Multiprofessional approach for class III malocclusion rehabilitation with autogenous calvarial bone graft followed by Le Fort 1 osteotomy and implant-supported prostheses – case report
DOI:
https://doi.org/10.33448/rsd-v10i7.16276Keywords:
Dental Implants; Implant-Supported Dental Prosthesis; Mouth Rehabilitation; Bone Grafting; Orthognathic Surgery; Classe III de Angle.Abstract
Extensive treatments can eventually be challenging. Even more so when the patient has limitations such as extensive tooth loss and skeletal changes, including overgrowth of the lower jaw. When indicated, these treatments tend to discourage patients due to the history of previous failures. Therefore, in addition to an interdisciplinary dental team composed of oral and maxillofacial surgeons, and prosthodontists, a nutrologist, a speech therapist, and a psychotherapist were involved in the treatment of this case. A 52-year-old female patient, Angle Class III malocclusion, with few teeth and extensive maxillary bone loss, attended the dental clinic of the Brazilian Association of Dentistry in Uberlândia. The treatment involved reverse planning, extraction of the dental remnants, calvarial bone grafting, placement of 6 titanium implants (Neodent) in the maxilla (upper jaw) and 5 in the mandible (lower jaw), orthognathic surgery, and installation of implant-supported fixed complete dentures in both jaws. Furthermore, psychotherapeutic and nutrologist’s interventions were necessary during the dental treatment, concluding the treatment with speech therapy. Within the limitations of this case, the multidisciplinary approach proved to be efficient. It promoted the reestablishment of the stomatognathic system functions without compromising nutrition during the periods when it was impossible to wear prostheses for better healing of the tissues.
References
Aloy-Prosper, A., Penarrocha-Oltra, D., Penarrocha-Diago, M., & Penarrocha-Diago, M. (2015). The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: a systematic review. Med Oral Patol Oral Cir Bucal, 20(2), e251-258. https://doi.org/10.4317/medoral.20194
Benech, A., Mazzanti, C., Arcuri, F., Giarda, M., & Brucoli, M. (2011). Simultaneous Le Fort I osteotomy and computer-guided implant placement. J Craniofac Surg, 22(3), 1042-1046. https://doi.org/10.1097/SCS.0b013e318210765d
Bitiniene, D., Zamaliauskiene, R., Kubilius, R., Leketas, M., Gailius, T., & Smirnovaite, K. (2018). Quality of life in patients with temporomandibular disorders. A systematic review. Stomatologija, 20(1), 3-9. https://www.ncbi.nlm.nih.gov/pubmed/29806652
Brandini, D. A., Amaral, M. F., Poi, W. R., Casatti, C. A., Bronckers, A. L., Everts, V., & Beneti, I. M. (2016). The effect of traumatic dental occlusion on the degradation of periodontal bone in rats. Indian J Dent Res, 27(6), 574-580. https://doi.org/10.4103/0970-9290.199600
Branemark, P. I., Hansson, B. O., Adell, R., Breine, U., Lindstrom, J., Hallen, O., & Ohman, A. (1977). Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl, 16, 1-132. https://www.ncbi.nlm.nih.gov/pubmed/356184
Cawood, J. I., & Howell, R. A. (1988). A classification of the edentulous jaws. Int J Oral Maxillofac Surg, 17(4), 232-236. https://doi.org/10.1016/s0901-5027(88)80047-x
Chiapasco, M., Brusati, R., & Ronchi, P. (2007). Le Fort I osteotomy with interpositional bone grafts and delayed oral implants for the rehabilitation of extremely atrophied maxillae: a 1-9-year clinical follow-up study on humans. Clin Oral Implants Res, 18(1), 74-85. https://doi.org/10.1111/j.1600-0501.2006.01287.x
de Avila, E. D., de Barros, L. A., Del'Acqua, M. A., Nogueira, S. S., & de Assis Mollo, F., Jr. (2014). Eight-year follow-up of a fixed-detachable maxillary prosthesis utilizing an attachment system: clinical protocol for individuals with skeletal class III malocclusions. J Oral Implantol, 40(3), 307-312. https://doi.org/10.1563/AAID-JOI-D-11-00195
de Avila, E. D., de Molon, R. S., Loffredo, L. C., Massucato, E. M., & Hochuli-Vieira, E. (2013). Health-related quality of life and depression in patients with dentofacial deformity. Oral Maxillofac Surg, 17(3), 187-191. https://doi.org/10.1007/s10006-012-0338-5
De Santis, D., Trevisiol, L., D'Agostino, A., Cucchi, A., De Gemmis, A., & Nocini, P. F. (2012). Guided bone regeneration with autogenous block grafts applied to Le Fort I osteotomy for treatment of severely resorbed maxillae: a 4- to 6-year prospective study. Clin Oral Implants Res, 23(1), 60-69. https://doi.org/10.1111/j.1600-0501.2011.02181.x
Ferri, J., Dujoncquoy, J. P., Carneiro, J. M., & Raoul, G. (2008). Maxillary reconstruction to enable implant insertion: a retrospective study of 181 patients. Head Face Med, 4, 31. https://doi.org/10.1186/1746-160X-4-31
