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游离腓骨血管化皮瓣重建下颌后种植体的存活率。

Survival of dental implants placed in vascularised fibula free flaps after jaw reconstruction.

机构信息

University Hospital Giessen, Dept. for Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. Hans-Peter Howaldt), Klinikstr. 33, 35392, Giessen, Germany.

University Hospital Kiel, Dept. for Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. Joerg Wiltfang), Arnold-Heller-Straße 16, 24105, Kiel, Germany.

出版信息

J Craniomaxillofac Surg. 2018 Aug;46(8):1205-1210. doi: 10.1016/j.jcms.2018.05.008. Epub 2018 Jun 5.

Abstract

PURPOSE

Ablative oncological surgery to treat head-and-neck cancer often triggers a requirement for jaw reconstruction. Modern surgical procedures using free microvascular flaps afford acceptable outcomes in terms of restoration of bony and soft tissue defects. A fibula free flap is often the preferred flap, as the bone length is considerable and a two-surgeon approach is possible. Dental implants play important roles in functional rehabilitation. Our aim was to evaluate the survival of dental implants placed in reconstructed areas after transfer of fibula tissue to the jaw.

MATERIALS AND METHODS

We retrospectively studied 34 patients who underwent ablative tumour surgery and jaw reconstruction using osteocutaneous fibula free flaps and who then received dental implants. We evaluated implant survival and success, survival of the fibula flap, and clinical and radiographic data.

RESULTS

We included 34 patients, 23 of whom were diagnosed with squamous cell carcinoma. In total, 134 dental implants were inserted in transferred fibula bone. The cumulative implant survival rate was 81%. The survival rate of the 34 fibula flaps transplanted after surgical reconstruction was 97%.

CONCLUSION

The insertion of endosseous implants after jaw reconstruction using vascularised fibula tissue yields successful dental rehabilitation in patients with oral cancers.

摘要

目的

头颈部癌症的消融性肿瘤切除术常引发下颌骨重建的需求。采用游离微血管皮瓣的现代外科手术方法,在骨和软组织缺损的修复方面可获得可接受的效果。游离腓骨瓣通常是首选的皮瓣,因为其骨长度相当可观,并且可以采用双外科医生的方法。牙种植体在功能康复中起着重要作用。我们的目的是评估游离腓骨组织移植至下颌骨后重建区域中牙种植体的存活率。

材料与方法

我们回顾性研究了 34 例接受游离骨-皮瓣腓骨移植肿瘤切除术和下颌骨重建术并随后接受牙种植体的患者。我们评估了种植体的存活率和成功率、腓骨瓣的存活率以及临床和影像学数据。

结果

我们纳入了 34 例患者,其中 23 例被诊断为鳞状细胞癌。总共在转移的腓骨骨中插入了 134 颗牙种植体。累积种植体存活率为 81%。34 个在手术重建后移植的腓骨瓣的存活率为 97%。

结论

在血管化腓骨组织用于下颌骨重建后插入骨内种植体可使口腔癌患者获得成功的牙齿修复。

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