Blog del Dr. Carlos Parra Atala, Especialísta en rehabilitación Oral, Fellow en Implantología de la Universidad de Pittsburgh. lugar de discusion y presentacion de casos clinicos e información referente a Rehabilitación Oral e Implantología

Tuesday, March 24, 2009

caso clinico.... pinchen las fotos para verlas en grande



































































ya chicos, aca les mando un caso clinico a ver que opinan...











Sergio Diaz, 61 años
Lista de Problemas:
1) Dabético insulino dependiente, por cirugía Pancreatica
2) Hipertensión Arterial controlada
3) Depresión hace 1 año
4) Farmacos: Enalapril, aspirina 100, amitriptilina, lovastatina, metformina, insulina (cristales)
Problemas Odontológicos:
1) desdetnado parcial superior III 3, inferior clase I
2) portador de protesis removible en mal estado
3) Pérdida de DVO aprox 2 mm.
4) inestabilidad Oclusal
5) Plano oclusal inferior y superior alterados
6) Anfracciones cervicales y atrición del grupo II y V
7) Policaries, Polirestauraciones (defectuosas)
8) Reabsorción Osea Marginal Moderada generalizada

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10 Comments:

Blogger Cristobal said...

aca va mi humilde opinion, primero que nada creo que se debe realizar un tto periodontal y exodoncia de pza de mal pronostico como la 15 (o 16) y premolares inferiores que por lo que se ve en la rx tienen gran perdida osea y la 15 esta fuera del plano, no se comenta nada en los datos del pcte sobre estas pzas me imagino que deben tener una movilidad considerable, luego de esto se debe devolver la dimension vertical en base a provisorios en las pzas del grupo 2 y ppr sup e inf una vez lograda la nueva dv y teniendo al pcte ya estabilizado y devuelta su funcion oclusal es el momento de decidir el tipo de rehabilitacion que se realizara, pfp en sector anterosuperior y ppr sup e inf o en base a implantes para devolver mesa oclusal posterior sup e inf, en mi opinion un pcte diabetico controlado no tiene contraindicaciones para la cirugia de implantes teniendo un bateria de examenes complementarios como hemoglobina glicosilada e interconsulta con pase del diabetologo, pero por otro lado a un pcte con depresion no se si es candidato para un tto de esa envergadura y tan largo.
yo creo que teniendo claro que hay q devolver la dv, dar estabilidad oclusal y devolver funcion a las pzas dentarias ya el tipo de tto que se realice para lograrlo no importa mucho, mientras se logren esos objetivos

saludos

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