Is Immediate Reconstruction of the Mandible With Nonvascularized Bone Graft Following Resection of Benign Pathology a Viable Treatment Option?
Is Immediate Reconstruction of the Mandible With Nonvascularized Bone Graft Following Resection of Benign Pathology a Viable Treatment Option?
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DOI：
10.1016/j.joms.2014.10.019
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发表时间：
2015-03-01
影响因子：
1.9
通讯作者：
Kolokythas, Antonia
中科院分区：
文献类型：
--
作者：
Schlieve, Thomas;Hull, William;Kolokythas, Antonia
目的：本研究的目的是解决以下临床问题：在良性病理切除后立即用无血管化骨移植物重建下颌骨是一种可行的治疗选择吗？另一个目的是确定是否有任何变量影响这种治疗方法的成功。材料和方法：作者从诊断为下颌骨良性肿瘤的患者样本中实施了一项回顾性队列研究，这些患者接受了节段性切除和自体非血管化骨移植物的初级重建。预测变量为年龄、性别、病变大小和诊断，结果变量为移植物成功与否，取决于是否重建下颌连续性，是否有足够的骨供移植物放置。分类资料及P值小于的采用c2检验进行统计分析。0.05认为有统计学意义。结果：20例下颌骨良性肿瘤经口切除后立即行无血管化骨移植重建。平均年龄为28.3岁（9至63岁），男性占55%（20人中有11人）。最常见的病变类型为成釉细胞瘤（13 / 20），所有患者均行自体髂前嵴植骨重建。90%的患者（18 / 20）重建成功。10例患者成功植入并修复。结论：通过谨慎的患者选择，经口切除治疗良性病变并立即用髂前嵴无血管化骨移植重建是成功的。此外，从种植体修复到恢复术前功能的总治疗时间被最小化。因此，这种治疗方法是一种可行的治疗选择，也是延迟重建或血管化骨瓣重建的替代方法。(C) 2015年美国口腔颌面外科医师协会。
Purpose: The purpose of this study was to address the following clinical question: Is immediate reconstruction of the mandible with a nonvascularized bone graft after resection of benign pathology a viable treatment option? Another purpose was to determine whether any variables affect the success of this treatment approach.Materials and Methods: The authors implemented a retrospective cohort study from a sample of patients diagnosed with a benign tumor of the mandible who were treated with segmental resection and primary reconstruction with an autogenous nonvascularized bone graft. The predictor variables were age, gender, lesion size, and diagnosis, and the outcome variable was graft success determined by re-establishment of mandibular continuity with sufficient bone for implant placement. The c 2 test was used for statistical analysis of the categorical data and P values less than .05 were considered statistically significant.Results: Twenty patients with benign mandibular tumors were treated with transoral resection and immediate reconstruction with nonvascularized bone grafts. The mean age was 28.3 years (range, 9 to 63 yr) and 55% (11 of 20) were men. The most common lesion type was ameloblastoma (13 of 20) and all patients underwent reconstruction with autogenous anterior iliac crest bone grafting. Ninety percent of patients (18 of 20) had successful reconstruction. Ten patients underwent successful implant placement and restoration.Conclusions: Using careful patient selection, treatment of benign pathology with transoral resection and immediate reconstruction with a nonvascularized bone graft from the anterior iliac crest can be successful. In addition, the total treatment time from implant restoration to return to preoperative function is minimized. Therefore, this method of treatment is a viable treatment option and an alternative to delayed reconstruction or reconstruction with vascularized bone flaps. (C) 2015 American Association of Oral and Maxillofacial Surgeons.