摘要
目的分析下颌骨缺损腓骨重建术后影响种植体存留率的因素,为临床治疗提供理论指导。方法收集2015年1月至2017年12月下颌骨缺损行腓骨重建后牙种植体植入的患者资料共20例,从角化龈是否缺失、软组织厚度和移植骨高度等三方面收集数据,与种植体周围边缘性骨吸收量进行比较。结果 20例患者中,角化龈完全缺失12例,单侧缺失5例,完全保留3例。重建术后3个月、6个月、12个月的软组织厚度分别为(5.88±0.54)mm,(3.46±0.30)mm和(3.17±0.31)mm;移植骨高度分别为(2.36±0.23)mm,(2.17±0.19)mm和(2.05±0.22)mm。种植体植入后3个月、6个月、12个月近中MBL值分别为(1.09±0.32)mm,(1.22±0.37)mm和(1.36±0.46)mm;远中MBL值分别为(1.10±0.29)mm,(1.25±0.31)mm和(1.35±0.39)mm。经统计学分析,角化龈、软组织厚度与边缘性骨吸收值成正相关,移植骨高度与边缘性骨吸收值成反相关。结论下颌骨缺损重建术后种植患者,应尽量增加移植骨高度,减少软组织厚度,并且在颌骨切除时,在保证切缘安全的情况下尽可能多地保留角化龈。
Objective To explore the factors affecting implant retention rate after mandibular reconstruction with fibula bone flap and provide theoretical direction for clinical therapy.Methods From January 2015 to December 2017,a total of 20 cases(male 12cases,female 8 cases,20 to 45 years old,average 27.2 years old)who received dental implantation after mandibular reconstruction were retrospectively analyzed.The data such as the status of keratinized gingiva,the thickness of peri-implant soft tissue and the height of bone graft were collected,and were all compared with the marginal bone loss(MBL).Results Of all the 20 patients,keratinized gingival loss was observed in 12 cases bilaterally,5 cases unilaterally,and preserved in 3 cases.Three months,6 months and 12 months after the reconstruction,the thickness of soft tissue were(5.88±0.54)mm,(3.46±0.30)mm,(3.17±0.31)mm,separately;and the height of bone graft were(2.36±0.23)mm,(2.17±0.19)mm,(2.05±0.22)mm,separately.Three months,6 months and 12 months after the implantation,the mesial MBL were(1.09±0.32)mm,(1.22±0.37)mm,(1.36±0.46)mm,separately;and the distal MBL were(1.10±0.29)mm,(1.25±0.31)mm,(1.35±0.39)mm,separately.Statistical analysis revealed that the keratinized gingiva and thickness of soft tissue were both positively correlated with the MBL,and the height of bone graft was inversely correlated with the MBL.Conclusion For the oral implant patients after mandibular reconstruction,the height of the bone graft should be increased and the thickness of soft tissue should be reduced.And keratinized gingiva should be preserved as much as possible if oncological safety is allowed during mandibular resection.
作者
王明一
王慧珊
刘剑楠
王震
周恬
曲行舟
WANG Mingyi;WANG Huishan;LIU Jiannan;WANG Zhen;ZHOU Tian;QU Xingzhou(Department of Oral&Maxillofacial-Head&Neck Oncology,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China;Shanghai Key Laboratory of Stomatology,Shanghai 200011,China;Shanghai Research Institute of Stomatology,Shanghai 200011,China;National Clinical Research Center of Stomatology,Shanghai 200011,China)
出处
《组织工程与重建外科杂志》
2018年第2期80-82,共3页
Journal of Tissue Engineering and Reconstructive Surgery
关键词
种植体留存率
角化龈
腓骨重建
下颌骨缺损
Implant retention rate
Keratinized gingiva
Fibula reconstruction
Mandible defect
