Akifuddin Syed, Awadalkreem Fadia
Dentomax Centre for Dentistry, Implants and Maxillofacial Surgery, Hyderabad, India.
Department of Prosthodontics, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
Int J Surg Case Rep. 2024 Nov;124:110433. doi: 10.1016/j.ijscr.2024.110433. Epub 2024 Oct 10.
Segmental mandibular reconstruction using free fibula flaps and implants is challenging for maxillofacial surgeons and prosthodontists. This case report describes the successful use of Corticobasal implant reconstructive prostheses after a free fibula flap with five years of follow-up.
A 24-year-old female presented to the clinic following segmental defect reconstruction using fibula reconstruction, owing to squamous cell carcinoma resection and seeking prosthetic treatment. An intraoral examination revealed a complete healing of the soft tissue. A panoramic radiograph showed a fibula bone graft rehabilitating the left side of the mandible supporting with a reconstructive plate. A multidisciplinary team was formed. A treatment plan included a mandibular reconstructive fixed Corticobasal implant prosthesis supported by eight basal cortical screw implants (BCS®, Dr. Ihde Dental AG, Switzerland) and a follow-up schedule was formulated. After 5-years of function, the implant demonstrated a 100 % survival rate, with no implant loss or fracture, excellent peri-implant soft tissue health, complete union of the bone graft, and a very stable prosthesis. The patient reported significant improvements in aesthetics, mastication, phonation, and self-satisfaction.
The multidisciplinary team has significantly improved the treatment outcomes. The prescribed treatment modality provides the patient with a fixed treatment modality, immediate loading, reduces the risk of biological and biomechanical complications, and hence improves the patient's functions and satisfaction.
A Corticobasal implant-supported prosthesis can be used in combination with a free fibula flap to reconstruct segmental mandibulectomy patients with a high survival rate and satisfactory aesthetic and functional outcomes.
对于颌面外科医生和口腔修复医生而言，使用游离腓骨瓣和种植体进行下颌骨节段性重建具有挑战性。本病例报告描述了在游离腓骨瓣术后成功使用皮质骨基台种植体重建假体，并进行了五年的随访。
一名24岁女性因鳞状细胞癌切除术后接受腓骨重建节段性缺损修复后前来诊所就诊，并寻求修复治疗。口腔检查显示软组织完全愈合。全景X线片显示腓骨骨移植修复了下颌骨左侧，并由重建钢板支撑。组建了一个多学科团队。治疗计划包括使用八个皮质骨基台螺钉种植体（BCS®，Ihde Dental AG博士，瑞士）支持的下颌骨重建固定皮质骨基台种植体假体，并制定了随访计划。经过5年的功能使用，种植体显示出100%的存活率，没有种植体丢失或骨折，种植体周围软组织健康状况良好，骨移植完全愈合，假体非常稳定。患者报告在美观、咀嚼、发声和自我满意度方面有显著改善。
多学科团队显著改善了治疗效果。规定的治疗方式为患者提供了固定的治疗方式、即刻负重，降低了生物学和生物力学并发症的风险，从而改善了患者的功能和满意度。
皮质骨基台种植体支持的假体可与游离腓骨瓣联合使用，以重建下颌骨节段性切除患者，具有较高的存活率以及令人满意的美学和功能效果。
