Schoen P J, Raghoebar G M, van Oort R P, Reintsema H, van der Laan B F, Burlage F R, Roodenburg J L, Vissink A
Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthetics, Groningen University Hospital, Groningen, The Netherlands.
Cancer. 2001 Dec 15;92(12):3045-50. doi: 10.1002/1097-0142(20011215)92:12<3045::aid-cncr10147>3.0.co;2-k.
Percutaneous endosseous implants have acquired an important place in the prosthetic rehabilitation of patients with craniofacial defects. The objective of this study was to evaluate the clinical outcome of the use of endosseous implants in the orbital and auricular region as well as to assess the satisfaction of patients with implant-retained craniofacial prostheses after tumor surgery.
The clinical outcome and patient satisfaction of implant-retained prostheses in the auricular and orbital region were evaluated in a group of 26 patients with facial defects after tumor surgery by using standardized questionnaires and a clinical assessment. Twelve patients (n = 31 implants) received the implants during ablative tumor surgery, from which 7 patients (n = 20 implants) were treated with radiation therapy after surgery (mean, 65 grays [Gy]). Fourteen patients (n = 44 implants) received the implants after the tumor surgery, from which 5 patients (n = 21 implants) were irradiated after ablative surgery (mean, 54.4 Gy), but before implant placement.
No implants were lost in patients who had not undergone irradiation (100%), whereas 5 implants were lost in the irradiated group (87.8%). The overall implant survival rate was 93.3%. The peri-implant tissues had a healthy appearance, and no cases of osteoradionecrosis occurred. When compared with patients treated with conventional adhesive retained facial prostheses, satisfaction was higher in patients treated with implant-retained facial prostheses.
From this study, it is concluded that implant-retained facial prostheses are better tolerated than adhesive retained prostheses and offer an improvement in the quality of life. Radiotherapy is not a contraindication for the use of osseointegrated implants in the maxillofacial region, but the loss of implants is higher than in nonirradiated sites.
经皮骨内植入物在颅面缺损患者的修复重建中占据重要地位。本研究的目的是评估骨内植入物在眼眶和耳部区域使用的临床效果,并评估肿瘤手术后使用植入物固位的颅面假体患者的满意度。
采用标准化问卷和临床评估,对一组26例肿瘤手术后面部缺损患者的耳部和眼眶区域植入物固位假体的临床效果和患者满意度进行评估。12例患者(共31枚植入物)在肿瘤切除术中植入植入物,其中7例患者(共20枚植入物)术后接受放射治疗(平均剂量65戈瑞[Gy])。14例患者(共44枚植入物)在肿瘤手术后植入植入物,其中5例患者(共21枚植入物)在切除术后(平均剂量54.4 Gy)但在植入物放置前接受放射治疗。
未接受放疗的患者中无植入物丢失(100%),而放疗组有5枚植入物丢失(87.8%)。总体植入物存活率为93.3%。种植体周围组织外观健康,未发生骨放射性坏死病例。与使用传统粘贴式面部假体治疗的患者相比,使用植入物固位面部假体治疗的患者满意度更高。
从本研究得出结论,植入物固位的面部假体比粘贴式假体耐受性更好,生活质量得到改善。放疗并非上颌面部骨整合植入物使用的禁忌症,但植入物丢失率高于未放疗部位。