Kumar R Mahesh, Varsha S, Chougule Shrusti, Divya D, Vyas Yash Vipulkumar, Hota Chinta Chetana
Department of Oral and Maxillofacial Surgery, Sri Siddhartha Dental College and Hospital, Tumkur, Karnataka, India.
Department of Prosthodontics, Sri Siddhartha Dental College and Hospital, Tumkur, Karnataka, India.
Ann Maxillofac Surg. 2025 Jan-Jun;15(1):25-29. doi: 10.4103/ams.ams_156_24. Epub 2025 May 26.
Conventional surgical obturators are widely used despite advancements in microvascular surgery for maxillary pathologies requiring resection due to poor surgical outcome/prognosis or financial constraints. This study was conducted to compare and evaluate three different techniques of fixation of immediate surgical obturators in maxillectomy cases.
The study comprises 56 maxillectomy cases performed over 33 months from January 2021 to August 2023 in Tumkur with a minimal follow-up of 3 months. The different techniques of fixation of immediate surgical obturators are compared and evaluated for duration of fabrication, intraoperative fixation, stability, post-operative function, tissue healing and biocompatibility.
Peak incidence was noted in the fourth and fifth decades of life. Both genders were almost equally involved in the study. The need for maxillectomy included - infective cystic pathology, odontogenic infections, mucormycosis, sinus pathologies and T1 maxillary carcinoma. The mean duration of hospitalisation was 5.3 days. The screw-based technique was superior in most of the criteria compared, followed by clasp-based technique and the material-based technique, respectively.
Based on the results of the study, the screw-based fixation technique offers an edge over the other two fixation techniques in terms of being trouble free for the surgeon, easy to fabricate, biocompatible and better patient quality of life. It can also be used in edentulous patients with extensive surgeries or extraoral support.
尽管微血管手术取得了进展,但由于手术效果/预后不佳或经济限制,传统手术闭孔器仍广泛应用于因上颌病变需要切除的情况。本研究旨在比较和评估上颌骨切除病例中即刻手术闭孔器的三种不同固定技术。
本研究包括2021年1月至2023年8月在图姆库尔进行的56例上颌骨切除病例,随访时间最短为3个月。对即刻手术闭孔器的不同固定技术在制作时间、术中固定、稳定性、术后功能、组织愈合和生物相容性方面进行了比较和评估。
发病高峰出现在40至50岁。研究中男女参与率几乎相同。上颌骨切除的需求包括感染性囊性病变、牙源性感染、毛霉菌病、鼻窦病变和T1期上颌癌。平均住院时间为5.3天。在大多数比较标准中,基于螺钉的技术优于其他技术,其次分别是基于卡环的技术和基于材料的技术。
根据研究结果,基于螺钉的固定技术在对手术医生来说无故障、易于制作、生物相容性好以及提高患者生活质量方面比其他两种固定技术更具优势。它也可用于接受广泛手术或需要口外支撑的无牙患者。