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上颌骨切除术后即刻游离腓骨瓣联合全牙弓种植体支持的中面部和下颌骨修复:“超级重建概念”

Immediate Free Fibula Flap After Maxillectomy With Simultaneous Full-arch Dental Implant-Supported Prosthetic Rehabilitation of the Midface and Mandible: The "Super Reconstruction Concept".

作者信息

Frias Vladimir, Al Afif Ayham, Markiewicz Michael R

机构信息

Department of Oral Oncology, Roswell Park Comprehensive Cancer Center.

Department of Head & Neck/Plastic & Reconstructive Surgery, Roswell Park Comprehensive Cancer Center.

出版信息

J Craniofac Surg. 2023 Oct 1;34(7):2153-2156. doi: 10.1097/SCS.0000000000009695. Epub 2023 Aug 29.

Abstract

Immediate reconstruction and dental rehabilitation for ablative defects of the head and neck in one surgery is now a commonly used technique among reconstructive surgeons. Often patients are edentulous or partially edentulous in the jaw opposing that with pathology. In this case, only rehabilitating the dental arch affected by pathology would not render the patient with a functional occlusion. We introduce the "super reconstruction" concept which includes not only rehabilitating the dental arch affected by pathology but also the opposing arch, giving the patient a fully functional occlusion at the time of ablative surgery. This concept is described through a case of a patient with a T4aN0M0 squamous cell carcinoma of the maxilla who underwent total maxillectomy, immediate fibula flap reconstruction of the maxilla with, and full arch dental implant placement into the maxilla and opposing mandible with prosthetic rehabilitation.

摘要

在一次手术中对头颈部缺损进行即刻重建和牙齿修复,如今已成为重建外科医生常用的技术。通常情况下,患者在与病变部位相对的颌骨处无牙或部分无牙。在这种情况下,仅修复受病变影响的牙弓并不能使患者获得功能性咬合。我们引入“超级重建”概念,这不仅包括修复受病变影响的牙弓,还包括对颌牙弓,从而在切除手术时为患者提供完全功能性咬合。通过一例上颌T4aN0M0鳞状细胞癌患者的病例来描述这一概念,该患者接受了全上颌骨切除术、上颌骨即刻腓骨瓣重建术,并在上颌骨和对颌下颌骨植入全牙弓牙种植体并进行修复。

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