Nguyen Truc Thi Hoang, Eo Mi Young, Myoung Hoon, Kim Myung-Joo, Kim Soung Min
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
Department of Prosthodontics, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
Int J Implant Dent. 2020 Aug 11;6(1):44. doi: 10.1186/s40729-020-00241-7.
To restore the health-related quality of life (HRQoL) of patients who underwent jaw resection and reconstruction surgery, dental rehabilitation is an essential procedure and also one of the most challenging for oral and maxillofacial surgeons. Even though recent studies have reported the possibility and reliability of dental implant rehabilitation with the fibula free flap (FFF), clinical reports of long-term follow-up cases are scarce. We herein reported seven cases of FFF reconstruction and implant rehabilitation. We also discussed implant planning strategy and surgical techniques.
From 2012 to 2019, seven patients were treated with FFF reconstructive jaw surgery combined with dental implant installation and fabrication of implant-supported prostheses at Seoul National University Dental Hospital, Seoul, Korea. Patient characteristics and FFF treatment results were collected. Records of dental implants were analyzed clinically and radiologically.
Among the seven patients in this report, there were three males and four females, with an average age of 54.4 years. A total of 39 implants were placed in the fibular bone. The mean follow-up period after implant installation was 24 months. Five implants failed and were removed 3 months after installation. The implant success rate was 87.2%. Marginal bone loss at 12 months after loading was 0.23 ± 0.18 mm on the mesial side and 0.25 ± 0.26 mm on the distal side.
With the challenges present in FFF-reconstructed patients, an implant-supported prosthesis is a reliable option for stable and functional oral rehabilitation. The implant-supported prosthesis on the FFF has great results regarding restoration of function (mastication, swallowing, and speaking), appearance, and overall HRQoL. Collaboration between surgeons and prosthodontists is essential for a satisfying outcome.
为恢复接受颌骨切除与重建手术患者的健康相关生活质量（HRQoL），牙齿修复是一项必不可少的程序，同时也是口腔颌面外科医生面临的最具挑战性的任务之一。尽管最近的研究报告了游离腓骨瓣（FFF）进行牙种植修复的可能性和可靠性，但长期随访病例的临床报告却很少。我们在此报告了7例FFF重建和种植修复病例。我们还讨论了种植计划策略和手术技术。
2012年至2019年，韩国首尔国立大学牙医院对7例患者进行了FFF重建颌骨手术，并结合牙种植体植入和种植体支持义齿的制作。收集了患者的特征和FFF治疗结果。对牙种植体记录进行了临床和影像学分析。
本报告中的7例患者中，男性3例，女性4例，平均年龄54.4岁。共在腓骨上植入39枚种植体。种植体植入后的平均随访期为24个月。5枚种植体失败并在植入后3个月被取出。种植成功率为87.2%。加载后12个月时，近中侧的边缘骨吸收为0.23±0.18mm，远中侧为0.25±0.26mm。
鉴于FFF重建患者存在的挑战，种植体支持义齿是稳定和功能性口腔修复的可靠选择。FFF上的种植体支持义齿在功能（咀嚼、吞咽和说话）恢复、外观和整体HRQoL方面取得了很好的效果。外科医生和修复医生之间的合作对于获得满意的结果至关重要。
