血管化腓骨重建下颌骨后用腓骨残端游离移植及牙种植的可行性研究

doi:10.19438/j.cjoms.2020.04.010

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (4): 338-342.doi: 10.19438/j.cjoms.2020.04.010

血管化腓骨重建下颌骨后用腓骨残端游离移植及牙种植的可行性研究

王明一^1,*, 傅振^2,*, 张陈平¹

1.上海交通大学医学院附属第九人民医院·口腔医学院,口腔颌面-头颈肿瘤科,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
2.南京中医药大学附属中西医结合医院口腔科,江苏南京 210028

收稿日期:2020-04-07 出版日期:2020-07-20 发布日期:2020-09-10
通讯作者: 张陈平,E-mail:doc_zcp@163.com
作者简介:王明一（1983-）,男,医学博士,E-mail: wmyall@163.com;傅振（1982-）,男,医学硕士,E-mail: 25070697@qq.com。^*并列第一作者

The feasibility of fibular free graft and dental implant after reconstruction of mandible with vascularized fibula flap

WANG Ming-yi¹, FU Zhen², ZHANG Chen-ping¹

1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Department of Stomatology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine. Nanjing 210028, Jiangsu Province, China

Received:2020-04-07 Online:2020-07-20 Published:2020-09-10

摘要/Abstract

摘要： 目的: 探讨利用残余腓骨增加下颌骨缺损腓骨重建患者垂直骨高度的临床效果。方法: 选择12例下颌骨缺损血管化腓骨重建后拟行种植牙修复的患者,利用腿部残余腓骨段进行垂直骨增量,同期或延期植入种植体并最终完成牙列修复,对术后骨吸收情况和种植体稳定性、存留率等数据采用SPSS 19.0软件包进行统计分析。结果: 术后6个月,近中骨块和远中骨块的吸收量分别为（0.94±0.18）mm和（0.89±0.15）mm;术后12个月,吸收量分别为（1.16±0.21）mm和（1.07±0.17）mm。种植体植入6个月和12个月后,ISQ值分别为（67.25±6.43）和（71.08±4.89）;边缘骨吸收量在植入术后6个月和12个月分别为（0.65±0.12）mm和（0.76±0.18）mm。术后1年种植体存留率为87.1%。结论: 非血管化腓骨具有可靠的抗吸收能力,在下颌骨缺损重建术后垂直骨高度不足的情况下,可为种植体植入提供充足骨量,并维持长期稳定性和存留率。

关键词: 垂直骨高度, 非血管化腓骨, 引导骨再生, 下颌骨重建, 种植修复

Abstract: PURPOSE: To investigate the effect of increasing vertical bone height for patients of mandible defects reconstructed with vascular fibular flap. METHODS: A total of 12 patients with mandibular defects were selected who wanted to receive dental implantation repairment after vascularized fibular reconstruction. Vertical bone augmentation was performed using the residual fibula segment, and dental implants were implanted in the same stage or second stage, and finally the dentures retained with implants were completed. Postoperative bone level, implant stability and survival rate were statistically analyzed using SPSS 19.0 software package. RESULTS: The bone loss of segment A and B were (0.94±0.18) mm and (0.89±0.15) mm 6 months after surgery, and (1.16±0.21) mm and (1.07±0.17) mm 12 months after surgery, respectively. ISQ values were (67.25±6.43) and (71.08±4.89) 6 and 12 months after implant implantation, respectively. Marginal bone level was (0.65±0.12) mm and (0.76±0.18) mm 6 and 12 months after implantation, respectively. The implant survival rate was 87.1% 1 year after surgery. CONCLUSIONS: Non-vascularized fibula has reliable anti-absorptive capacity, which can provide sufficient bone mass for implant implantation and maintain its long-term stability and survival rate in cases of insufficient vertical bone height after mandibular reconstruction.

Key words: Vertical bone height, Nonvascular fibular flap, Guided bone regeneration, Mandibular reconstruction, Dental implant

中图分类号:

R782.2

王明一, 傅振, 张陈平. 血管化腓骨重建下颌骨后用腓骨残端游离移植及牙种植的可行性研究[J]. 中国口腔颌面外科杂志, 2020, 18(4): 338-342.

WANG Ming-yi, FU Zhen, ZHANG Chen-ping. The feasibility of fibular free graft and dental implant after reconstruction of mandible with vascularized fibula flap[J]. China J Oral Maxillofac Surg, 2020, 18(4): 338-342.

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血管化腓骨重建下颌骨后用腓骨残端游离移植及牙种植的可行性研究

The feasibility of fibular free graft and dental implant after reconstruction of mandible with vascularized fibula flap

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