Frejman, M. W., Vargas, I. A., Rosing, C. K., & Closs, L. Q. (2013). Dentofacial deformities are associated with lower degrees of self-esteem and higher impact on oral health-related quality of life: results from an observational study involving adults. J Oral Maxillofac Surg, 71(4), 763-767. https://doi.org/10.1016/j.joms.2012.08.011
Gil, J. N., Claus, J. D., Campos, F. E., & Lima, S. M., Jr. (2008). Management of the severely resorbed maxilla using Le Fort I osteotomy. Int J Oral Maxillofac Surg, 37(12), 1153-1155. https://doi.org/10.1016/j.ijom.2008.10.003
Gondivkar, S. M., Gadbail, A. R., Gondivkar, R. S., Sarode, S. C., Sarode, G. S., Patil, S., & Awan, K. H. (2019). Nutrition and oral health. Dis Mon, 65(6), 147-154. https://doi.org/10.1016/j.disamonth.2018.09.009
Jacobson, N., & Starr, C. (2008). Implant-supported rehabilitation of severe malocclusion due to unilateral condylar hypoplasia: case report. J Oral Implantol, 34(2), 90-96. https://doi.org/10.1563/1548-1336(2008)34[90:IROSMD]2.0.CO;2
Keller, E. E., Tolman, D. E., & Eckert, S. (1999). Surgical-prosthodontic reconstruction of advanced maxillary bone compromise with autogenous onlay block bone grafts and osseointegrated endosseous implants: a 12-year study of 32 consecutive patients. Int J Oral Maxillofac Implants, 14(2), 197-209. https://www.ncbi.nlm.nih.gov/pubmed/10212536
Khan, S. U., Ghani, F., & Nazir, Z. (2018). The effect of some missing teeth on a subjects' oral health related quality of life. Pak J Med Sci, 34(6), 1457-1462. https://doi.org/10.12669/pjms.346.15706
Kurahashi, M., Kondo, H., Iinuma, M., Tamura, Y., Chen, H., & Kubo, K. Y. (2015). Tooth loss early in life accelerates age-related bone deterioration in mice. Tohoku J Exp Med, 235(1), 29-37. https://doi.org/10.1620/tjem.235.29
Ohba, S., Nakatani, Y., Kawasaki, T., Tajima, N., Tobita, T., Yoshida, N., Sawase, T., & Asahina, I. (2015). Oral Rehabilitation With Orthognathic Surgery After Dental Implant Placement for Class III Malocclusion With Skeletal Asymmetry and Posterior Bite Collapse. Implant Dent, 24(4), 487-490. https://doi.org/10.1097/ID.0000000000000279
Pieri, F., Lizio, G., Bianchi, A., Corinaldesi, G., & Marchetti, C. (2012). Immediate loading of dental implants placed in severely resorbed edentulous maxillae reconstructed with Le Fort I osteotomy and interpositional bone grafting. J Periodontol, 83(8), 963-972. https://doi.org/10.1902/jop.2012.110460
Rasmusson, L., Thor, A., & Sennerby, L. (2012). Stability evaluation of implants integrated in grafted and nongrafted maxillary bone: a clinical study from implant placement to abutment connection. Clin Implant Dent Relat Res, 14(1), 61-66. https://doi.org/10.1111/j.1708-8208.2010.00239.x
Ribeiro-Junior, P. D., Padovan, L. E., Goncales, E. S., & Nary-Filho, H. (2009). Bone grafting and insertion of dental implants followed by Le Fort advancement for correction of severely atrophic maxilla in young patients. Int J Oral Maxillofac Surg, 38(10), 1101-1106. https://doi.org/10.1016/j.ijom.2009.06.004
Saber, A. M., Altoukhi, D. H., Horaib, M. F., El-Housseiny, A. A., Alamoudi, N. M., & Sabbagh, H. J. (2018, Apr 5). Consequences of early extraction of compromised first permanent molar: a systematic review. Retrieved 1 from https://www.ncbi.nlm.nih.gov/pubmed/29622000
Sbordone, L., Toti, P., Menchini-Fabris, G. B., Sbordone, C., Piombino, P., & Guidetti, F. (2009). Volume changes of autogenous bone grafts after alveolar ridge augmentation of atrophic maxillae and mandibles. Int J Oral Maxillofac Surg, 38(10), 1059-1065. https://doi.org/10.1016/j.ijom.2009.06.024
Soehardi, A., Meijer, G. J., Hoppenreijs, T. J., Brouns, J. J., de Koning, M., & Stoelinga, P. J. (2015). Stability, complications, implant survival, and patient satisfaction after Le Fort I osteotomy and interposed bone grafts: follow-up of 5-18 years. Int J Oral Maxillofac Surg, 44(1), 97-103. https://doi.org/10.1016/j.ijom.2014.06.002
Varol, A., Atali, O., Sipahi, A., & Basa, S. (2016). Implant Rehabilitation for Extremely Atrophic Maxillae (Cawood Type VI) with Le Fort I Downgrafting and Autogenous Iliac Block Grafts: A 4-year Follow-up Study. Int J Oral Maxillofac Implants, 31(6), 1415-1422. https://doi.org/10.11607/jomi.4740
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Copyright (c) 2021 Paulo Sérgio Borella; Júlio César de Carvalho Alves; Larissa Ayres Scagliarini Alvares; Áquila Valente de Souza; Karoline Ferreira da Mota; Sérgio Antônio Araújo Costa; Karla Zancopé; Marcel Santana Prudente; Flávio Domingues das Neves
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