摘要
目的:评价采用多种骨瓣进行功能性颌骨重建的临床效果。方法:61例颌骨缺损患者,首先应用多种骨瓣重建颌骨的连续性,然后植入骨结合种植体,利用种植义齿重建患者的咀嚼和发音功能。61例患者中,男39例,女22例,平均年龄48岁(20～61岁)。游离髂骨瓣32例,血管化腓骨瓣21例,单纯牵引成骨重建颌骨7例,其他骨瓣1例。共植入种植体247颗。种植固定义齿修复29例,种植体支持的活动义齿修复32例。结果:种植义齿修复完成后平均追踪49个月(6～114个月),种植体脱落6颗。1例患者在修复完成2年后因肿瘤复发死亡(含4颗种植体,不计入存活种植体)。至最后复查,共237颗种植体仍在行使功能,累计5年存活率为95.95%。结论:应用游离髂骨瓣、血管化腓骨瓣重建颌骨的连续性后,植入骨结合种植体,能够有效地重建患者的咀嚼、发音功能,近期效果满意。
PURPOSE： To evaluate the clinical result of functional reconstruction of the maxilla and mandible using various free or revascularized osteous flaps. METHODS： From 1996 to 2004, 61 patients with maxillary or mandibular defects, including 39 males and 22 females with an average age of 48 years （ranged from 20 to 61 years）, underwent functional reconstruction with dental implants in Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University. The continuity of the jaws was first reconstructed by various bone grafts, then dental implants were placed in the secondary stage. Chewing and phonetic function was reconstructed through implant restoration several months later. As for bone grafts, free iliac crest grafts were transplanted in 32 cases, revascularized fibular flaps in 21 cases, distraction osteogenesis alone for jaw reconstruction in 7 cases, and other bone graft in 1 case. Totally 247 dental implants were placed. Implant-supported fixed prostheses were restored in 29 cases, and implant-supported removable prostheses in 32 cases. RESULTS： After dental prostheses delivered, all the patients were followed up for 6 to 114 months, with a mean time of 49 months. 6 implants were lost, one patient died of tumor recurrence 2 years after dental implant restoration （with 4 implants）. Until the last recall, 237 implants survived with function. The 5-year survive rate was 95.95%. CONCLUSIONS： Based on the study, the maxilla and mandible could be functionally reconstructed through dental implants that were placed on the grafts. Vertical distraction osteogenesis could improve the vertical bone deficiency of bone grafts. Periimplant soft tissue reconstruction is necessary in most cases with bone grafts.
出处
《中国口腔颌面外科杂志》
CAS
2006年第1期14-19,共6页
China Journal of Oral and Maxillofacial Surgery
