Roumanas E D, Markowitz B L, Lorant J A, Calcaterra T C, Jones N F, Beumer J
Division of Maxillofacial Prosthetics, Plastic and Reconstructive Surgery, University of California, Los Angeles, USA.
Plast Reconstr Surg. 1997 Feb;99(2):356-65. doi: 10.1097/00006534-199702000-00008.
Twenty patients with microvascular fibula flap reconstruction of oromandibular defects were selected for implant-retained prosthodontic rehabilitation. A total of 71 osseointegrated implants were placed within the grafted fibulas. Four patients had immediate implant placement at the time of their reconstructive surgery, and the remaining 16 patients had implants placed secondarily. One patient received postoperative radiation therapy (5910 cGy) 6 weeks following reconstruction and immediate implant placement. No implants were placed in previously irradiated flaps. A minimum 6-month period of osseointegration was allowed prior to second stage surgery. Fifty-four of the 71 implants were uncovered; 46 of these implants were functional, and 3 were in the process of being restored. Among the 54 implants (15 patients) that were uncovered, only 1 failed to osseointegrate, 2 implants were reburied, and 2 were removed. The follow-up period ranged from 1 to 49 months since second stage surgery. Although a number of prosthodontic designs were used, 11 of the 15 patients were restored with removable overlay prostheses. Only those implants exposed to postoperative radiation demonstrated radiographic bone loss following functional loading.
选择20例采用微血管腓骨瓣重建口腔颌面部缺损的患者进行种植体支持的修复治疗。共在移植的腓骨内植入71枚骨整合种植体。4例患者在重建手术时即刻植入种植体，其余16例患者二期植入种植体。1例患者在重建及即刻植入种植体后6周接受了术后放疗（5910 cGy）。先前接受过放疗的皮瓣未植入种植体。二期手术前允许至少6个月的骨整合期。71枚种植体中有54枚暴露；其中46枚种植体功能良好，3枚正在修复中。在暴露的54枚种植体（15例患者）中，只有1枚未实现骨整合，2枚种植体重新埋入，2枚被取出。自二期手术以来，随访期为1至49个月。尽管采用了多种修复设计，但15例患者中有11例采用可摘覆盖义齿修复。只有那些接受术后放疗的种植体在功能加载后出现了影像学上的骨丢失。
