Patel Stavan Y, Kim Dongsoo D, Ghali Ghali E
Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, Department of Oral and Maxillofacial Surgery/Head and Neck Surgery, Louisiana State University Health Science Center, 1501 Kings Highway, Shreveport, LA 71103, USA.
Division of Head and Neck Oncology and Microvascular Reconstructive Surgery, Department of Oral and Maxillofacial Surgery/Head and Neck Surgery, Louisiana State University Health Science Center, 1501 Kings Highway, Shreveport, LA 71103, USA.
Oral Maxillofac Surg Clin North Am. 2019 May;31(2):259-284. doi: 10.1016/j.coms.2018.12.005. Epub 2019 Mar 5.
Maxillofacial subunit reconstruction using vascularized fibula free flap and endosseous implants is a complex and exciting topic. Use of this technique has profoundly improved patients' function, form, and quality of life. This article outlines the goals and requirements of reconstruction and patient selection. Current data are examined and issues related to flap selection, irradiation, primary versus secondary implant placement, timing and type of implants, use of virtual surgical planning, soft-tissue management, and prosthesis selection fabrication are discussed. Careful planning, communication, and collaboration between reconstructive surgeons and prosthodontists are critical in achieving optimal and stable long-term outcomes.
使用带血管游离腓骨瓣和骨内种植体进行颌面亚单位重建是一个复杂且令人兴奋的课题。这项技术的应用极大地改善了患者的功能、外形和生活质量。本文概述了重建的目标和要求以及患者选择。对当前数据进行了审视，并讨论了与皮瓣选择、放疗、一期与二期种植体植入、种植体的时机和类型、虚拟手术规划的使用、软组织管理以及假体选择制作相关的问题。在实现最佳和稳定的长期效果方面，重建外科医生和口腔修复医生之间的精心规划、沟通与合作至关重要。
