正颌手术和间隔式骨移植重建严重萎缩颌骨的效果评价

中国口腔颌面外科杂志 ›› 2015, Vol. 13 ›› Issue (2): 140-146.

正颌手术和间隔式骨移植重建严重萎缩颌骨的效果评价

周苗^{1, 2}, 海德克·特海登², 朴正国¹

1.广州医科大学附属口腔医院,广州口腔疾病研究所·口腔医学重点实验室,广东广州 510140;
2.卡塞尔红十字医院口腔颌面外科,德国卡塞尔 34121

收稿日期:2014-05-26 修回日期:2014-12-18 出版日期:2015-03-20 发布日期:2015-04-23
通讯作者: 周苗,E-mail: zhm1000@gmail.com
作者简介:周苗 (1977-),男,博士,讲师
基金资助:
国家自然科学基金（81000421）; 广东省科技厅科技计划项目 ( 2013B021800314); 国际口腔种植协会 (International Team of Implantology, ITI) 基金（881-2012）

Reconstruction of severely atrophied jaw by orthognathic surgery and interpositional bone augmentation

ZHOU Miao^{1, 2}, Hendrik Terheyden², PIAO Zheng-guo¹

1.Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease,Stomatology Hospital of Guangzhou Medical University. Guangzhou 510140, Guangdong Province, China;
2.Department of Oral and Maxillofacial Surgery, Kassel Red Cross Hospital. Kassel 34121, Germany

Received:2014-05-26 Revised:2014-12-18 Online:2015-03-20 Published:2015-04-23
Supported by:
Supported by National Natural Science Foundation of China (81000421), Research Fund from Guangdong Provincial Department of Science and Technology (2013B021800314), and Research Fund from International Team for Implantology (881-2012)

摘要/Abstract

摘要： 目的: 评估正颌手术和间隔式骨移植重建严重萎缩颌骨的临床效果。方法: 12例重度牙周炎所致颌骨严重萎缩患者,其中男5 例、女7 例,在颌骨重建后行牙种植义齿修复。对于严重萎缩的上颌骨,采用正颌手术和间隔式骨移植（Le Fort I 型截骨术+ 上颌窦提升+块状骨移植）进行重建。在严重萎缩的下颌骨,采用间隔式骨移植或附加块状骨移植进行重建。重建4~6个月后拆除钛板和钛钉,共植入122颗种植体。种植后4~6个月进行修复。应用临床和放射学检查等手段观察种植体愈合、骨结合情况和修复效果,采用SPSS 13.0软件包对数据进行统计学分析。结果: 上、下颌骨高度和宽度得到较大提升。植入的种植体中,2颗在植入1个月时脱落,其余功能负载良好,存留率为98.36%。所有种植体均完成修复,修复后随访30~61个月,均负载正常。重建后患者的容貌和咀嚼功能得到明显改善。结论: 正颌手术联合间隔式骨移植是一种重建严重萎缩颌骨患者面容和牙颌功能的可靠方法。由于观察时间尚短,远期效果有待进一步评估。

关键词: 正颌外科, 间隔式骨移植, 严重萎缩颌骨, 颌骨重建, 牙种植修复

Abstract: PURPOSE: To evaluate the clinical effectiveness of rehabilitation of severely atrophied jaw by orthognathic surgery and interpostional bone augmentation. METHODS: We conducted a retrospective review of 12 patients who had received orthognathic surgery and interpostional bone augmentation (maxilla: Le Fort I osteotomy + maxillary sinus elevation + onlay; mandible: interposition + onlay). The study group included 5 males and 7 females, aged 59 to 77 years (mean, 67.9 years). Four to six months after jaw reconstruction, one hundred and twenty-two implants were embedded. After another 4-6 months, the implants prostheses were successfully made. The survival of the dental implants and the final prosthesis were evaluated by clinical and radiographic examinations. RESULTS: Except for 2 lost implants, the other fixtures functioned successfully after 30-61 months of follow-up. Cumulative survival and success rates of all fixtures were 98.36%. The patients' profile and masticatory efficiency were significantly improved after implant prosthesis. SPSS 13.0 software package was used for statistical analysis. CONCLUSIONS: Orthognathic surgery and interpostional bone augmentation are promising methods to rehabilitate the facial contour and dental function in those patients with extremely atrophied jaw. Due to limited follow-up peroid, the long-term results need to be investigated.

Key words: Orthognathic surgery, Interpostional bone augmentation, Severely atrophied jaw, Jaw reconstruction, Dental implants prosthesis

中图分类号:

R782.12

周苗, 海德克·特海登, 朴正国. 正颌手术和间隔式骨移植重建严重萎缩颌骨的效果评价[J]. 中国口腔颌面外科杂志, 2015, 13(2): 140-146.

ZHOU Miao, Hendrik Terheyden, PIAO Zheng-guo. Reconstruction of severely atrophied jaw by orthognathic surgery and interpositional bone augmentation[J]. China J Oral Maxillofac Surg, 2015, 13(2): 140-146.

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