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用于颌面骨缺损重建的非血管化自体骨移植

Non-Vascularized Autogenous Bone Grafts for Reconstruction of Maxillofacial Osseous Defects.

作者信息

Ahmed Waseem, Asim Muhammad Adil, Ehsan Afeefa, Abbas Qalab

机构信息

Department of Oral Surgery, Armed Forces Institute of Dentistry, Rawalpindi.

Department of Oral and Maxillofacial Surgery, Rawal Institute of Health Sciences, Islamabad.

出版信息

J Coll Physicians Surg Pak. 2018 Jan;28(1):17-21. doi: 10.29271/jcpsp.2018.01.17.

Abstract

OBJECTIVE

To determine the outcomes of non-vascularized bone grafts for reconstruction of maxillofacial defects.

STUDY DESIGN

Case series.

PLACE AND DURATION OF STUDY

Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, from January 2013 to December 2015.

METHODOLOGY

Descriptive analyses of 30 patients, who underwent maxillofacial reconstruction with non-vascularized bone grafts, were conducted. The demographic information, diagnosis, and type of graft harvested to reconstruct the defect were statistically analyzed. Outcomes of reconstruction with non-vascularized bone grafts were analyzed in terms of mouth opening, success of dental rehabilitation, and postoperative complications, i.e. surgical site infection and hardware loosening.

RESULTS

A total of 30 patients ranging from 8 to 60 years (33.57 ±14.74 years) had maxillofacial defects reconstructed mostly due to gunshot injuries, followed by post-resection defects. Overall 15 cases (50%) were reconstructed with iliac crest cortico-cancellous bone graft, 11 cases (36.7%) with rib; while in four cases (13.3%), costochondral graft was used for reconstruction. In 26 cases (86.7%), graft was found to be successful. In three cases, re-operation for onlay bone graft was required to provide optimal dental rehabilitation; while in just one case, postoperative surgical site infection was observed.

CONCLUSION

Non-vascularized bone grafts provide a reasonable and effective modality for reconstruction of maxillofacial defects.

摘要

目的

确定非血管化骨移植修复颌面部缺损的效果。

研究设计

病例系列研究。

研究地点和时间

2013年1月至2015年12月,拉瓦尔品第武装部队牙科学院口腔颌面外科。

方法

对30例行非血管化骨移植颌面部重建的患者进行描述性分析。对患者的人口统计学信息、诊断情况以及用于修复缺损的移植骨类型进行统计学分析。从开口度、牙修复成功率和术后并发症(即手术部位感染和内固定松动)方面分析非血管化骨移植的重建效果。

结果

共有30例年龄在8至60岁(平均33.57±14.74岁)的患者进行了颌面部缺损重建,主要原因是枪伤,其次是切除术后缺损。总体而言,15例(50%)采用髂骨皮质松质骨移植重建,11例(36.7%)采用肋骨移植;4例(13.3%)采用肋软骨移植进行重建。26例(86.7%)移植成功。3例需要再次手术进行贴附植骨以实现最佳的牙修复;仅1例观察到术后手术部位感染。

结论

非血管化骨移植为颌面部缺损的修复提供了一种合理有效的方式。

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