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

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.

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