口内入路行下颌骨良性肿瘤切除游离腓骨移植同期种植体植入的临床分析  

Clinical analysis of mandibular tumor resection with free fibula transplantation and implant implantation via the intraoral approach

作　　者：李建成 颜明明 马正豪 田瑞雪 王续纪 胡恺 姜丽娜 Li Jiancheng;Yan Mingming;Ma Zhenghao;Tian Ruixue;Wang Xuji;Hu Kai;Jiang Lina(Dept.of Stomatology,The First Affiliated Hospital of Bengbu Medical University,Bengbu 233004,China;School of Stomatology,Bengbu Medical University,Bengbu 233030,China)

机构地区：[1]蚌埠医科大学第一附属医院口腔科,蚌埠233004 [2]蚌埠医科大学口腔医学院,蚌埠233030

出　　处：《华西口腔医学杂志》2025年第2期212-219,共8页West China Journal of Stomatology

基　　金：安徽省高校合作攻关和公共卫生协同创新项目(GXXT-2020-021);蚌埠医科大学转化医学重点专项项目(BYTM20190-05);蚌埠医学院研究生科研创新计划(Byycx23076)。

摘　　要：目的探讨数字化技术辅助下口内入路行下颌骨良性肿瘤切除游离腓骨移植重建同期种植体植入的临床应用。方法收集12例下颌骨良性肿瘤患者,术前均数字化技术行下颌骨三维重建,模拟下颌骨肿瘤切除腓骨切取重建及种植体植入;术中导板引导下,口内入路行下颌骨肿瘤切除,腓骨切取、塑形、重建和口内就位固定,并即刻行种植体植入;术后6个月实施种植后二期手术,二期术后1~2个月行义齿修复。结果口内入路切除后下颌骨缺损类型为:BrownⅠ类1例,BrownⅠc类4例,BrownⅡ类1例,BrownⅡc类3例,BrownⅢ类3例。切取腓骨长度为12~22 cm,腓骨塑形截断数:2段2例,3段6例,4段3例,5段1例,均行折叠性腓骨重建缺损下颌骨和牙槽骨。共计植入44个种植体,术后无1例种植失败。结论口内入路行下颌骨良性肿瘤的切除方法可靠,术后并发症少,且能很好地将数字化设计的重建折叠腓骨精确就位固定。移植腓骨即刻种植不影响血供,成功率高,是下颌骨良性肿瘤切除后下颌骨重建的有效方法。Objective To investigate the clinical application of the digital-assisted reconstruction of the mandible and tumors with free fibula transplantation and immediate implantation via the intraoral approach.Methods Twelve patients with benign mandibular tumors were collected.Three-dimensional mandibular reconstruction was performed digitally before surgery to simulate mandibular tumor resection,fibula resection and reconstruction,and implant implantation.The intraoperative resection of the mandibular tumor was conducted through the intraoral approach under the guidance of a guide plate,and fibula resection,molding,reconstruction,and oral fixation were immediately performed.Implant implantation was performed during the second phase of implant surgery and denture restoration was performed 1-2 months after surgery.Results The types of mandibular defects were BrownⅠ(one case),Ⅰ c (four cases), Ⅱ (one case), Ⅱc(three cases), and Ⅲ (three cases). The length of the fibular bone was 12-22 cm. Thenumber of fibular molding amputations was as follows: two cases in two segments, six cases in three segments, three casesin four segments, and one case in five segments. All of these cases underwent folding fibular reconstruction of mandibularand alveolar bone defects. A total of 44 implants were implanted, and none failed after operation. Conclusion Theintraoral approach is a reliable method for the resection of mandibular benign tumors, with few postoperative complicationsand the ability to position and fix accurately the reconstructed folded fibula under digital design. The immediate implantationof the transplanted fibula does not affect the blood supply and has a high success rate. It is an effective and reliablemethod for the resection and reconstruction of mandibular benign tumors.

关 键 词：口内入路 下颌骨良性肿瘤 腓骨移植 同期种植 

分 类 号：R739.8[医药卫生—肿瘤]