Li K K, Stephens W L, Gliklich R
Department of Dentistry, Oral and Maxillofacial Surgery, Brigham and Women's Hospital, Boston, MA, USA.
J Oral Maxillofac Surg. 1996 May;54(5):542-6; discussion 547. doi: 10.1016/s0278-2391(96)90626-6.
This study evaluated the outcome of patients who underwent simultaneous Le Fort I osteotomy, an interpositional bone graft, and implant placement for reconstruction of the severely atrophic edentulous maxilla.
Twenty patients operated by the same surgeon were included in the study. Patients were followed annually with clinical and radiographic examinations for an average of 33 months.
One hundred thirty-nine implants were initially inserted in the bone grafts at the time of Le Fort I osteotomy. Twenty-five implants (18%) failed to osseointegrate. Seventeen of the 25 implants lost were from three patients. The most significant prognostic factor appeared to be the thickness of the atrophic maxillary ridge. Twelve of the 20 patients completed prosthetic restoration, with an average follow-up of 21 months after loading. No implants were lost after loading, and all prostheses have remained stable.
This method of reconstruction of the severely atrophic maxilla achieves an implant survival rate of 82% while correcting the unfavorable maxillomandibular relationship commonly seen in these patients.
本研究评估了接受同期勒福Ⅰ型截骨术、植入骨移植体及种植体植入以重建严重萎缩无牙上颌骨患者的治疗效果。
本研究纳入了由同一位外科医生手术的20例患者。患者每年接受临床和影像学检查随访，平均随访33个月。
在勒福Ⅰ型截骨术时，最初在骨移植体中植入了139枚种植体。25枚种植体（18%）未能实现骨整合。25枚丢失的种植体中有17枚来自3例患者。最显著的预后因素似乎是萎缩上颌嵴的厚度。20例患者中有12例完成了修复修复，加载后平均随访21个月。加载后无种植体丢失，所有修复体均保持稳定。
这种重建严重萎缩上颌骨的方法在纠正这些患者常见的不利上颌下颌关系的同时，实现了82%的种植体存留率。
