下颌骨缺损不同植入材料重建的X线影像学追踪观察

目的探讨下颌骨缺损重建的各种治疗方法的效果。方法对经病理确诊且经过治疗的67例下颌骨缺损重建患者的X线片表现进行回顾性分析,比较各种治疗方法的治疗效果。结果在下颌骨切除术后的67例患者,进行了即刻或二期植骨修复治疗。肋骨植入28例,其中7例感染,3例复发,1例植入骨断裂错位愈合;髂骨植入16例,其中1例感染;腓骨植入12例,其中3例同期行种植体的植入,共5枚;人工骨植入6例,其中1例为有机玻璃植入后感染再行人工骨植入,l例术后复发;有机玻璃植入2例,术后均感染;人工高分子材料网及骨松质植入1例;单纯钛板植入2例;复合植入物1例。结论肋骨、髂骨、腓骨植骨修复治疗为目前下颌缺损重建的主要方式,而带血管蒂的游离腓骨组织瓣移植术具有肋骨、髂骨移植术不可比拟的优点,是下颌骨切除术后修复重建的最佳方法之一。

Mandibular reconstructions using multiple grafts:radiologic follow-up observation

Objective Multiple grafts had been used to reconstruct mandibular defects. This study was to evaluate the effects of these reconstructions.Methods The radiological characteristics of 67 cases mandible defects (from 1974 to 2004 ) were analyzed retrospectively, compared with effects of all grafts.Results Sixty-seven cases were reconstructed and followed up after average 2 years. Twelve cases used vascularized free fibular flap, 3 out of them received primary insertion of osteointergrated dental implants, all the 5 implants survived. Ilium 15 cases, 1 infected. Rib 28 cases, 7 infected, 3 recurrences, 1 broken and then malunioned. Polymethyl methacrylate plastics 2 cases, both infected. Hydroxyapatite 6 cases,particulate cancellers bone and marrow grafts with titaniumesh 1 case; titanium plate 2 cases; compound transplant 1 case.Conclusion Ribs,iliac bone and fibular flaps are the modern major method for reconstruction of mandibular defects.Vascularized free fibular flap takes its distinct advantages to other autogeneous bone free flaps, and is conformed to be one of the best methods for mandibular reconstruction.