钛板携带种植体修复下颌骨缺损的临床应用

目的:探讨钛板携带种植体与植骨联合修复大型下颌骨缺损的可行性。方法:对9例下颌骨体部和颏部同时缺损者用带有HA涂层种植体的钛板进行修复,并在钛板上方和种植体周围植骨,术后给抗生素防感染,6个月后安装基台和义齿、拍X线片、观察钛板和种植体与植骨的结合情况,并对咀嚼功能、面部形态及并发症进行评价。结果:钛板携带种植体植入下颌骨后切口一期愈合,6个月至5年随访,8例面部形态恢复良好,安装基台行义齿修复后可咀嚼软食,未见伤口裂开和钛板外露,X线拍片见种植体周围的植骨生存良好,植骨与种植体之间无低密度影;1例在放射治疗18个月后植骨吸收,部分钛板和种植体暴露,但仍可佩戴义齿,无明显假体周围炎。结论:钛板携带种植体与植骨联合修复大型下颌骨缺损可恢复患者的面形和咀嚼功能,对大型下颌骨缺损的修复是可行的方法。

Clinical Application on Reconstruction of Mandibular Defect with Titanium Plate Combined with Implants

Objective:To evaluate the feasibility of reconstruction of large mandibula defect with the association of titani-um plate combined with implants and bone transplantation.Methods:Titanium plates combined with HA covered implants were applied to 9 patients with the defect of mandibula body and mental region. The titanium plates and implants were cov-ered by transplanted bone. Antibiotics were used to prevent postoperative infection. The abuments were installed and den-tures were manufactured 6 months later.X -ray photographs were carried out to observe the imterface between the trans-planted bone and the titanium plate or implant. Masticatory function and face form and complication were also evaluated.Results:The incisions were primary healing after operation. The patients were recalled 6 months to 5years post operation.8 cases healed with well face form,could masticate pap after denture restoration,without incision dehiscence or titaniumplate exposure.X -ray photographs showed no absorption of the transplanted bone, no image of lowdensity between titani-um plate and transplanted bone. 1 case healed with transplanted bone absorbed 18 months after radiotherapy,and part of ti-tanium plate and implant exposed. But denture could be used without significant inflammation around prothesis.Conclu-sion:The reconstruction of large mandibula defect with the association of titanium plate combined with implants and bonetransplantation is feasible and can be used to reconstruct face form and masticatory function.