Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2012 Nov;16(13):1882-90.
The most frequent type of treatment for patients diagnosed with a malignant neoplasia of the oral cavity is surgical removal of the tumor. As a result of the resection performed, it is difficult to obtain satisfactory results in the oral rehabilitation of these patients. When possible, fixed prostheses are the best option, because they guarantee stability, but they should be made so that the operator can remove them periodically to check the health of the oral tissues underneath and to intercept any relapse of the tumor. This study analyses two cases of patients surgically treated for a tumor of the upper maxilla at the Oral and Maxillo-Facial Surgery of Sapienza University, in Rome. In the first case the surgical site was covered with local flaps, and the patient was rehabilitated with an implant-supported removable prosthesis. In the second case the maxilla was reconstructed with a fibula vascularized free flap, and the patient was rehabilitated with an implant-supported prosthesis screwed to a titanium bar solidarizing the implants. Therefore, this prosthesis was fixed, but could be removed by the dentist. The different approach to these two cases was influenced by the different anatomic situations after the reconstruction. It is important for the dentist to approach these patients knowing the kind of surgery they received because this aspect will influence rehabilitative choices. Rehabilitation should be planned, when possible, before surgical treatment, in order to cooperate with the maxillo-facial surgeon in choosing the most appropriate restorative treatment.
对于被诊断患有口腔恶性肿瘤的患者，最常见的治疗方法是手术切除肿瘤。由于切除手术的实施，这些患者的口腔康复往往难以取得满意的效果。在可能的情况下，固定义齿是最佳选择，因为它们能保证稳定性，但必须制作得能让医生定期取下，以检查口腔组织下方的健康状况，并及时发现肿瘤的任何复发。本研究分析了罗马萨皮恩扎大学口腔颌面外科治疗的两例上颌肿瘤患者。在第一例中，手术部位用局部皮瓣覆盖，患者通过种植体支持的可摘义齿进行康复。在第二例中，用带血管的腓骨游离皮瓣重建上颌骨，患者通过植入物支持的义齿进行康复，该义齿用钛棒固定到植入物上，以固定植入物。因此，这种义齿是固定的，但可以由牙医取下。这两种情况的不同处理方法受到重建后不同解剖情况的影响。牙医了解患者接受的手术类型非常重要，因为这会影响康复选择。应在手术治疗前规划康复，以便与颌面外科医生合作，选择最合适的修复治疗。
