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用于肿瘤切除术后上颌骨重建的个性化骨膜下钛植入物:一例一年随访病例报告

Patient-Specific Subperiosteal Titanium Implant for Maxillary Reconstruction Following Oncologic Resection: A One-Year Follow-Up Case Report.

作者信息

Gerçek Aydın Onur, Adiloğlu Selen, Karaer Berke, Ersu Bahadır, Tüz Hakan Hıfzı

机构信息

Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey.

Faculty of Dentistry Department of Prosthodontics, Hacettepe University, Ankara, Turkey.

出版信息

J Oral Implantol. 2025 Apr 1;51(2):166-171. doi: 10.1563/aaid-joi-D-24-00236.

Abstract

Maxillary defects resulting from oncologic resection pose significant challenges for oral rehabilitation, affecting function, aesthetics, and quality of life. Traditional implant-based solutions are often unfeasible due to insufficient bone volume, necessitating alternative approaches. This case report presents a 54-year-old male who underwent a total maxillectomy for palatal squamous cell carcinoma, followed by chemoradiotherapy. A customized subperiosteal titanium maxillary implant (CSTMI) was designed using virtual surgical planning (VSP), stereolithographic (STL) models, and CAD/CAM technology. The CSTMI framework, incorporating endosseous implants, was secured to the orbital rims and pterygoid plates to optimize prosthetic stability and load distribution. The healing of the patient was uneventful, with no signs of inflammation or dehiscence. The prosthesis improved speech, swallowing, and oral function, significantly enhancing quality of life. At the one-year follow-up, minor screw loosening was successfully managed without complications. CSTMI represents a viable alternative for maxillary reconstruction in patients unsuitable for traditional implants, providing functional and aesthetic rehabilitation. Digital workflows, including VSP and CAD/CAM, are crucial for treatment precision. Long-term studies are needed to assess implant survival, biomechanical optimization, and clinical success.

摘要

肿瘤切除导致的上颌骨缺损给口腔修复带来了重大挑战,影响功能、美观和生活质量。由于骨量不足,传统的基于种植体的解决方案往往不可行,因此需要采用替代方法。本病例报告介绍了一名54岁男性,因腭部鳞状细胞癌接受了全上颌骨切除术,随后进行了放化疗。使用虚拟手术规划(VSP)、立体光刻(STL)模型和CAD/CAM技术设计了定制的骨膜下钛上颌种植体(CSTMI)。结合骨内种植体的CSTMI框架固定在眶缘和翼突板上,以优化假体稳定性和负荷分布。患者愈合顺利,无炎症或裂开迹象。假体改善了语音、吞咽和口腔功能,显著提高了生活质量。在一年的随访中,成功处理了轻微的螺钉松动,无并发症。CSTMI是不适用于传统种植体的患者上颌骨重建的可行替代方案,可提供功能和美观的修复。包括VSP和CAD/CAM在内的数字化工作流程对于治疗精度至关重要。需要进行长期研究来评估种植体的存活率、生物力学优化和临床成功率。

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