目的:随着颌面外科技术的进步,血管化游离骨瓣移植已成为修复颌面部缺损的标准治疗方法。在这个荟萃分析中,我们总结了VBFF上颌骨和下颌骨重建术后植入物的存活率,并探讨了影响患者预后的因素。
方法:PubMed,Embase,和万方数据库在2022年5月31日之前进行了搜索。治疗效果的结果以风险比或比值比表示,使用95%置信区间。在α=0.05时计算统计学显著性(双尾z检验)。
结果:35项研究纳入我们的分析。结果显示,VBFF的3年和5年植入物存活率分别为95.2%和85.4%,分别。未发现颌骨缺损(上颌骨或下颌骨)的位置或植入时间对生存率有统计学意义的影响。然而,在辐照骨组织中放置的植入物的失败中观察到统计学上的显着差异。
结论:在同时植入和延迟植入之间的植入物存活率没有发现统计学上的显着差异,或上颌骨和下颌骨之间的缺陷。然而,放置在辐照皮瓣中的牙种植体的存活率往往低于手术放置在未辐照皮瓣中的牙种植体。
As maxillofacial surgical techniques have advanced, vascularized bone free flap transplantation has become the standard treatment for repairing maxillofacial defects. In this meta-analysis, we summarize the survival rates of implants after VBFF surgery for maxillary and mandibular reconstructions and investigate the factors affecting patient outcomes.
The PubMed, Embase, and Wanfang databases were searched up to May 31, 2022. The results of the treatment effect are presented as the risk ratio or odds ratio, using 95% confidence intervals. Statistical significance was calculated at α = 0.05 (two-tailed z tests).
35 studies were included in our analysis. The results revealed a 3-year and 5-year implant survival rate of 95.2% and 85.4% in VBFFs, respectively. The location of jaw defects (maxilla or mandible) or timing of implantation was not found to have a statistically significant influence on the survival rate. However, statistically significant differences were observed in the failure of implants placed in irradiated bone tissue.
Statistically significant differences were not found in the implant survival rate between simultaneous and delayed implantation, or between maxillary and mandibular defects. However, dental implants placed in irradiated flaps tended to have a lower survival rate than those surgically placed in non-irradiated flaps.