Meloni S M, De Riu G, Pisano M, Massarelli O, Tullio A
Maxillofacial Surgery Unit, University Hospital of Sassari, Italy.
Br J Oral Maxillofac Surg. 2012 Dec;50(8):726-31. doi: 10.1016/j.bjoms.2011.12.006. Epub 2012 Jan 11.
Continuity defects in bone after resection of the jaw may cause problems, and osseo-myocutaneous free flaps are the gold standard for their reconstruction. Implant-supported prosthetic rehabilitation is reliable with these microvascular options, although it is still a serious challenge. The aim of this prospective clinical study was to describe the advantages of implants restored according to a computer-assisted surgical protocol. A group of 10 consecutive patients (both sexes) had already been treated and followed up for at least 1 year after prosthetic loading. The NobelGuide protocol had to be modified to adapt the technique for these patients who had had reconstructions. A total of 56 fixtures were installed and, when possible, immediately loaded (overall survival of implants 95%). Every patient was given correct provisional prosthetic rehabilitation, which was most satisfactory as far as chewing, social functioning, and overall quality of life were concerned. Three-dimensional computed tomographic (CT) examination showed a mean (SD) marginal bone loss of 1.06 (0.5)mm. We used a modified technique of computer-assisted implant surgery in jaws that had been reconstructed with free flaps; from these preliminary findings this approach seems valid when it comes to function, improving prosthetic restoration, and aesthetics.
颌骨切除术后骨的连续性缺损可能会引发问题,而骨肌皮游离皮瓣是其重建的金标准。尽管仍然是一项严峻挑战,但对于这些微血管修复选择而言,种植体支持的修复性康复是可靠的。这项前瞻性临床研究的目的是描述根据计算机辅助手术方案进行种植体修复的优势。一组连续的10例患者(男女均有)在修复体加载后已接受治疗并随访至少1年。必须对NobelGuide方案进行修改,以使其适用于这些已接受重建的患者。总共植入了56枚种植体,并且在可能的情况下立即进行加载(种植体的总体存活率为95%)。每位患者都获得了正确的临时修复性康复,就咀嚼、社交功能和总体生活质量而言,这是非常令人满意的。三维计算机断层扫描(CT)检查显示平均(标准差)边缘骨吸收为1.06(0.5)mm。我们在已用游离皮瓣重建的颌骨中采用了改良的计算机辅助种植手术技术;从这些初步结果来看,就功能、改善修复体修复和美观而言,这种方法似乎是有效的。