2017 Volume 16 Issue 2 Pages 57-68
The combination of dental injuries and oral-maxillofacial trauma is common in the field of maxillofacial emergencies. Traumatic injuries can cause anatomic deficiencies in both soft and hard tissues, often resulting in the loss of attached mucosa and severe boney alveolar processes, with a loss of teeth and supporting structures. These sequelae can complicate the potential prosthetic management of functional and esthetic dental implant rehabilitation, rendering use of a top-down, restorative dental implant in comprehensive maxillofacial trauma management and care difficult. These patients require various boney regenerative treatments, including pre-implant bone augmentation surgery (e.g., bone grafting, guided bone regeneration, and distraction), followed by further soft-tissue surgery (e.g., gingival grafting with vestibuloplasty) to achieve a positive long-term prognosis and stable management. Thus, it is important to adopt a prosthetic oral rehabilitation strategy that involves functional and esthetic dental implant treatment for these oral maxillofacial trauma patients to improve their prognosis. The appropriate treatment for such patients is intense, and we routinely promote and endorse the following for functional and esthetic oral rehabilitation using dental implants: 1) A multidisciplinary approach by a team consisting of professionals in various fields, such as dentistry and oral-maxillofacial surgery, as well as dental hygienists specializing in perio-oral implant maintenance care. 2) The use of three-dimensionally sufficient boney pre-implant augmentative regeneration based on various regenerative augmentation techniques. 3) Implant soft-tissue care, including keratinized gingival grafting with vestibuloplasty management and regular follow ups for maintenance. 4) Precise, safe, and minimally invasive computer-assisted oral-maxillofacial regenerative and implant surgery. This clinical report describes the comprehensive oral-maxillofacial trauma management and care approach we adopt for primary maxillofacial emergencies involving functional and esthetic oral rehabilitation using dental implants.
