植體種類－勤美悠植牙醫診所

植牙的想法與概念並不是近幾年才有

早在1910年代就想出一些辦法來解決缺牙的痛苦

如下圖全口缺牙的患者活動假牙直接壓在牙肉上

沒甚麼固著力假牙易鬆脫

所以就想盡辦法加上金屬架來當作假牙的支撐

因此設計出各種不同的植體

從古至今植牙的方式與種類有若干演進

今就植體的種類概略說明....

最早在 1913年 Greenfild 就提出以金屬為材料

做成"籃狀"植體(hollow basket) 埋入骨內來支撐假牙的構想...

1940 以後植體種類大致分為三類

Subperiosteal Implant (骨膜下植體)

Transosseous Implant (穿骨植體)

Endosseous Implant (骨內植體)

Subperiosteal Implant(骨膜下植體)

1940年代由Dahl, Goidberg&Gershkoff 所提出發展而來

主要是針對全口無牙的病患(Totally edentulous mandible & maxilla)所設計

全口無牙的患者配戴活動假牙時因沒有固著假牙容易”鬆脫”

所以他們就想以手術方式在顎骨上加上一個金屬架以”抓住”活動假牙

多用在顎骨嚴重萎縮 (advanced bone loss )的患者

以鈷-鉻-鉬(C0-Cr-Mo)或氧化鋁(Aluminum oxide)為材料

做成支架跨在顎骨上以骨膜包覆之(所以稱為”骨膜下植體”)

作為支撐假牙的金屬架

但效果並不好支撐力道不盡理想

術後腫脹發炎較嚴重

戴上假牙後疼痛比例高 (Post-insertion Dysesthesia)

而且容易造成下齒槽神經的撕裂(Laceration of the mandibular nerve)

成功率較低所以現在比較少有人用此方法來重建咬合

有興趣的人可參考2007 德國Zwerger S 等人所發表的相關文章…

[Long-term results of fittig subperiosteal implants: report of twelve patient cases].

Zwerger S, Abu-Id MH, Kreusch T.

Source

Asklepios Klinik Nord, Heidberg, Mund-, Kiefer- und Gesichtschirurgie, Tangstedter Landstr. 400, Hamburg 22417, Germany. stefan.zwerger@k-nord.lbk-hh.de

Abstract

The subperiosteal dental implantation implant was orginally described in the 1940s. The inadequate long-term results of subperiosteal implants are in contrast to the excellent results documented for endosseus oral implants. Consequently, subperiosteal implants and other soft-tissue-anchored implants should not be used presently. The present report documented twelve patient cases with complications after treatment with subperiosteal implants. Typical complications of SI are implant exposure, inflammation, infection, fistula formation and implant mobility. After removing the SI severe atrophic bone was seen. The placement of osseointegrated oral implants was mostly not possible without autogenous bone grafting. The present report is in conclusion with other studies, that a regular control of patients with subperiosteal implants is necessary. Subperiosteal implants should definitely be removed, if continuous periods of complication occur. The complete oral rehabilitation requires further surgical treatment in the field of preprosthetic surgery.

Transosseous Implant(穿骨植體)