. Implant-bone load transfer mechanisms in complete-arch prostheses supported by four implants: a three-dimensional finite element approach. J Prosthet Dent. 2013; 109: 9-21. 11. Babbush CA, Kanawati A, Kotsakis GA, Hinrichs JE. Patient-related and financial outcomes analysis of conventional full-arch rehabilitation versus the All-on-4 concept: a cohort study. Implant Dent. 2014; 23: 218-224. 12. Malo P, Rangert B, Nobre M. All-on-4 immediate-function concept with Branemark System implants for completely edentulous maxillae: a 1-year retrospective clinical study. Clin Implant Dent Relat Res. 2005; 7 Suppl 1: S88-94. 13. Bural C, Oztas E, Ozturk S, Bayraktar G. Multidisciplinary treatment of non-syndromic oligodontia. Eur J Dent. 2012; 6: 218-226. 14. Chan MH, Holmes C. Contemporary “Allon- 4” concept. Dent Clin North Am. 2015; 59: 421-470. 15. Dhanrajani PJ. Hypodontia: etiology, clinical features, and management. Quintessence Int. 2002; 33: 294-302. 16. Gorlin RJ, Cohen M Jr, L L. Syndromes of the head and neck. 3rd ed. ed. New York: Oxford University Press; 1990. 17. Polder BJ, Van’t Hof MA, Van der Linden FP, Kuijpers-Jagtman AM. A meta-analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol. 2004; 32: 217-226. 18. Jepson NJ, Nohl FS, Carter NE, Gillgrass TJ, Meechan JG, Hobson RS, et al. The interdisciplinary management of hypodontia: restorative dentistry. Br Dent J. 2003; 194: 299-304. 19. Hall RK. Congenitally missing teeth--a diagnostic feature in many syndromes of the head and neck. J Int Assoc Dent Child. 1983; 14: 69-75. 20. Dermaut LR, Goeffers KR, De Smit AA. Prevalence of tooth agenesis correlated with jaw relationship and dental crowding. Am J Orthod Dentofacial Orthop. 1986; 90: 204-210. 21. Kotsiomiti E, Kassa D, Kapari D. Oligodontia and associated characteristics: assessment in view of prosthodontic rehabilitation. Eur J Prosthodont Restor Dent. 2007; 15: 55-60. 22. Bailleul-Forestier I, Berdal A, Vinckier F, de Ravel T, Fryns JP, Verloes A. The genetic basis of inherited anomalies of the teeth. Part 2: syndromes with significant dental involvement. Eur J Med Genet. 2008; 51: 383-408. 23. Prabhu NT, John R, Munshi AK. Rieger’s syndrome: a case report. Quintessence Int. 1997; 28: 749-752. 24. Jumlongras D, Bei M, Stimson JM, Wang WF, DePalma SR, Seidman CE, et al. A nonsense mutation in MSX1 causes Witkop syndrome. Am J Hum Genet. 2001; 69: 67-74. 25. Gurrieri F, Franco B, Toriello H, Neri G. Oral-facial-digital syndromes: review and diagnostic guidelines. Am J Med Genet A. 2007; 143A: 3314-3323. 26. McGovern E, Al-Mudaffer M, McMahon C, Brosnahan D, Fleming P, Reardon W. Oculofacio- cardio-dental syndrome in a mother and daughter. Int J Oral Maxillofac Surg. 2006; 35: 1060-1062. 27. Minic S, Novotny GE, Trpinac D, Obradovic M. Clinical features of incontinentia pigmenti with emphasis on oral and dental abnormalities. Clin Oral Investig. 2006; 10: 343-347. 28. . !!! INVALID CITATION !!! {}. 29. Mostowska A, Kobielak A, Trzeciak WH. Molecular basis of non-syndromic tooth agenesis: mutations of MSX1 and PAX9 reflect their role in patterning human dentition. Eur J Oral Sci. 2003; 111: 365-370. 30. Bellini CM, Romeo D, Galbusera F, Taschieri S, Raimondi MT, Zampelis A, et al. Comparison of tilted versus nontilted implantsupported prosthetic designs for the restoration of the edentuous mandible: a biomechanical study. Int J Oral Maxillofac Implants. 2009; 24: 511-517. 31. Aparicio C, Perales P, Rangert B. Tilted implants as an alternative to maxillary sinus grafting: a clinical, radiologic, and periotest study. Clin Implant Dent Relat Res. 2001; 3: 39-49. 32. Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support. Int J Oral Maxillofac Implants. 2000; 15: 405-414. 33. Malo P, de Araujo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc. 2011; 142: 310-320. 34. Galindo DF, Butura CC. Immediately loaded mandibular fixed implant prostheses using the all-on-four protocol: a report of 183 consecutively treated patients with 1 year of function in definitive prostheses. Int J Oral Maxillofac Implants. 2012; 27: 628-633. 35. Butura CC, Galindo DF, Jensen OT. Mandibular all-on-four therapy using angled implants: a three-year clinical study of 857 implants in 219 jaws. Dent Clin North Am. 2011; 55: 795-811. 36. Babbush CA, Kutsko GT, Brokloff J. The allon- four immediate function treatment concept with NobelActive implants: a retrospective study. J Oral Implantol. 2011; 37: 431-445. 37. Babbush CA, Brokloff J. A single-center retrospective analysis of 1001 consecutively placed NobelActive implants. Implant Dent. 2012; 21: 28-35. 38. Graves S, Mahler BA, Javid B, Armellini D, Jensen OT. Maxillary all-on-four therapy using angled implants: a 16-month clinical study of 1110 implants in 276 jaws. Oral Maxillofac Surg Clin North Am. 2011; 23: 277-287, vi. 39. Chrcanovic BR, Albrektsson T, Wennerberg A. Survival and Complications of Zygomatic Implants: An Updated Systematic Review. J Oral Maxillofac Surg. 2016; 74: 1949-1964. 40. Aparicio C, Manresa C, Francisco K, Claros P, Alandez J, Gonzalez-Martin O, et al. Zygomatic implants: indications, techniques and outcomes, and the zygomatic success code. Periodontol 2000. 2014; 66:41-58.