折叠腓骨瓣修复下颌骨缺损后种植修复的疗效观察

Implant restoration on folded fibular graft for the repair of mandibular defect

目的 探讨折叠腓骨瓣修复下颌骨缺损后行种植修复的治疗要点.方法 纳入2012年3月至2016年7月就诊于郑州大学第一附属医院口腔颌面外科,因下颌骨成釉细胞瘤接受折叠腓骨复合瓣游离移植修复下颌骨缺损重建手术的患者15例,术后6~9个月进行种植修复,3~4个月后进行烤瓷冠修复.结果 所有患者颞下颌关节区域无压痛,开口度为3.1~3.9 cm,咬合关系良好,咀嚼和吞咽功能无明显异常,锥形束CT示种植体骨结合良好,能够正常使用牙间隙刷和冲牙器,均未见明显的种植体周围炎.随访12~48个月种植体全部存留.结论 折叠腓骨修复下颌骨缺损后行种植修复,可以更好地恢复患者的面部外观及口腔重要生理功能.

 Objective To discuss the key points of implant restoration on folded fibular graft for mandibular defect. Methods Fifteen patients with mandibular ameloblastoma were treated by segmental resection of the mandible.The mandibular defect was reconstructed with vascularized folded fibular graft. Implant restoration on the graft was conduced 6-9 months after operation.The results were evaluated. Results All patients had no tenderness in the temporomandibular joint region. The mouth opening reached 3.1-3.9 cm and the occlusion relationship was good. There was no obvious abnormality in masticatory and swallowing function. After 12-48 months of follow-up, the implants were all survived. Conclusions The application of folded fibula for both mandible defect repair and postoperative implant restoration could achieve satisfactory results in restoration of the facial appearance and physiological function of oral cavity.