Romano, Antonio (2012) Riabilitazione implantare computer-assistita nei pazienti che hanno subito una resezione mandibolare e ricostruzione mediante lembo libero di fibula. Doctoral Thesis.
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Aim: The aim of this project is to evaluate the computer-assisted flapless implant surgery with immediate loading in patients who underwent mandibular fibula free flap reconstruction. The functional assets, the improvement of quality of life and implants survival following immediate loading will be examined.
Methods: In this study are enrolled 15 patients that underwent mono or bilateral mandibular resection and reconstruction with free fibula flaps. Patients are clinically and radiologically free of evident disease. Minimum follow up after radiation therapy was one year. Computer assisted, flapless dental implant placement is performed with NobelGuide® software (Nobel Biocare, Gothenburg, Sweden). Success of implants, parodontal status, reliability of the prosthetic rehabilitation, morbidity of patients will be evaluated and recorded in the next one year follow up.
Results: At the moment six patients were treatead with a total of 32 fixtures installed. Only one implant was lost every patient have a prosthetic rehabilitation.
Conclusion: Mandibular bone defects from extensive resections for oral cancer are usually reconstructed with microvascular osteomuscular bone grafts. Dental implants are frequently needed in order to stabilize the prosthesis. Particular anatomical structure of the free bone flap that constitutes the reconstructed mandibular body, the scar retraction and the thickness of the soft tissues of these patients make implant rehabilitation a challenge.
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