Application of Dense Hydroxylapatite-Metal Complex Artificial Root Implant to Maxillofacial Prosthetics

颌面修复术可用于治疗口腔癌手术后的语言和咀嚼困难，但对于那些已经切除了大部分颌骨而剩下的牙齿很少或没有的患者来说，通常很困难。在这些患者中，颌面修复体的保持和稳定是重要的。我们制作了磷灰石-钛牙种植体来治疗难以保留和稳定颌面修复体的患者，并在临床和实验动物中评估了它们的实用性。制作了几种实验性牙种植体，其中包括一片式、两片式、单独的磷灰石和磷灰石-钛复合体。金属部件为OP锚钉型和圆柱型，更易于准备。本研究使用了以下牙种植体：圆柱形、盘状和三明治。将各种牙科植入物植入狗的颌骨中。植入后1 ~ 3个月，磷灰石根表面与新形成的编织骨直接结合，植入后7个半月~ 1年，磷灰石根与新形成的板层骨直接结合，提供了牢固的骨整合。在测试的牙科植入物中，两件式磷灰石钛根似乎是最有用的。临床上使用的牙种植体是基于实验研究的结果。两件式磷灰石-钛复合体牙种植体用于口腔癌手术后用传统方法制作的修复体不能令人满意地保持或稳定的患者。每例患者均佩戴OP锚式附着体修复体。在所有使用我们的牙种植体的病例中，我们发现修复体的稳定性和咀嚼效率都有一定的改善。从这些研究中，我们得出结论，我们的牙种植系统在颌面部康复的临床应用是可能的和有益的。

Maxillofacial prosthesis is useful for treatment of speech and mastication difficulties after surgery for oral cancer, but is often difficult in patients who have had extensive portions of the jaw removed with few or no remaining teeth. Retention and stabilization of a maxillofacial porsthesis in such patients are important. We made apatite-titanium dental implants to treat patients for whom it was difficult to retain and stalilize a maxillofacial prosthesis, and evaluated their usefulness both clinically and in experimental animals. Several kinds of experimental dental implants were made, among which were one-piece, two-piece, apatite alone and apatite-titaniumcomplex. Metal parts were of the OP-anchor type and cylindrical type, which allowed easier preparation. The following dental implants were used for this study : cylindrical, discoidal and sandwich. Various dental implants were implanted in the jaws of dogs. One to three months after implantation, the surface of the apatite root was directly bound to the newly formed woven bone and 7 and a half months to 1 year after implantation the apatite root was directly bound to the newly formed lamellar bone, which provided strong bone integration. Of the dental implants tested, the two-piece apatite-titanium roots seemed to be most useful. The dental implants used in clinically were based on the finding from the experimental studies. Two-piece apatite-titanium complex dental implants were used in patients in whom prostheses made by the conventional method could not be satisfactorily retained or stabillized after surgery for oral cancer. A maxillofacial prostheses with OP-anchor type attachment was worn by each patient. In all cases in which we applied our dental implants some improvement of stabilization of the prosthesis and of chewing efficiency was revealed. From these studies we conclude that clinical application of our dental implant system in maxillofacial rehabilitation would be possible and beneficial.