Clinical outcomes of implant denture application following mandibular defect repair with fibula flaps in 58 cases
10.3760/cma.j.cn114453-20201010-00524
- VernacularTitle:58例腓骨瓣修复下颌骨缺损后行种植义齿修复的疗效观察
- Author:
Ning GAO
1
;
Kun FU
;
Jinghua CAI
;
Wei HE
Author Information
1. 郑州大学第一附属医院口腔颌面外科 450052
- Keywords:
Mandibular osteotomy;
Ameloblastoma;
Fibula;
Dental implantation;
Quality of life
- From:
Chinese Journal of Plastic Surgery
2021;37(6):624-631
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the therapeutic effect of implant denture after repairing mandibular defect with fibula flaps.Methods:The patients who received implant dentures following mandibular defect repair with fibula flaps to treat mandibular ameloblastoma were included as study subjects. These patients were admitted to the First Affiliated Hospital of Zhengzhou University from March 2015 to January 2018. The free fibular flap was used to repair the mandibular defect after the diseased tissue was removed. The Straumann soft tissue level implants were placed 6-9 months after bone grafting, and the upper porcelain crown was repaired 3 to 4 months after implantation to restore the occlusal relationship and chewing function. The patients were followed up 6 and 12 months after surgery to observe the effect of surgical repair. European Organization for Research and Treatment of Cancer quality of life questionnaire head and neck module (EORTC QLQ-H&N35) and the 14-item Oral Health Impact Profile (OHIP-14) questionnaires were applied to investigate and evaluate the quality of life of the patients before surgery and 6 months and 12 months after surgery.Results:There were a total of 58 patients, 36 males and 22 females, from 18 to 62 years old, with an average of 31.6 years old. In all of the 58 cases, the free flaps survived with restored curvature of the patient’s mandibular defect, symmetrical maxillofacial region and occlusal relationship. Their functions of speech, chewing, and swallowing have all returned to normal. The EORTC QLQ-H&N35 questionnaire survey showed that the score in terms of diet, social contact and teeth was the highest at 6 months after surgery, with statistically significant difference from the preoperative level ( P<0.05); and the score decreased at 12 months after surgery, without statistically significant difference from the preoperative level ( P<0.05). Compared to the preoperative level, the scores in terms of mouth opening both gradually decreased at 6 months and 12 months after surgery, without statistically significant difference ( P<0.05). The score in terms of language at 6 months after surgery was higher than the preoperative level and then fell to the preoperative level at 12 months after surgery. There were no significant changes of the scores in terms of swallowing at each time point ( P>0.05). The OHIP-14 showed that the scores in terms of functional limitation, physical impairment and disability increased at 6 months after surgery with statistically significant difference compared with the preoperative level ( P<0.05), and decreased at 12 months after surgery without statistically significant difference compared with the preoperative level ( P>0.05). The scores in terms of psychological discomfort, psychological disorder and social disorder increased at 6 months after surgery with statistically significant difference compared with the preoperative level ( P<0.05). The scores decreased at 12 months after surgery and were significantly lower than the preoperative level ( P<0.05). The physiological pain gradually decreased at 6 and 12 months after surgery compared with the preoperative level with statistically significant difference ( P<0.05). However, there was no statistically significant difference between 6 and 12 months after surgery( P>0.05). Conclusions:The application of free fibular flaps to repair mandibular defects and the use of the implant dentures can not only restore the patients’ facial contour, but also restore the patients’ occlusal relationship and chewing function, which better improve the patients’ quality of life.
