Int J Oral Maxillofac Implants. 2019 September/October;34(5):1223–1230. doi: 10.11607/jomi.7278. Epub 2019 Feb 19.
To evaluate effects of preoperative virtual planning and jaw reconstruction guided by dental implant rehabilitation on dental prosthesis rehabilitation after jaw reconstruction.
Patients indicated for segmental jaw resection and who agreed to receive jaw reconstruction procedures were enrolled in the study. Appropriate surgical procedures were determined by a maxillofacial surgeon and a prosthodontist before surgery. The virtual design was created according to preoperative computed tomography. Patients were divided into navigation and non-navigation groups. Implant surgery was performed 6 months after reconstruction surgery. After treatment completion, factors such as survival rate of implants, site of reconstruction, type of graft, and type of prosthesis were compared.
In total, 29 patients were included in the study, with 16 patients in the non-navigation group and 13 in the navigation group. A total of 101 implants were inserted, and the implant success rate was 98.02% (2 implants extracted due to peri-implantitis). All patients received prosthetic treatment. Of the 13 navigation group patients, 9 received fixed implant-supported prostheses, whereas the other 4 received removable dentures. Of the 16 non-navigation group patients, 9 eventually received fixed implant-supported prostheses and 7 received removable dentures. There were no significant intergroup differences in terms of prosthesis type (P = .702). However, the proportion of fixed implant-supported prostheses in the navigation group was higher compared with the non-navigation group.
Preoperative virtual planning and dental implant rehabilitation-guided jaw reconstruction through preoperative designing can provide a good opportunity to achieve high rates of implant success and dental rehabilitation. This method can also benefit fixed implant-supported prosthetic restorations. Moreover, the use of navigation after virtual planning has no effect on the type of prosthetic reconstruction.
评估术前虚拟规划和牙种植体修复指导的下颌骨重建对下颌骨重建后义齿修复的影响。
本研究纳入了因节段性下颌骨切除而需接受下颌骨重建手术且同意接受该手术的患者。在术前，颌面外科医生和修复医生共同确定了合适的手术方案。根据术前计算机断层扫描进行虚拟设计。患者被分为导航组和非导航组。重建手术后 6 个月进行种植体手术。治疗完成后，比较了种植体存活率、重建部位、移植物类型和义齿类型等因素。
共有 29 例患者入组研究，其中非导航组 16 例，导航组 13 例。共植入 101 枚种植体，种植体成功率为 98.02%（因种植体周围炎拔除 2 枚）。所有患者均接受了修复治疗。导航组的 13 例患者中，9 例接受了固定种植体支持式义齿修复，另 4 例接受了可摘局部义齿。非导航组的 16 例患者中，9 例最终接受了固定种植体支持式义齿修复，7 例接受了可摘局部义齿。两组在义齿类型方面无显著差异（P =.702）。然而，导航组固定种植体支持式义齿修复的比例高于非导航组。
术前虚拟规划和术前设计指导的牙种植体修复指导的下颌骨重建可以为获得高种植体成功率和牙齿修复提供良好的机会。该方法还可以有益于固定种植体支持式修复体。此外，虚拟规划后使用导航对修复重建类型无影响。
