Huang Wei, Wu Yiqun, Zou Duohong, Zhang Zhiyong, Zhang Chenping, Sun Jian, Xu Bin, Zhang Zhiyuan
Department of Oral and Craniofacial Implantology, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital Affiliated with the Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clin Implant Dent Relat Res. 2014 Apr;16(2):282-91. doi: 10.1111/j.1708-8208.2012.00481.x. Epub 2012 Aug 9.
Defects of the maxilla due to tumor extirpation can create accordingly high levels of psychological and physical trauma for patients and their families. However, the reconstruction of maxillary defects remains very challenging. Today, using autogenous bone grafts and dental implants is an effective method to restore maxillary defects.
The purpose of this study was to evaluate the long-term clinical outcomes of maxillary rehabilitation with dental implants after tumor resection. Patient satisfaction after maxillary reconstruction was also assessed with regard to function and comfort.
Over a 6-year period (2000-2005), 24 patients with maxillary tumors underwent resection with either immediate (n = 18) or delayed reconstruction or underwent prosthetic rehabilitation (n = 6).The patients received 88 implants in total, including 9 zygomatic and 79 conventional implants, for maxillary rehabilitation of the defective areas.
Autogenous bone grafts were successful in all patients, although partial loss of the graft was observed in one patient who received an iliac graft. Patient follow-up was started at the point of the prosthetic loading of implants. The median treatment time was 99.1 months (range:18-137 months). One patient died after 18 months of follow-up due to tumor recurrence, and two patients were lost to follow-up after 3 years of observation. Ten conventional dental implants were removed due to peri-implantitis. Six patients chose implant-supported obturators. The cumulative survival and success rates of the implants were 88.6 and 86.3%, respectively.
This study demonstrated that the rehabilitation of maxillary defects following tumor resection using implant-supported fixed prostheses with autogenous bone grafts or prosthetic rehabilitation is successful and is associated with high patient satisfaction. Oral function can be restored using dental implants for patients with maxillary defects.
因肿瘤切除导致的上颌骨缺损会给患者及其家属带来相当程度的心理和身体创伤。然而，上颌骨缺损的重建仍然极具挑战性。如今，使用自体骨移植和牙种植体是修复上颌骨缺损的有效方法。
本研究旨在评估肿瘤切除后采用牙种植体进行上颌骨修复的长期临床效果。同时还评估了上颌骨重建后患者在功能和舒适度方面的满意度。
在6年期间（2000 - 2005年），24例上颌骨肿瘤患者接受了手术切除，其中18例进行了即刻重建或延迟重建，6例接受了修复性康复治疗。患者共植入88枚种植体，包括9枚颧骨种植体和79枚常规种植体，用于上颌骨缺损区域的修复。
所有患者的自体骨移植均成功，不过，1例接受髂骨移植的患者出现了部分骨移植丢失。患者随访从种植体修复加载时开始。中位治疗时间为99.1个月（范围：18 - 137个月）。1例患者在随访18个月后因肿瘤复发死亡，2例患者在观察3年后失访。10枚常规牙种植体因种植体周围炎被取出。6例患者选择了种植体支持的阻塞器。种植体的累积生存率和成功率分别为88.6%和86.3%。
本研究表明，采用自体骨移植或修复性康复治疗，通过种植体支持的固定修复体修复肿瘤切除后的上颌骨缺损是成功的，且患者满意度较高。对于上颌骨缺损患者，使用牙种植体可恢复口腔功能。
