颌骨缺损血管化游离骨瓣重建后的种植修复治疗

doi:10.7518/hxkq.2023.2023005

华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (2): 123-128.doi: 10.7518/hxkq.2023.2023005

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颌骨缺损血管化游离骨瓣重建后的种植修复治疗

单小峰(), 蔡志刚

北京大学口腔医学院·口腔医院口腔颌面外科国家口腔医学中心国家口腔疾病临床医学研究中心口腔生物材料和数字诊疗装备国家工程研究中心口腔数字医学北京市重点实验室国家卫生健康委口腔医学计算机应用工程技术研究中心，北京 100081

收稿日期:2023-01-05 修回日期:2023-03-09 出版日期:2023-04-01 发布日期:2023-04-14
通讯作者: 单小峰 E-mail:kqsxf@263.net
作者简介:单小峰，教授，口腔医学博士，现任北京大学口腔医院口腔颌面外科主任医师、教授，博士研究生导师，口腔颌面外科副主任。现为中华口腔医学会口腔颌面外科专业委员会委员，中华口腔医学会口腔颌面修复专业委员会委员，北京市口腔颌面外科专业委员会常务委员，中华口腔医学会口腔颌面头颈肿瘤专业委员会委员，中华医学会显微外科学分会青年委员。曾主持国家自然科学基金1项和首都特色医疗项目1项，现主持首都医学发展基金1项。作为第一作者或通信作者发表SCI论文20余篇。主要研究方向为口腔颌面头颈肿瘤的诊治、口腔颌面部缺损的功能性重建、颌骨重建以后的种植修复以及唾液腺和口腔癌的基础研究。E-mail：kqsxf@263.net
基金资助:
首都卫生发展科研专项(CFH2020-2-4102);北京大学口腔医院国家重大疾病多学科合作诊疗能力建设项目(PKUSSNMP-202015)

Dental implant treatment in vascularized bone flaps after jaw reconstruction

Shan Xiaofeng(), Cai Zhigang.

Dept. of Oral and Maxillofacial Surgery，Peking University School and Hospital of Stomatology & National Center of Stomato-logy & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomate-rials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Enginee-ring and Technology for Computerized Dentistry，Beijing 100081，China

Received:2023-01-05 Revised:2023-03-09 Online:2023-04-01 Published:2023-04-14
Contact: Shan Xiaofeng E-mail:kqsxf@263.net
Supported by:
Capital’s Funds for Health Improvement and Research(CFH2020-2-4102);National Program for Multidisciplinary Cooperative Treatment on Major Diseases of Peking University School and Hospital of Stomatology(PKUSSNMP-202015);Correspondence: Shan Xiaofeng, E-mail: kqsxf@263.net

摘要/Abstract

摘要：

因为肿瘤等原因造成的颌骨缺损，常严重影响外形和功能。口腔颌面部肿瘤治疗的目标除了治愈肿瘤，还应该包括尽量恢复患者患病前的功能。显微外科技术和数字化外科技术的发展推动了以血管化游离骨瓣重建颌骨缺损的发展，术前的可视化设计可以帮助获得更好的外形。在重建的颌骨上如何恢复咬合功能，提高患者的生活质量，成为一个重要的研究方向。本文将从颌骨重建理念、血管化骨瓣的选择、种植时机的选择、种植体周围软组织的处理、放疗对颌骨重建后种植义齿的影响等方面进行讨论。

关键词: 颌骨缺损重建, 血管化腓骨瓣, 血管化髂骨瓣, 种植义齿, 放疗

Abstract:

Jaw defects caused by various reasons often seriously affect appearance and function. The goal of the treatment of oral and maxillofacial tumors should include the cure of the tumor and the restoration of premorbid function. The development of microsurgery and digital surgery technology has promoted the development of jaw reconstruction with vascularized free bone flap. Good appearance and improved predictability could be obtained with the help of preope-rative visual design. How to rehabilitate occlusal function on the reconstructed jaw and improve the quality of life of patients has become an important research direction. This article discusses the challenge of jaw reconstruction, the selection of vascularized bone flap, the choice of implant timing, the treatment of peri-implant soft tissue, and the influence of radiotherapy on implants after jaw reconstruction.

Key words: jaw defect reconstruction, vascularized fibula flap, vascularized iliac crest flap, dental implant, radial therapy

中图分类号:

R 782.2

单小峰, 蔡志刚. 颌骨缺损血管化游离骨瓣重建后的种植修复治疗[J]. 华西口腔医学杂志, 2023, 41(2): 123-128.

Shan Xiaofeng, Cai Zhigang.. Dental implant treatment in vascularized bone flaps after jaw reconstruction[J]. West China Journal of Stomatology, 2023, 41(2): 123-128.

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骨瓣类型	骨长度/cm	血管蒂长度/cm	骨质类型	血管蒂动脉直径/mm	双组手术	供区并发症	骨瓣成功率	种植成功率
腓骨瓣	<20	较长	骨皮质	2~3	可以	较轻	高	较高
髂骨瓣	<10	4~5	骨皮质和松质	1~2	可以	较轻	高	较高

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颌骨缺损血管化游离骨瓣重建后的种植修复治疗

Dental implant treatment in vascularized bone flaps after jaw reconstruction

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