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

Monday, May 18, 2009

Sindrome de Combinación o de Kelly

el otro dia me llegó una paciente preguntando por implantes, al examinarla me encuentro con el siguiente panorama.....


este es un caso atipico de sindrome de combinación o de kelly, obviamente descrito por el Dr. Kelly hace muchisimos años, la pacte presenta:
1)PPR superior clase IV larguisima (el S de K se presenta típicamente con totales superiores)
2)Remanencia del grupo V, tipicamente el pacte casi no usa la protesis inferior
3)reabsorción osea de la zona de la premaxila el tejido oseo casi inexistente, lo que se ve es ppalmente tejido muy blando
4)exostosis de las tuberosidades producto de la succion producida por el sellado posterior (en este caso inexistente por ser una PPR

estos casos son una pesadilla de rehabilitar por el tejido movil de la premaxila y la reabsorción casi completa del hueso de la premaxila, además de las exostosis oseas de las tuberosidades.

que tal?

29 Comments:

Anonymous cristobal ducci said...

q hizo doc pidio algun examen complementario como scanner o panoramica
eso

12:47 PM

 
Anonymous Anonymous said...

en estos casos que se hace el tejido movil del maxilar....se deja ....se logra algo con acondicionador de tejido..... en fin se hace algo

7:45 PM

 
Blogger tukparra said...

Lamentablemente la paciente no volvio más, hubiese estado entretenido terminarla.
antiguamente se tomaban impresiones con yeso....(se pincelaba el yeso directamente sobre el reborde) la idea es que sea lo más muco estática posible, no sé si yo haría lo mismo, pero definitivamente tomar una impresion lo mas pasiva sobre los tejidos. si el reborde es demasiado hipermovil, tambien sería una posibilidad remodelarlo quirurgicamente.
de requerir implantes, creo que pretender hacer una protesis fija en este maxilar sería una pega un poco titánica, colocaría la mayor cantidad de implantes posibles, (no creo que quepan en la premaxila) y haría una sobredentadura, asi devolver la inmensa cantidad de tejido perdido y por consiguiente la funcion, soporte labial, estética y fonetica, obviamente el diseño y factibilidad debieran evaluarse con examenes complementarios, Pan Rx y conebeam.

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Blogger diplomado said...

Hola Carlos soy Luis (mirodoncia) .Era justamente lo que yo estaba opinando hacerca de ese diagnostico .

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