目的:本研究的目的是评估下颌骨重建的准确性和长期稳定性的潜在差异,关于不同的重建程序。
方法:总共,42例接受原发性节段下颌骨切除并立即进行同种异体重建的患者,使用手动预弯曲或患者特定的下颌重建板(PSMRP),包括在这项研究中。下颌尺寸,就六个临床相关距离而言(头颅[最外侧点],头颅[最内侧点],事故[大多数尾点],下颌孔,冠状突[大多数颅点],下颌骨最接近性点的背侧尖端)从断层图像确定,之前进行了比较,手术后。
结果:当使用常规弯曲钛重建板时,尺寸改变明显更常见。这些发生在冠状突区域(p=0.014)。与PSMRP组(17%/0%)相比,手动预弯曲组中发现钢板骨折的频率更高(p=0.022)。
结论:结果表明,使用PSMRP可以防止下颌近端节段的旋转,从而避免功能损害。此外,PSMRP的使用可能会增强同种异体重建的长期稳定性.
OBJECTIVE: The aim of the current study was to evaluate potential differences in the accuracy of mandibular reconstruction and long-term stability, with respect to different reconstructive procedures.
METHODS: In total, 42 patients who had undergone primary segmental mandibular resection with immediate alloplastic reconstruction, with either manually pre-bent or patient-specific mandibular reconstruction plates (PSMRP), were included in this study. Mandibular dimensions, in terms of six clinically relevant distances (capitulum [most lateral points], capitulum [most medial points], incisura [most caudal points], mandibular foramina, coronoid process [most cranial points], dorsal tip of the mandible closest to the gonion point) determined from tomographic images, were compared prior to, and after surgery.
RESULTS: Dimensional alterations were significantly more often found when conventionally bent titanium reconstruction plates were used. These occurred in the area of the coronoid process (p = 0.014). Plate fractures were significantly (p = 0.022) more often found within the manually pre-bent group than within the PSMRP group (17%/0%).
CONCLUSIONS: The results suggest that the use of PSMRP may prevent rotation of the proximal mandibular segment, thus avoiding functional impairment. In addition, the use of PSMRP may potentially enhance the long-term stability of alloplastic reconstructions.