Shokfi T,Stahl LE,Kanekar SG,et a1.Osseouschanges over time in free fibular flap reconstruction.Laryngoscope,2018Oct.目的:评估游离腓骨移植物中的骨吸收.记录与有牙和无牙颌自体下颌骨相比的再吸收特征。方法:术后CT图像用于...Shokfi T,Stahl LE,Kanekar SG,et a1.Osseouschanges over time in free fibular flap reconstruction.Laryngoscope,2018Oct.目的:评估游离腓骨移植物中的骨吸收.记录与有牙和无牙颌自体下颌骨相比的再吸收特征。方法:术后CT图像用于评估腓骨移植物吸收率以及有牙或无牙颌下颌骨的相应部位,测量骨高度、宽度和皮质厚度。结果:18例患者在切除原发性头颈癌后接受了腓骨游离瓣重建术。使用Jewer分类对下颌骨缺损进行分类。腓骨瓣的骨高度平均损失为0.23±0.09mm/年;有牙的下颌骨,平均损失为0.55±0.13mm/年;无牙下颌骨的平均损失为0.98±0.41mm/年。骨宽度的变化分别为0.19±0.08mm/年、0.55q±0.33mm/年、和0.73±0.15mm/年。腓骨瓣、牙列和无牙颌组织的皮质下吸收率分别为0.33±O.34mm/年、0.35±0.13mm/年和0.53±0.11mm/年.皮质上吸收率分别为0.30±0.11mm/年、0_35±0.08mm/年和0.51±0.08mm/年。结论:腓骨游离瓣重建下颌骨提供了极好的功能结果.并且可以获得长期稳定性。与无牙和有牙下颌骨相比,腓骨移植物的骨吸收明显较低。与有牙下颌骨相比,无牙下颌骨的萎缩率显著增加,这可能对腓骨瓣和天然下颌骨的长期生存能力产生影响。牙修复对整体骨质稳定性的作用值得进一步研究。展开更多
Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modem surgery...Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modem surgery has developed more effective techniques, including no vascularized bone grafts, better alloplastic materials, vascularized loco regional grafts, soft and hard tissue compounds, bone fixation and stretching materials, and mechanisms for study models. These components have become indispensable in the surgeon＇s arsenal with regard to reconstructive surgery. A gold standard for mandibular bone reconstruction is the use of autogenous grafts. The objective of this study was to describe a clinical case of mandibular reconstruction with autogenous graft associated with adjuvant hyperbaric oxygen therapy. The clinical case presented shows the treatment performed for after-effects correction due to the non-consolidation of sagittal mandibular osteotomy performed for correction of standard III dentofacial deformity, resulting in a pseudoarthrosis with bite deviation and facial asymmetry. As a treatment plan, mandibular reconstruction was instituted with autogenous graft of anterior iliac crest associated with the use prototyping biomodel and hyperbaric oxygen therapy. After a control of 1 year and 6 months, no signs of recurrence were identified and the radiographic image showed excellent positioning, good volume and maintenance of the mandibular contour.展开更多
文摘Shokfi T,Stahl LE,Kanekar SG,et a1.Osseouschanges over time in free fibular flap reconstruction.Laryngoscope,2018Oct.目的:评估游离腓骨移植物中的骨吸收.记录与有牙和无牙颌自体下颌骨相比的再吸收特征。方法:术后CT图像用于评估腓骨移植物吸收率以及有牙或无牙颌下颌骨的相应部位,测量骨高度、宽度和皮质厚度。结果:18例患者在切除原发性头颈癌后接受了腓骨游离瓣重建术。使用Jewer分类对下颌骨缺损进行分类。腓骨瓣的骨高度平均损失为0.23±0.09mm/年;有牙的下颌骨,平均损失为0.55±0.13mm/年;无牙下颌骨的平均损失为0.98±0.41mm/年。骨宽度的变化分别为0.19±0.08mm/年、0.55q±0.33mm/年、和0.73±0.15mm/年。腓骨瓣、牙列和无牙颌组织的皮质下吸收率分别为0.33±O.34mm/年、0.35±0.13mm/年和0.53±0.11mm/年.皮质上吸收率分别为0.30±0.11mm/年、0_35±0.08mm/年和0.51±0.08mm/年。结论:腓骨游离瓣重建下颌骨提供了极好的功能结果.并且可以获得长期稳定性。与无牙和有牙下颌骨相比,腓骨移植物的骨吸收明显较低。与有牙下颌骨相比,无牙下颌骨的萎缩率显著增加,这可能对腓骨瓣和天然下颌骨的长期生存能力产生影响。牙修复对整体骨质稳定性的作用值得进一步研究。
文摘Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modem surgery has developed more effective techniques, including no vascularized bone grafts, better alloplastic materials, vascularized loco regional grafts, soft and hard tissue compounds, bone fixation and stretching materials, and mechanisms for study models. These components have become indispensable in the surgeon＇s arsenal with regard to reconstructive surgery. A gold standard for mandibular bone reconstruction is the use of autogenous grafts. The objective of this study was to describe a clinical case of mandibular reconstruction with autogenous graft associated with adjuvant hyperbaric oxygen therapy. The clinical case presented shows the treatment performed for after-effects correction due to the non-consolidation of sagittal mandibular osteotomy performed for correction of standard III dentofacial deformity, resulting in a pseudoarthrosis with bite deviation and facial asymmetry. As a treatment plan, mandibular reconstruction was instituted with autogenous graft of anterior iliac crest associated with the use prototyping biomodel and hyperbaric oxygen therapy. After a control of 1 year and 6 months, no signs of recurrence were identified and the radiographic image showed excellent positioning, good volume and maintenance of the mandibular contour.
