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題名 | 下顎骨邊緣切除術後以單層腓骨皮瓣合併人工植體重建之咀嚼功能負載評估=Outcome of Marginal Bone Level in Vascular Fibular Bone Flap Combined with Dental Implant as Onlay Graft on Marginal Mandibulectomy Patients |
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作者 | 張陽明; 林志鴻; 鄭鈞仁; Chang, Yang-ming; Lin, Chi-hung; Cheng, Chun-jen; |
期刊 | 臺灣口腔顎面外科學會雜誌 |
出版日期 | 20160900 |
卷期 | 27:3 2016.09[民105.09] |
頁次 | 頁178-187 |
分類號 | 416.96 |
語文 | chi |
關鍵詞 | 腓骨骨皮瓣; 下顎邊緣切除術; 人工植體; 腭側黏膜移植; Fibula osteoseptocutaneous flap; Marginal mandibulectomy; Dental implant; Palatal mucosa graft; |
中文摘要 | 本研究之目的在探討下顎骨邊緣切除病患施予腓骨皮瓣移植,並以人工植體種植於排骨上之臨床表現;分析人工植體之存活率及其功能負載下人工植體周邊以兩種不同類型軟組織對植體周邊骨吸收之影響。研究自2001年至2009年共十一位病患,男性十名與女性一名,其中三位曾罹患造釉細胞瘤;八位則為鱗狀細胞癌。研究統計種植之人工植體總計三十八根,其中九位病患總計三十根植體是在腓骨骨皮瓣移植的同時間植入;兩位病患總計八根植體則為第二次手術植入。四位病患共計十三根植體以腭側黏膜移植於人工植體周邊;其餘七位病患共計二十五根植體則在植體二次手術時在植體周圍施予皮瓣削薄術式。所有排骨骨皮瓣移植成功,人工植體在咀嚼功能負載下平均存活72.5個月(介於33至113個月)。植體周邊的骨平均吸收量在腭側黏膜移植組近心側與遠心側皆為0.52±0.28釐米;在皮瓣削薄組近心側為1.76±1.56釐米,遠心側則為1.68±1.47釐米。前者骨吸收量較少且兩組間有統計學上顯著差異(P=0.008)。本研究顯示人工植體周邊施行腭側黏膜移植有助於減少功能負載後之骨吸收。 |
英文摘要 | The aims of this study were to evaluate the clinical outcome of vascularized fibular bone flap as onlay graft over the previous marginal mandibulectomy patients regarding the survival rate of dental implants placed and the effect of two different types of soft tissue around implants on marginal bone loss under functional loading. From 2001 to 2009, a total eleven patients (ten males and one female) were included, three patients had suffered from ameloblastoma and eight had squamous cell carcinoma. A total sum of thirty-eight dental implants were placed either at the time of vascularized fibula osteoseptocutaneous flaps transfer (total thirty implants on nine patients) or secondarily (eight implants on two patients). Four patients received palatal mucosa graft to replace intra-oral skin flaps around the dental implants (N=13), the other seven patients received skin flap thinning around the dental implants (N=25) at the second stage of osteointegrated implantation. All vascularized fibula osteoseptocutaneous flaps were successfully transferred and all implants survived at an average of 72.5 months (33-113 months) follow up after occlusal functional loading. The marginal bone loss was 0.52±0.28mm on both mesial and distal sides in the palatal mucosa graft patient group but were 1.76±1.56 mm and 1.68±1.47 mm respectively on mesial and distal side in the skin flap thinning group. There is significant statistic difference (P=0.008) with less bone resorption in the former group. In the study, palatal mucosa graft around the implants helps to reduce bone resorption after functional loading was implicated. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。