Kharade Pankaj, Dholam Kanchan, Bhirangi Pravin
Department of Prosthodontics, Dr ZA Dental College and Hospital, Aligarh Muslim University, Aligarh.
Department of Dental and Prosthetic Surgery, Tata Memorial Hospital, Mumbai, India.
J Craniofac Surg. 2018 Jan;29(1):e31-e33. doi: 10.1097/SCS.0000000000004007.
Intraoral defects secondary to resection of mandible leading to mandibular discontinuity are very complicated to treat as the muscles exert forces on the residual portion of the mandible. Primarily this leads to disfigurement of the face. These forces also make mastication difficult due to imbalance. Ultimately it leads to poor quality of life for the patient. Apart from that the clinical outcome and prognosis of prosthetic rehabilitation of such patients is very poor. The composite fibular flap is the preferred donor site for reconstruction of most complex orofacial-mandibular defects. The addition of a skin island allows for absolute tension-free intraoral closure that enhances tongue mobility. After reconstruction with free fibula graft, planning for prosthodontic rehabilitation by various methods can be carried out. Treatment strategy is dependent on the intraoral situation and patient's acceptance. This article reports various treatment considerations for implant retained prosthetic rehabilitation in a patient who had undergone mandibular reconstruction with free fibula flap.
下颌骨切除导致下颌骨连续性中断继发的口腔内缺损治疗起来非常复杂，因为肌肉会对下颌骨的残余部分施加力量。这主要会导致面部畸形。这些力量还会由于不平衡而使咀嚼变得困难。最终会导致患者生活质量下降。除此之外，这类患者的修复性康复的临床效果和预后非常差。复合腓骨瓣是修复大多数复杂口腔颌面 - 下颌骨缺损的首选供区。添加皮岛可实现绝对无张力的口腔内闭合，从而增强舌头的活动度。在用游离腓骨移植进行重建后，可以通过各种方法进行义齿修复的规划。治疗策略取决于口腔内情况和患者的接受程度。本文报告了一名接受游离腓骨瓣下颌骨重建患者种植体支持式修复性康复的各种治疗考虑因素。
