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采用新型固定式种植体支持义齿概念的下颌骨重建后生活质量评估:一项初步研究。

Evaluation of Quality of Life After Mandibular Reconstruction Using a Novel Fixed Implant-Supported Dental Prosthesis Concept: A Pilot Study.

出版信息

Int J Prosthodont. 2019 Mar/Apr;32(2):162-173. doi: 10.11607/ijp.6001.

Abstract

PURPOSE

To evaluate the feasibility and efficacy of a novel concept of early loaded (ie, within 2 weeks) implant-supported fixed dental prostheses (ISFDP) for patients who underwent mandibular reconstruction.

MATERIALS AND METHODS

All patients requiring mandibular reconstruction between July 2013 and March 2016 at AZ Sint-Jan Brugge-Oostende AV were screened for dental rehabilitation according to the proposed concept. Of 17 patients, 10 were eligible for inclusion. Clinical and radiologic assessments of implant integration and prosthetic survival were performed at 6, 12, 24, and 36 months. Patient satisfaction was assessed prior to and after prosthetic rehabilitation using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires Core 30 and Head & Neck 35, as well as a visual analog scale.

RESULTS

Ten patients received mandibular reconstructive surgery for an oral cavity tumor (n = 6), osteoradionecrosis (n = 3), or medication-related osteonecrosis of the jaw (n = 1). Implants were placed within an average of 6 (2 to 21) months postsurgery in a one-stage procedure. Prosthetic rehabilitation was achieved within 2 weeks in 8 of the 10 patients. Two patients received their ISFDP delayed due to postoperative complications. Implant integration and prosthetic outcome at a maximum of 36 months of follow-up were successful in 7 of the 10 patients. At that time, two patients had passed away, while one patient had the ISFPD removed because of graft necrosis after radiotherapy. Patient satisfaction was high, with significant improvement after dental rehabilitation in comparison to mandibular reconstruction alone.

CONCLUSION

The present concept offers a feasible and fast prosthetic rehabilitation that improves patient quality of life.

摘要

目的

评估一种新的概念,即在患者接受下颌骨重建术后 2 周内(即早期负载)植入物支持的固定义齿修复(ISFDP)的可行性和疗效。

材料和方法

根据提出的概念,对 2013 年 7 月至 2016 年 3 月期间在 AZ Sint-Jan Brugge-Oostende AV 接受下颌骨重建的所有患者进行了口腔修复筛查。在 17 名患者中,有 10 名符合纳入标准。在 6、12、24 和 36 个月时,对植入物的整合和修复体的生存情况进行了临床和影像学评估。在修复体修复之前和之后,使用欧洲癌症研究和治疗组织生活质量问卷核心 30 项和头颈部 35 项,以及视觉模拟评分法评估了患者的满意度。

结果

10 名患者因口腔肿瘤(n=6)、放射性骨坏死(n=3)或药物相关性下颌骨坏死(n=1)接受了下颌骨重建手术。在术后平均 6(2 至 21)个月内进行了一期手术植入。在 10 名患者中有 8 名在 2 周内完成了修复体的修复。由于术后并发症,有 2 名患者的 ISFDP 修复延迟。在 10 名患者中的 7 名患者中,在最长 36 个月的随访中,植入物整合和修复效果成功。此时,有 2 名患者已经去世,1 名患者因放疗后移植体坏死而移除了 ISFDP。患者满意度高,与单独接受下颌骨重建相比,修复后生活质量显著提高。

结论

本研究提出的概念为患者提供了一种可行且快速的修复方法,改善了患者的生活质量。

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