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口腔颌面部缺损多因发育畸形、外伤、肿瘤切除后引起,常涉及多个解剖部位的多种组织,导致咀嚼、吞咽、语音、感觉等功能丧失及颌面部畸形,给患者生理、心理带来极大的创伤。随着种植技术被引入口腔颌面部缺损修复领域,真正意义上的口腔颌面部缺损的功能重建才得以逐步实现。对于合并上颌骨缺损的口腔颌面部复杂缺损,种植支持式赝复体治疗仍是部分案例修复行之有效的方法;大部则考虑如引导骨组织再生技术、上颌窦底提升植骨技术以及游离式植骨等各骨增量技术,结合牙种植技术进行同期或延期种植修复。同时颧种植体的应用更丰富了其修复内容。在合并下颌骨缺损的口腔颌面部复杂缺损中,游离植骨同期或延期种植、血管化及非血管化骨移植同期种植以及基于“反求技术”和“快速原型技术”的下颌骨形态与功能重建和下颌骨牙槽突及颌骨移植瓣的垂直牵张成骨后再行种植修复均可取得较完善的修复效果。目前种植在口腔颌面部缺损中的应用愈见广泛,本文主要对其现代种植修复重建的设计与技术等方面进行综述。
Oral and maxillofacial defects due to the development of deformity, trauma, tumor resection caused, often involving multiple anatomical parts of a variety of organizations, leading to chewing, swallowing, loss of speech and sensory functions and maxillofacial deformities, to the patient’s physical and psychological Bring great trauma. With the introduction of implant technology into the field of oral and maxillofacial defect repair, the functional reconstruction of oral and maxillofacial defects has been gradually realized. For complex defects of the oral and maxillofacial region complicated with maxillary defects, implantation of prosthetic prostheses is still an effective method in some cases. Most of the techniques include guided bone regeneration and maxillary sinus floor elevation bone grafting Free bone graft and other bone increment techniques, combined with dental implant technology for the same period or postponed implant repair. At the same time the application of zygomatic implant more enriched its repair content. In the complex defect of oral and maxillofacial region complicated with mandibular defects, simultaneous or delayed free grafting, simultaneous implantation of vascularized and non-vascularized bone graft, and based on “reverse technique” and “rapid prototyping” Mandibular shape and functional reconstruction and mandibular alveolar process and vertical distraction of the mandibular graft can be performed after orthopedic implant surgery can achieve a better repair effect. At present, the application of implant in oral and maxillofacial region is more and more widely. This article mainly reviews the design and technology of modern implant restoration and reconstruction.