| Objective:To investigate the imaging changes of byiliac bone graft with supported by dental implant in reconstruction of mandible defect,and the quality of life of the patients.The result will be compared with conventional prostheses.Methods:Twenty-four subjects were enrolled from June 2000 to June 2017.All participants already had byiliac bone reconstruction for segmental defects,excluding 9 cases without repaired,loss of visits,and with radiotherapy before or after surgery.The remaining 14 cases including 4 cases with dental rehabilitation using two to four implant-supported prostheses(IP)of postoperative bone graft implant surgery and other 10(10/15)cases with conventional prostheses(CP)(non-implant supported).We assessed the function and appearance of maxillofacial repair of patients before and after treatment,measured?compared and statisticsed the bone resorption form iconography both IP and CP.During the follow-up period of six months to 4 years,we evaluated the patients,subjective rating scale,oral function and appearance through questionnaire survey.Result:1.4 cases of IP removed titanium before implant surgery,and then implanted 2-4 implants.Two plants of one(1/4)case became loose after six months,and we re-implanted one implant one month after.In 4 cases,the upper prostheses were made after 3-6 months.2.The imageology of the IP showed that the circumferential gap was blurred in 3 months and 6 months.We couldn't see bone sparsity around the implant during the healing process.The occlusion of the 4 cases was good.The height of bone graft was measured at four parts,including the left 0.5cm of the right plant,the right 0.5cm of the middle part,the left 0.5cm of the middle part and the right 0.5cm at the left plant.And the time points were 3±1,6±1,12±1 and one year later.The average absorption rates of these four cases were 2.956±1.143?1.513±0.963?10.123±1.757?13.510±11.582.Four patients were followed up with satisfactory appearance,good relationship of occlusion and normal eating.No implant loosening and abscission occurred during the follow-up period.The masticatory ability of 4 cases were all better,of which 1 cases had a slight discomfort in the mandible area when chewing the hard food,so they had long eaten soft food.3.In the CP group,the height of bone graft was measured at four parts,The height of bone graft was measured at four parts,including the left 0.5cm of the right plant,the right 0.5cm of the middle part,the left 0.5cm of the middle part and the right 0.5cm at the left plant.And the time points were 3±1,6±1,12±1 and one year later.The average absorption rates of these 5 cases were 6.469±1.181?19.463±6.288?12.368±5.018?13.606±3.075 and 12.063±5.588.10 cases of CP were repaired with active dentures half to 2 years after the operation.Of the 10 cases after repair,3 showed poor masticatory function.But the masticatory ability improved with the enhancement of the ability to control the denture.90%of the traditional denture repaired patients choose more soft food,but did not affect daily life.Conclusion:1.Bone resorption occurred in bone graft area both IP and CP.The gap between the 4 cases of implant prosthesis was large,which may be related to the bone healing,the design of the upper repair and the individual difference in the patient.2.In two cases of implant dentures,we can find the bone resorption was less,but there was no significant difference between IP and CP group.3.Reconstruction of mandibular fibula flap after implant repair or traditional removable denture is effective,which improved aesthetics,linguistic and chewing function to a large extent.This study shows that the implant denture has a greater advantage than the traditional prosthesis in the masticatory function,and is more comfortable. |
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