上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (10): 1382-1387.doi: 10.3969/j.issn.1674-8115.2020.10.014

• 论著·临床研究 • 上一篇    下一篇

颧种植技术重建上颌骨缺损的疗效评估

林歆妍1，周文洁1，王 凤2，黄 伟2，王 震3，曲行舟3#，吴轶群1#   

  1. 1.上海交通大学医学院附属第九人民医院·口腔医学院口腔第二门诊部，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海市口腔医学研究所，上海 200011；2.上海交通大学医学院附属第九人民医院口腔种植科，上海 200011；3.上海交通大学医学院附属第九人民医院口腔颌面头颈肿瘤科，上海 200011
  • 出版日期:2020-10-28 发布日期:2020-11-27
  • 通讯作者: 吴轶群，电子信箱：yiqunwu@hotmail.com。曲行舟，电子信箱：quxingzhou@126.com。#为共同通信作者。
  • 作者简介:林歆妍（1996—），女，硕士生；电子信箱：xinsan@sjtu.edu.cn。
  • 基金资助:
    国家重点研发计划（2017YFB1302904）；上海交通大学医学院附属第九人民医院临床研究型多学科诊疗团队项目（2017-1-005）。

Functional reconstruction of maxillectomy defect with zygomatic implant

LIN Xin-yan1, ZHOU Wen-jie1, WANG Feng2, HUANG Wei2, WANG Zhen3,QU Xing-zhou3#, WU Yi-qun1#   

  1. 1. Department of Second Dental Center, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China; 2. Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; 3. Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2020-10-28 Published:2020-11-27
  • Supported by:
    National Key Research and Development Program of China (2017YFB1302904); Clinical Multi-Disciplinary Team Research Program of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (2017-1-005).

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摘要： 目的·评估应用颧种植技术重建上颌骨缺损的临床效果。方法·纳入2013年1月—2019年12月单侧或双侧上颌骨缺损颧种植修复重建患者，评估颧种植体留存率、上部修复体成功率、术中/术后并发症，随访观察颧种植体周围软组织状况、患者语音及咀嚼功能恢复情况、患者对修复重建后面型的满意度等。结果·25例患者共植入69枚颧种植体、15枚常规种植体，上颌骨缺损侧植入颧种植体平均每例1.6枚（39/25）。上部赝复体多采用杆卡、磁性固位体、Locator?等方式进行固位。患者平均随访时间3.7年，颧种植体留存率达94.2%（65/69）。术后修复体封闭了口鼻腔交通，患者均恢复清晰语音，进食流质类饮食无渗漏，咀嚼功能改善明显；患者对术后面型较为满意。术后常见并发症包括颧区皮肤瘘管和种植体周围软组织增生。结论·颧种植技术可作为功能性重建上颌骨缺损的有效方法，恢复面中1/3形态和口腔功能。

关键词: 颧种植体, 上颌骨缺损, 重建, 留存率

Abstract:

Objective · To evaluate the outcomes of maxillary reconstruction using zygomatic implant （ZI） technique. Methods · Eligible patients who were treated with maxillary resection and rehabilitated with ZI-supported obturator prostheses were enrolled from January 2013 to December 2019. The survival rate of the ZI, the success rate of the prosthesis, the postoperative complications, the restoration of speech and mastication, and patients' satisfaction on appearance were evaluated to determine the clinical outcomes of this technique. Results · A total of 69 ZIs and 15 conventional dental implants were inserted in 25 patients. Clip-bar, magnetic retainer and Locator? were fabricated for obturator retention. The survival rate of the ZIs was 94.2% （65/69） after a mean follow-up of 3.7 years. Reconstruction prevented the communication between oral cavity and nasopharynx so that speech and mastication function was fully recovered. The patients were satisfied with oral function and appearances after reconstruction. Postoperative complications presented an incidence of 4% （3/69）, including facial fistula and soft tissue hyperplasia around ZI. Conclusion · ZI technique is a feasible treatment to reconstruct the maxillectomy defect with favorable clinical outcomes, providing good facial morphology and functional restoration, which avoids extensive bone grafting and shortens the treatment period.

Key words: zygomatic implant, maxillary defect, reconstruction, survival rate

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