下颌骨纤维骨性病变致种植失败一例及文献回顾

Implant failure caused by mandible fibro-osseous lesions:a case report and the literature review

本文报道一例同期于患者双侧下颌后牙区各植入一颗种植体,6个月后右侧种植体骨结合失败、松动取出,左侧种植体骨结合良好,常规修复并负荷。术后回顾分析发现该病例右侧下颌后牙区骨内存在影像学表现不明显的纤维骨性病变,并最终通过组织病理学检查确诊。颌骨纤维骨性病变主要是指一类在组织形态学上表现为纤维和骨化的混合性病变,这类病变临床及影像学表现往往不明显,难以发现;或者与其他疾病表现相似,鉴别困难。本文通过对该病例失败原因进行分析,对颌骨纤维骨性病变临床、影像学及组织病理学的特征等进行相关文献回顾和讨论,以期为临床提供纤维骨性病变种植风险评估预警。

A case of implanting in the bilateral mandibular posterior area simultaneously with different prognosis was reported.Finally,the implant on the right side was loose and removed after six months,which was failed without osseointegration.Otherwise,a good osseointegration was formed on the left side,and the implant was loaded routinely.In the right mandibular posterior area,there were fibro-osseous lesions with unremarkable imaging findings,which were finally diagnosed by histopathology.Mandible fibro-osseous lesions mainly refer to a mixture of pathological changes of fibrosis and ossification in technology.The performance of such lesions is not obvious or present with similar symptoms and radiographic appearances,which lead to difficulties in diagnosis.In this article,the causes of failure in this case were analyzed.Furthermore,the features of ossifying fibroma and fibrous dysplasia in clinical manifestation,radiology,histopathology and so on were reviewed in this article,in order to provide a risk assessment and early warning of implants with fibro-osseous lesions for clinic.