Nocini Pier Francesco, Trevisiol Lorenzo, D'Agostino Antonio, Zanette Giovanni, Favero Vittorio, Procacci Pasquale
Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.
Department of Surgery, Section of Dentistry and Maxillofacial Surgery, University of Verona, Policlinico "Giovanni Battista Rossi" Piazzale Ludovico Antonio Scuro, 10, 37134, Verona, Italy.
Oral Maxillofac Surg. 2016 Sep;20(3):303-8. doi: 10.1007/s10006-016-0552-7. Epub 2016 Feb 25.
Extreme atrophy of the jaws constitutes a challenge for maxillofacial surgeons. The technique involving Le Fort I osteotomy, bone grafting, and endosseous implants remains the gold standard treatment for class V and class VI atrophy of the maxilla. As severe maxillary atrophy is associated to impaired microvascularization of overlying soft tissues, reconstruction using vascularized free fibula flaps together with endosseous implants is one of the possible treatment plans. When this approach fails, however, retreating these patients using traditional techniques often proves unsatisfactory. This study outlines our clinical experience with full-arch zygoma implant-supported prosthetic rehabilitation to treat severe atrophic maxilla following failure of strategies including multiple Le Fort I procedures or vascularized free fibular flaps.
颌骨极度萎缩给颌面外科医生带来了挑战。涉及勒福Ⅰ型截骨术、骨移植和骨内种植体的技术仍然是上颌骨Ⅴ类和Ⅵ类萎缩的金标准治疗方法。由于严重的上颌萎缩与覆盖软组织的微血管化受损有关，使用带血管蒂的游离腓骨瓣联合骨内种植体进行重建是可能的治疗方案之一。然而，当这种方法失败时，采用传统技术对这些患者进行治疗往往效果不佳。本研究概述了我们在全牙弓颧骨种植体支持的修复性康复治疗严重萎缩性上颌骨方面的临床经验，这些患者此前采用了包括多次勒福Ⅰ型手术或带血管蒂的游离腓骨瓣等治疗策略但均告失败。
