导航辅助穿颧种植体植入修复双侧上颌骨缺损的临床应用  

Clinical application of navigation assisted zygomatic implant for bilateral maxillary defects

作　　者：曲行舟[1] 王震 Ong Hui Shan 王明一[1] 王洋[1] Qu Xingzhou;Wang Zhen;Ong Hui Shan;Wang Mingyi;Wang Yang(Department of Oral Maxillofacial-Head&Neck Oncology,Shanghai Ninth People’s Hospital,Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[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,200011

出　　处：《中华整形外科杂志》2021年第5期514-519,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨导航辅助穿颧种植技术在双侧上颌骨缺损修复中的临床应用效果。方法收集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2013年1月至2019年12月行双侧上颌骨次全切除的患者资料。纳入标准:James Brown’sⅡ类双侧上颌骨缺损患者,上颌无余留牙并伴有口鼻相通。排除标准:病变累及颧骨体或术后需要放疗者。利用数字化技术应用Simplant 3D软件将阻塞器与缺损拟合,确定种植体植入方向与平台显露位置,肿瘤切除同期或术后二期在Brainlab工作平台导航引导下行双侧颧骨种植体植入,最终采用种植体支持式阻塞器修复上颌骨缺损。随访1年,采用阻塞器功能评分量表(OFS)对临床效果进行评估。结果本研究共纳入20例,男13例,女7例,年龄28~72岁,平均53.6岁。共植入颧骨种植体68枚,脱落2枚,种植体骨结合率97.06%。种植阻塞器修复率为90%(2例因肿瘤复发未进行最终修复)。经OFS量表评价,患者在咀嚼、发音以及外观等方面均获得了满意的效果。结论穿颧种植能够给双侧上颌骨缺损患者提供良好的修复效果,导航技术能够提高颧种植体植入的准确性。Objective To investigate the clinical value of navigation assisted zygomatic implant technique in the repair of bilateral maxillary defects.Methods Clinical data:from January 2013 to December 2019,patients underwent bilateral subtotal maxillectomy in the Department of Oral and Maxillofacial Head and Neck Oncology,the Ninth People’s Hospital Affiliated to Medical College of Shanghai Jiao Tong University.Inclusion criteria:James Brown’s classⅡpatients with bilateral maxillary defect,with oral nasal communication,without residual teeth.Exclusion criteria:patients with zygomatic pathologic involvement or requiring postoperative radiotherapy.The obturator was fitted with the defect by using digital technology and Simplant 3D software,and the implant direction and exposure position of the platform were determined.The bilateral zygomatic implants were implanted under the guidance of Brainlab platform navigation at the same time or in the second stage after tumor resection.Finally,the implant supported obturator was used to repair the maxillary defect.The patients were followed up for 1 year,and the clinical effect was evaluated by obturator functional scale(OFS).Results A total of 20 patients,13 males and 7 females,aged from 28 to 72 years,with an average of 53.6 years,were included in this study.A total of 68 zygomatic implants were implanted and 2 of them failed.The osseointegration rate was 97.06%.The repair rate of implant occluder was 90%.By the evaluation of OFS scale,the patients achieved satisfactory result in chewing,pronunciation and appearance.Conclusions Zygomatic implant can provide decent repair effect for maxillary obturator,and navigation technology can make zygomatic implant accurately implanted into the ideal site.

关 键 词：外科手术 计算机辅助 上颌骨 腭阻塞器 穿颧种植 

分 类 号：R782.2[医药卫生—口腔医学]