Navarro Cuéllar Carlos, Ochandiano Caicoya Santiago, Navarro Cuéllar Ignacio, Valladares Pérez Salvador, Fariña Sirandoni Rodrigo, Antúnez-Conde Raúl, Díez Montiel Alberto, Sánchez Pérez Arturo, López López Ana María, Navarro Vila Carlos, Salmerón Escobar José Ignacio
Maxillofacial Surgery Department at Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo 46, 28007 Madrid, Spain.
Maxillofacial Surgery Department at Hospital Clínico Metropolitano El Carmen-Maipú, 9250000 Santiago, Chile.
J Clin Med. 2020 Dec 30;10(1):101. doi: 10.3390/jcm10010101.
Double-barrel flap, vertical distraction and iliac crest graft are used to reconstruct the vertical height of the fibula. Twenty-four patients with fibula flap were reconstructed comparing these techniques (eight patients in each group) in terms of height of bone, bone resorption, implant success rate and the effects of radiotherapy. The increase in vertical bone with vertical distraction, double-barrel flap and iliac crest was 12.5 ± 0.78 mm, 18.5 ± 0.5 mm, and 17.75 ± 0.6 mm, ( < 0.001). The perimplant bone resorption was 2.31 ± 0.12 mm, 1.23 ± 0.09 mm and 1.43 ± 0.042 mm ( < 0.001), respectively. There were significant differences in vertical bone reconstruction and bone resorption between double-barrel flap and vertical distraction and between iliac crest and vertical distraction ( < 0.001). The study did not show significant differences in implant failure ( = 0.346). Radiotherapy did not affect vertical bone reconstruction ( = 0.125) or bone resorption ( = 0.237) but it showed higher implant failure in radiated patients ( = 0.015). The double-barrel flap and iliac crest graft showed better stability in the height of bone and less bone resorption and higher implant success rates compared with vertical distraction. Radiation therapy did not affect the vertical bone reconstruction but resulted in a higher implant failure.
采用双蒂皮瓣、垂直牵张和髂嵴移植术重建腓骨的垂直高度。对24例接受腓骨皮瓣重建的患者（每组8例），从骨高度、骨吸收、种植体成功率及放疗效果等方面对这些技术进行比较。垂直牵张、双蒂皮瓣和髂嵴移植术后垂直骨增加量分别为12.5±0.78mm、18.5±0.5mm和17.75±0.6mm（P<0.001）。种植体周围骨吸收分别为2.31±0.12mm、1.23±0.09mm和1.43±0.042mm（P<0.001）。双蒂皮瓣与垂直牵张、髂嵴与垂直牵张在垂直骨重建和骨吸收方面存在显著差异（P<0.001）。该研究未显示种植体失败方面的显著差异（P=0.346）。放疗对垂直骨重建（P=0.125）或骨吸收（P=0.237）无影响，但放疗患者的种植体失败率较高（P=0.015）。与垂直牵张相比，双蒂皮瓣和髂嵴移植在骨高度方面显示出更好的稳定性，骨吸收更少，种植体成功率更高。放疗不影响垂直骨重建，但会导致更高的种植体失败率。
