组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2018, Vol. 14 ›› Issue (2): 80-82.doi: 10.3969/j.issn.1673-0364.a475

• 论著 • 上一篇    下一篇

下颌骨缺损重建术后影响种植体存留率因素的回顾性分析

王明一，王慧珊，刘剑楠，王震，周恬，曲行舟   

  1. 上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科上海市口腔医学重点实验室上海市口腔医学研究所国家口腔疾病临床研究中心
  • 收稿日期:2018-02-03 修回日期:2018-03-09 发布日期:2020-07-23

A Retrospective Analysis of the Factors Affecting Implant Retention Rate after Mandibular Reconstruction

WANG Mingyi,WANG Huishan,LIU Jiannan,WANG Zhen,ZHOU Tian,QU Xingzhou   

  1. Department of Oral & Maxillofacial-Head & Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine;Shanghai Key Laboratory of Stomatology;Shanghai Research Institute of Stomatology;National Clinical Research Center of Stomatology
  • Received:2018-02-03 Revised:2018-03-09 Published:2020-07-23

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。

关键词: 种植体留存率, 角化龈, 腓骨重建, 下颌骨缺损

Abstract: 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.

Key words: Implant retention rate, Keratinized gingiva, Fibula reconstruction, Mandible defect

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