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骨膜下剥离联合义齿引导上皮再生:重建下颌骨种植体周围软组织管理的新方法

Sub-Periosteal Dissection with Denture-Guided Epithelial Regeneration: A Novel Method for Peri-Implant Soft Tissue Management in Reconstructed Mandibles.

作者信息

Kumar Vinay V, Jacob P C, Kuriakose Moni A

机构信息

Department of Surgical Oncology- Head and Neck Surgery, Majumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bengaluru, India ; Department of Oral and Maxillofacial Surgery, M.R. Ambedkar Dental College & Hospital, 37, Lazar Layout, Frazer Town, Bengaluru, 560005 India ; Department of Oral Maxillofacial and Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.

Department of Prosthodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, India ; Ora-Care Dental Clinic, 81-Coles Road, Frazer Town, Bengaluru, India.

出版信息

J Maxillofac Oral Surg. 2016 Dec;15(4):449-455. doi: 10.1007/s12663-015-0854-6. Epub 2015 Nov 23.

Abstract

BACKGROUND

In patients with reconstructed mandibles using free fibula flaps, management of soft tissues around implants supporting dental rehabilitation, is often a clinical problem.

AIM

The aim of this paper is to describe a new technique, namely "Sub-periosteal dissection and denture-guided epithelial regeneration (SD-DGER)", as a method of peri-implant soft tissue management in these patients.

MATERIALS AND METHODS

The technique consists of performing a subperiosteal dissection with creation of buccal and lingual flaps. These flaps form the buccal and lingual vestibule. Implants are placed and an interim denture is immediately loaded onto the implants to guide the regenerated epithelium. A keratinized mucosal layer is formed on the bare fibula bone in six months time.

RESULTS

This technique was successful in producing fixed keratinized epithelial tissue around implants in patients with mandibles reconstructed using the free fibula flap in patients who did not undergo radiotherapy.

CONCLUSION

The sub-periosteal dissection with denture guided epithelial regeneration is a predictable form of peri-implant soft tissue management in selected patients with reconstructed jaws.

摘要

背景

在使用游离腓骨瓣重建下颌骨的患者中,支持牙齿修复的种植体周围软组织的处理常常是一个临床问题。

目的

本文旨在描述一种新技术,即“骨膜下剥离与义齿引导上皮再生(SD-DGER)”,作为这些患者种植体周围软组织管理的一种方法。

材料与方法

该技术包括进行骨膜下剥离并制作颊侧和舌侧瓣。这些瓣形成颊侧和舌侧前庭。植入种植体并立即在种植体上加载临时义齿以引导再生上皮。六个月后在裸露的腓骨骨上形成角化黏膜层。

结果

在未接受放疗且使用游离腓骨瓣重建下颌骨的患者中,该技术成功地在种植体周围产生了固定的角化上皮组织。

结论

骨膜下剥离与义齿引导上皮再生是选定的颌骨重建患者种植体周围软组织管理的一种可预测形式。

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