Arcuri M R, Fridrich K L, Funk G F, Tabor M W, LaVelle W E
Department of Hospital Dentistry, University of Iowa Hospital and Clinics, Iowa City, USA.
J Prosthet Dent. 1997 Feb;77(2):177-83. doi: 10.1016/s0022-3913(97)70232-4.
Treatment for head and neck malignancies commonly involves radiation therapy. As a result of this therapy the vascular supply to irradiated structures is altered and results in decreased tissue perfusion. In addition to vascular changes, bony structures undergo a reduction in osteoblastic and osteoclastic activity. These tissue alterations, especially in the mandible, enhance the risk of osteoradionecrosis. To avoid this occurrence, many patients who have undergone radiation therapy do not receive elective preprosthetic surgeries, including implant therapy. PURPOSE OF STUDY AND METHODS: This report presents the preliminary results of placing 18 titanium screw implants into previously irradiated mandibles in conjunction with hyperbaric oxygen therapy.
Of the 18 implants placed, 17 (94%) were judged to be osseointegrated at the abutment connection. One implant did not receive an abutment and was "put to sleep." The remaining 16 (88%) were used for prosthetic rehabilitation.
The use of implants in irradiated tissues may provide a means of enhancing prosthetic rehabilitation while reducing the risk of tissue trauma that may develop into osteoradionecrosis.
头颈部恶性肿瘤的治疗通常包括放射治疗。这种治疗会改变受照射结构的血管供应，导致组织灌注减少。除了血管变化外，骨结构的成骨细胞和破骨细胞活性也会降低。这些组织改变，尤其是在下颌骨，会增加放射性骨坏死的风险。为避免这种情况发生，许多接受过放射治疗的患者不接受包括种植治疗在内的选择性修复前手术。研究目的及方法：本报告介绍了将18枚钛螺钉种植体植入先前接受过照射的下颌骨并结合高压氧治疗的初步结果。
在植入的18枚种植体中，17枚（94%）在基台连接处被判定为骨整合。一枚种植体未安装基台并“停用”。其余16枚（88%）用于修复重建。
在受照射组织中使用种植体可能提供一种增强修复重建的方法，同时降低可能发展为放射性骨坏死的组织创伤风险。
