Maxillofacial O.U.S. Gerardo Hospital Monza, Dept. of Medicine and Surgery, School of Medicine, University of Milano-Bicocca, Milan, Italy.
Department of Veterans Affairs Medical Center, San Francisco, CA, USA.
J Craniomaxillofac Surg. 2017 Oct;45(10):1655-1661. doi: 10.1016/j.jcms.2017.06.021. Epub 2017 Jul 8.
To determine the dental implant and prostheses success rate in a cohort of patients who underwent a vascularized fibula-free flap (FFF) for maxillary or mandibular reconstruction.
The investigators implemented a retrospective cohort study composed of patients who had undergone primary or secondary FFF reconstruction jaw surgery plus placement of 2-6 implants in the reconstructed arch, which were restored with an implant-supported prosthesis. The sample was composed of all patients who underwent FFF surgery between 1998 and 2012 and had either simultaneous or secondary dental implant placement. A total of 28 patients met inclusion criteria. Of these, 22 patients participated in the retrospective review. Patients were examined by an independent observer between January-December 2015. In addition, all patients completed a questionnaire to access satisfaction with the implant-supported prosthesis.
The patient cohort consisted of 12 males and 10 females, age 12-70 years. A total of 100 implants were placed, 92 implants in fibular bone and 8 implants in native bone. In the maxilla, 35 implants were placed into fibular bone and 4 into native bone (11 in irradiated patients and 28 in non-irradiated patients). In the mandible, 57 implants were placed into fibular bone and 4 into native bone (15 in irradiated patients and 46 in non-irradiated patients). The mean follow-up after implant loading was 7.8 years (range 1.3-17.5 years). The implant survival rate was 98% (95% CI: 92.2%-99.5%). No statistically significant difference was found in implant success between maxillary and mandibular implants, or between radiated and non-radiated bone. The prostheses success rate, determined by clinical exam and patient satisfaction, was 100%.
The results of this study suggest that implant survival is high and implant-supported prostheses are a reliable rehabilitation option in patients whose jaws have been reconstruction with a FFF.
确定接受游离腓骨瓣（FFF）进行上颌或下颌重建的患者中，牙种植体和修复体的成功率。
研究人员进行了一项回顾性队列研究，纳入了 1998 年至 2012 年间接受过 FFF 手术且在重建的牙槽骨中植入 2-6 枚种植体，并用种植体支持的修复体进行修复的患者。样本包括所有接受 FFF 手术且同时或后续进行牙种植体植入的患者。共有 28 名患者符合纳入标准，其中 22 名患者参与了回顾性研究。2015 年 1 月至 12 月期间，由一名独立观察者对患者进行了检查。此外，所有患者都完成了一份调查问卷，以评估对种植体支持的修复体的满意度。
患者队列由 12 名男性和 10 名女性组成，年龄为 12-70 岁。共植入了 100 枚种植体，其中 92 枚种植体植入腓骨，8 枚种植体植入原生骨。在上颌骨中，35 枚种植体植入腓骨，4 枚种植体植入原生骨（11 枚在放疗患者中，28 枚在非放疗患者中）。在下颌骨中，57 枚种植体植入腓骨，4 枚植入原生骨（15 枚在放疗患者中，46 枚在非放疗患者中）。种植体加载后平均随访时间为 7.8 年（范围 1.3-17.5 年）。种植体的存活率为 98%（95%可信区间：92.2%-99.5%）。上颌和下颌种植体之间，以及放疗和非放疗骨之间的种植体成功率无统计学差异。通过临床检查和患者满意度确定的修复体成功率为 100%。
本研究结果表明，在接受游离腓骨瓣重建的患者中，种植体的存活率较高，且种植体支持的修复体是一种可靠的修复选择。
