血管化髂骨移植同期种植体植入重建上颌骨的初步报道

Maxilla reconstruction with the free iliac osteomuscular flap and simultaneous osseointegrated implant embedding

目的探讨血管化髂骨移植同期种植体植入重建上颌骨的方法。方法2003年9～10月,对2例上颌骨缺损患者行髂骨复合组织瓣重建上颌骨同期骨结合式种植体植入术,其中1例为二期重建,1例为即刻重建。结果2例患者随访8～9个月,上颌骨外形满意,无口鼻漏,语音清晰,完成义齿修复后咀嚼功能恢复良好,咬合关系佳,临床效果满意。结论血管化髂骨移植同期种植体植入修复上颌骨缺损,不仅可以用软组织封闭口鼻漏,口腔上颌窦漏,恢复面部外形,还可以用骨组织重建上颌骨,牙槽骨等结构,同时利用种植体进行修复以恢复咀嚼功能,在上颌骨重建中具有极高的临床应用价值。

Objective\ To evaluate the clinical outcome of reconstruction of maxillary defects with vascularized iliac crest flap and simultaneous osseointegrated implant embedding. Methods\ During September to October 2003, two patients with maxillary defects from tumor resection underwent microsurgical reconstruction. The free iliac osteomuscular flap transferring and simultaneous osseointegrated implant embedding were performed to repair the defects. Three months after the reconstructive surgery, an abutment operation was preformed and denture was applied in both cases. Results\ The flaps survived well. Postoperative follow up for 8 to 9 months showed that the patients obtained good zygomaxillary appearance, normal occlusion, and satisfactory pronunciation, without oronasal fistula or other serious complications. Conclusions\ The free iliac crest osteomuscular flap with simultaneous osseointegrated implant embedding is an ideal, effective and cosmetically acceptable method for maxilla reconstruction.\;