Department of Reconstruction Surgery, Keio University Hospital, Shinanomachi, Tokyo, Japan.
Int J Oral Maxillofac Implants. 2009 Nov-Dec;24(6):999-1005.
Following resection of malignant tumors from the mandible, immediate reconstruction of the discontinuous jaw is commonly performed. The present study aims to define the risks associated with dynamic loading of the reconstructed mandible.
Computer-aided design simulations of eight mandibles were produced and termed normal models. The normal models were then modified by removing part of the right body and restoring the defects with bone from the rib or fibula. These modified models were termed reconstructed models. Thereafter, an implant was embedded in the first molar region of the left side for all models. Using finite element analysis, the stresses occurring at the implant-bone interface with simulated mastication were calculated. The Wilcoxon signed rank test was applied to compare the magnitudes of stresses in both models.
In terms of the stress exerted at the implant-bone interface during mastication, the normal models and the reconstructed models showed no significant differences (P > .05).
Placement of an implant on the nonreconstructed side following partial resection and mandibular reconstruction presents no significant risk.
下颌骨恶性肿瘤切除后,通常立即进行不连续颌骨的重建。本研究旨在确定重建下颌骨动态加载相关的风险。
制作了 8 个下颌骨的计算机辅助设计模拟,并将其命名为正常模型。然后通过去除右侧体部并使用肋骨或腓骨的骨来修复缺陷来修改正常模型。这些修改后的模型被称为重建模型。此后,所有模型的左侧第一磨牙区域均嵌入植入物。使用有限元分析,计算了模拟咀嚼时发生在种植体-骨界面的应力。应用 Wilcoxon 符号秩检验比较两种模型的应力大小。
在咀嚼过程中种植体-骨界面上的应力方面,正常模型和重建模型之间无显著差异(P>0.05)。
在部分切除和下颌骨重建后,在非重建侧植入种植体不会带来显著风险。