Kharade Pankaj, Islam Saidul, Verma Mahesh, Sharma Swati, Bodh Ranjeet
*Department of Prosthodontics, Dr. Z.A Dental College and Hospital, Aligarh Muslim University, Aligarh †Life Line Hospital, Kolkata ‡Maulana Azad Institute of Dental Sciences, New Delhi §Department of Conservative Dentistry and Endodontics, Dr. Z.A Dental College and Hospital, Aligarh Muslim University, Aligarh ||Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
J Craniofac Surg. 2017 Nov;28(8):e735-e737. doi: 10.1097/SCS.0000000000003883.
Surgical management of extensive tumors in the mandibular region leads to massive disfigurement of the face. Also the prosthetic outcome of such patients rehabilitated with free soft tissue flaps is very poor. Reconstruction of extensive defects to overcome the disfigurement is a challenging procedure and can be achieved with free fibula flap. Free fibula graft provides sufficient length of bone for the reconstruction of the postsurgical defects. Excellent vascularity of fibula flap allows for easy uptake of the graft and osseointegration of the dental implants. The addition of a skin island allows for absolute tension-free intraoral closure that enhances tongue mobility. Fibula graft allows proper tissue support after mandibular reconstruction. After rehabilitation with free fibula graft we can plan for prosthodontic rehabilitation with implant retained prosthesis leading to improved masticatory function. It also helps to improve speech outcome as a stable prosthesis can be delivered with the help of implants retained in the fibula graft. It is essential to assess the outcome of surgical reconstruction with fibula graft followed by prosthetic rehabilitation with implant retained prosthesis for their recognition as a treatment of preference. This article details the clinical report along with various clinical parameters for implant retained prosthetic rehabilitation of the patient who had undergone mandibular resection and reconstruction with free fibula graft.
下颌区域广泛肿瘤的手术治疗会导致面部严重毁容。此外，采用游离软组织瓣修复的此类患者的修复效果也非常差。通过游离腓骨瓣重建广泛缺损以克服毁容是一项具有挑战性的手术，且可以实现。游离腓骨移植可为术后缺损的重建提供足够长度的骨。腓骨瓣良好的血供有利于移植骨的顺利吸收以及牙种植体的骨整合。添加皮岛可实现绝对无张力的口内闭合，从而增强舌的活动度。腓骨移植可在下颌骨重建后提供适当的组织支撑。采用游离腓骨移植修复后，我们可以计划使用种植体固位修复体进行口腔修复，从而改善咀嚼功能。这也有助于改善语音效果，因为借助保留在腓骨移植中的种植体可以提供稳定的修复体。评估腓骨移植手术重建以及随后使用种植体固位修复体进行修复的效果，对于将其认可为首选治疗方法至关重要。本文详细介绍了一名接受下颌骨切除并使用游离腓骨移植进行重建的患者的临床报告以及种植体固位修复体修复的各种临床参数。
