■腓骨皮瓣和天然下颌骨之间的垂直差异导致修复困难。这项研究的目的是通过虚拟手术计划(VSP)使用三种不同的技术评估肿瘤患者下颌骨的三维重建结果,切割导向器,定制的钛网和板与CAD/CAM技术,用于植入物放置的STL模型和术中动态导航。材料和方法。
■对14例肿瘤患者进行了三种不同的下颌骨重建和种植修复技术。5名患者(36%)接受了VSP,切割导向器,STL模型和定制的双桶钛板与双桶皮瓣和即时植入物。6名患者(43%),VSP,进行了STL模型和定制的钛网(CAD/CAM),用于在腓骨瓣上移植的and骨移植物和延迟的牙科植入物进行三维重建。3例患者(21%)接受了VSP,使用切割导向器和定制的钛板进行下颌骨重建和使用术中动态导航的植入物康复。垂直骨重建,种植体周围骨吸收,植入成功率,放射治疗在垂直重建中的作用,骨吸收和植入失败,咀嚼,评估美学结果和吞咽困难。
■发现双筒技术与钛网技术的骨生长之间存在显着差异(p<0.002)。关于骨吸收,技术之间没有显着差异(p=0.11)。放置60个植入物,骨整合率为91.49%。在骨整合期间丢失了5个植入物(8%)。测量种植体周围骨吸收的平均值为1.27mm。使用的垂直增益技术和植入物存活率之间没有显着差异(p>0.385)。未照射患者的植入物存活率较高(p<0.017)。所有患者都使用固定的植入物支持的假体进行康复,报告有规律的饮食(80%)。正常吞咽(85.7%)和出色的美学效果。
■VSP的多阶段实现,STL模型和切割指南,CAD/CAM技术,定制板和内部动态植入物导航下颌骨缺损增加了骨与骨的接触,解决垂直差异,并提高手术效率,降低并发症发生率和最小的骨吸收。它提供了精确的重建,优化植入物的放置,从而改善面部对称性,美学和功能。
UNASSIGNED: Vertical discrepancy between the fibula flap and the native mandible results in difficult prosthetic rehabilitation. The aim of this study was to evaluate the outcomes of 3D reconstruction of the mandible in oncologic patients using three different techniques through virtual surgical planning (VSP), cutting guides, customized titanium mesh and plates with CAD/CAM technology, STL models and intraoperative dynamic navigation for implant placement. Material and methods.
UNASSIGNED: Three different techniques for mandibular reconstruction and implant rehabilitation were performed in 14 oncologic patients. Five patients (36%) underwent VSP, cutting guides, STL models and a customized double-barrel titanium plate with a double-barrel flap and immediate implants. In six patients (43%), VSP, STL models and a custom-made titanium mesh (CAD/CAM) for 3D reconstruction with iliac crest graft over a fibula flap with deferred dental implants were performed. Three patients (21%) underwent VSP with cutting guides and customized titanium plates for mandibular reconstruction and implant rehabilitation using intraoperative dynamic navigation was accomplished. Vertical bone reconstruction, peri-implant bone resorption, implant success rate, effects of radiotherapy in vertical reconstruction, bone resorption and implant failure, mastication, aesthetic result and dysphagia were evaluated.
UNASSIGNED: Significant differences in bone growth between the double-barrel technique and iliac crest graft with titanium mesh technique were found (p<0.002). Regarding bone resorption, there were no significant differences between the techniques (p=0.11). 60 implants were placed with an osseointegration rate of 91.49%. Five implants were lost during the osseointegration period (8%). Peri-implant bone resorption was measured with a mean of 1.27 mm. There was no significant difference between the vertical gain technique used and implant survival (p>0.385). Implant survival rates were higher in non-irradiated patients (p<0.017). All patients were rehabilitated with a fixed implant-supported prosthesis reporting a regular diet (80%), normal swallowing (85.7%) and excellent aesthetic results.
UNASSIGNED: Multi-stage implementation of VSP, STL models and cutting guides, CAD/CAM technology, customized plates and in-house dynamic implant navigation for mandibular defects increases bone-to-bone contact, resolves vertical discrepancy and improves operative efficiency with reduced complication rates and minimal bone resorption. It provides accurate reconstruction that optimizes implant placement, thereby improving facial symmetry, aesthetics and function.