Comparative analysis of dental implant treatment outcomes following mandibular reconstruction with double-barrel fibula bone grafting or vertical distraction osteogenesis fibula: a retrospective study
Comparative analysis of dental implant treatment outcomes following mandibular reconstruction with double-barrel fibula bone grafting or vertical distraction osteogenesis fibula: a retrospective study
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DOI：
10.1111/clr.12300
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发表时间：
2015-02-01
影响因子：
4.3
通讯作者：
Wu, Yiqun
中科院分区：
文献类型：
--
作者：
Wang, Feng;Huang, Wei;Wu, Yiqun
本研究的目的有两个方面：(I)比较采用双管腓骨(DBF)技术和垂直腓骨牵引成骨(VDOF)技术的肿瘤切除后的垂直骨高度(VBH)；(Ii)比较DBF和VDOF后加载种植体的性能，特别是种植体存活率、种植成功率和骨吸收。材料和方法从2006年3月到2008年5月，19例患者接受了DBF(A组，n=9)或VDOF(B组，n=10)种植重建下颌骨。两组患者均于术后及术后每年进行临床和X线检查，包括VBH、改良菌斑指数(MPI)、改良骨沟出血指数(MSBI)和边缘骨量(MBL)。结果肿瘤切除后，9例患者植入24颗种植体，10例患者植入27颗种植体进行下颌骨重建。A组和B组DBF和VDOF手术均获得成功，VBH分别为20 mm和17 mm。经3年随访，A组与B组的mSBI评分差异无统计学意义(P=0.40)。A组4例8颗种植体，B组2例3颗种植体，肉芽肿性软组织生长。经3年随访，A组与B组的MBL差异无统计学意义(p=0.736)。A组和B组的累积成活率和种植成功率分别为100%和87.5%，B组分别为100%和85.2%。结论通过对19例患者共51颗种植体的研究，认为DBF或VDOF瓣结合牙种植体重建下颌骨是一种可预测的方法。与放置在VDOF骨中的种植体相比，放置在DBF骨中的种植体具有相对较高的相关牙周炎发生率。在功能负荷过程中，DBF骨似乎比VDOF骨更能抵抗种植体周围的吸收过程。
PurposeThe purpose of this study was twofold: (i) to compare vertical bone height (VBH) after tumor resection through grafting with either a double-barrel fibula (DBF) technique or vertical distraction osteogenesis of the fibula (VDOF); (ii) to compare the performance of loaded dental implants following either DBF or VDOF with special focus on implant survival, implant success, and bone resorption.Materials and methodsThis retrospective clinical study involved 19 patients who underwent implant placement following DBF (group A, n=9) or VDOF (group B, n=10) for mandibular reconstruction from March 2006 to May 2008. Clinical and radiographic assessments, including VBH, modified Plaque Index (mPI), modified Sulcus Bleeding Index (mSBI), and marginal bone level (MBL), were taken for both groups after delivery of the final prostheses and annually thereafter.ResultsNine patients underwent DBF with 24 implants placed and 10 patients underwent VDOF with 27 implants placed for mandibular reconstruction after tumor resection. Overall, all DBF and VDOF procedures were successful for group A and group B. VBH for group A and group B were 20 and 17mm. There was no statistically significant difference of mSBI scores between group A and group B in the 3-year follow-up (P=0.40). In four cases with eight implants of group A and two cases with three implants of group B, granulomatous soft tissue grew. There was no statistically significant differences of MBL between group A and group B in the 3-year follow-up (p=0.736). The cumulative survival and success rates of implants for group A were 100% and 87.5%, and for group B were 100% and 85.2% in 3-year follow-up, respectively.ConclusionsOn the basis of the study of 19 patients who received a total of 51 implants, reconstruction of the mandible with DBF flap or VDOF flap, combined with dental implant therapy, was considered a predictable option. Compared with implants placed in VDOF bone, implants placed in DBF bone had a relative higher incidence of associated gingival inflammation. The DBF bone seems more resistant to peri-implant resorption processes than VDOF bone during functional loading.