Toljanic Joseph A, Eckert Steven E, Roumanas Eleni, Beumer John, Huryn Joseph M, Zlotolow Ian M, Reisberg David J, Habakuk Susan W, Wright Robert F, Rubenstein Jeffrey E, Schneid Thomas R, Mullasseril Paul, Garcia Lily T, Bedard Jean-Francois, Choi Yong-Geun
Section of Dentistry, University of Chicago, Chicago, IL, USA.
J Prosthet Dent. 2005 Aug;94(2):177-82. doi: 10.1016/j.prosdent.2005.04.016.
Since their introduction, craniofacial implants have been used in prosthetic rehabilitation of facial defects. The literature, however, indicates marked variability in outcomes using implants for the retention of orbital prostheses.
A multicenter report updating the experience in the United States with the use of craniofacial implants for prosthetic rehabilitation of orbital defects is presented.
Surveys were sent to clinicians at 25 centers where maxillofacial prosthetic treatment is provided to obtain retrospective data regarding patients who completed implant-retained orbital prosthetic rehabilitation. Data on implant placement location, radiation treatment history, and use of hyperbaric oxygen therapy were collected and assessed in relationship to implant survival over time. The Kaplan-Meier life table and Wilcoxon analyses (alpha = .05) were used to assess the significance of the findings.
Ten centers responded, providing data suitable for statistical analysis on 153 implants placed to retain 44 orbital prostheses and followed for a mean period of 52.6 months. Forty-one implant integration failures occurred during this follow-up period, resulting in an overall integration survival rate of 73.2%. No significant relationship was found between radiation treatment history, hyperbaric oxygen therapy history, or implant placement location and implant survival. Individual responses revealed large variability between reporting centers in treatment outcomes.
Craniofacial implants may offer marked benefits in the prosthetic rehabilitation of orbital defects when compared to conventional adhesive retention designs. However, questions remain regarding long-term predictability and the impact specific factors may have on treatment outcomes. Insufficient data is currently available from which to draw statistically meaningful conclusions. The establishment of a national database designed to acquire adequate data to assess treatment outcomes is recommended.
自引入以来，颅面植入物已用于面部缺损的修复康复。然而，文献表明，使用植入物来固定眼眶假体的效果存在显著差异。
本文呈现一份多中心报告，更新美国使用颅面植入物进行眼眶缺损修复康复的经验。
向25个提供颌面修复治疗的中心的临床医生发送调查问卷，以获取关于完成植入物固定眼眶假体修复康复患者的回顾性数据。收集并评估植入物放置位置、放射治疗史和高压氧治疗使用情况等数据与植入物随时间的存活情况之间的关系。采用Kaplan-Meier生存表和Wilcoxon分析（α = 0.05）来评估研究结果的显著性。
10个中心做出回应，提供了适用于统计分析的153枚用于固定44个眼眶假体的数据，平均随访期为52.6个月。在此随访期间发生了41次植入物整合失败，总体整合存活率为73.2%。未发现放射治疗史、高压氧治疗史或植入物放置位置与植入物存活之间存在显著关系。个别回复显示，报告中心之间的治疗结果存在很大差异。
与传统的粘合剂固定设计相比，颅面植入物在眼眶缺损的修复康复中可能具有显著优势。然而，关于长期可预测性以及特定因素对治疗结果的影响仍存在疑问。目前可获得的数据不足，无法得出具有统计学意义上的结论。建议建立一个旨在获取足够数据以评估治疗结果的国家数据库。
