Article record

使用原发性骨内种植体和埋藏皮片促进种植体固位牙科修复体的腓骨游离皮瓣颌骨重建后的长期健康相关生活质量

Long-Term Health-Related Quality of Life After Jaw Reconstruction With Fibula Free Flaps Using Primary Endosseous Implants and Buried Skin Grafts to Facilitate Implant-Retained Dental Prostheses.

临床研究咽喉科IF 1.7Q3

文献信息

PMID	42736169
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Yu Jin Jeong 查看其他 12 位作者 Masako Dunn；Emma Charters；Rebecca Venchiarutti；Timothy Manzie；Dale Howes；James Wykes；Carsten E Palme；David Leinkram；Tsu-Hui Hubert Low；Yee Mon Aung；Sydney Ch'ng；Jonathan R Clark
作者单位	Department of Head and Neck Surgery, Chris O'brien Lifehouse, Sydney, New South Wales, Australia. 查看其他 6 条单位信息 Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.；Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.；School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.；Royal Prince Alfred Institute of Academic Surgery, Sydney, New South Wales, Australia.；Department of Otolaryngology Head & Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.；NHMRC Centre of Research Excellence for Applied Innovations in Oral Cancer, Sydney, Australia.
期刊	ANZ journal of surgery
SCI 分区	Q3
IF	1.7
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

背景： 健康相关生活质量（HRQoL）数据对于理解颌骨重建后的患者结局不可或缺。本研究旨在使用经过验证的患者报告结局测量（PROMs）评估采用埋藏皮片促进种植体固位牙科修复体康复的颌骨重建后的长期HRQoL。
方法： 开展了一项队列研究，纳入2012年10月至2023年6月在澳大利亚悉尼Chris O'Brien Lifehouse接受Rohner所述预层压技术或悉尼改良Alberta重建技术（SM-ART）且有HRQoL数据的所有患者。HRQoL采用FACE-Q头颈癌模块、MD Anderson吞咽困难量表（MDADI）和言语障碍指数（SHI）进行评估，从基线至术后5年，每隔一年评估一次。
结果： 共纳入28例（Rohner技术；n = 19或SM-ART；n = 9）（中位年龄52岁）。5例患者中共记录到6枚牙种植体丢失（种植体丢失中位时间21.5个月）。3例患者需要移除义齿；然而，所有患者在随访结束时均拥有种植体固位修复体。尽管与基线相比，术后12个月时大多数子量表的横断面HRQoL评分较低，但可获得应答者的平均评分在60个月时显示出向基线有利的趋势。外观困扰显著优于基线（平均差[MD] +19.9，95%置信区间[CI] -4.1至43.9），而口腔功能（MD -16.6，95% CI -53.4至20.2）和进食困扰（MD -8.5，95% CI -50.3至33.3）提示存在更持续的缺陷。
结论： 在采用这些重建技术以优化牙科康复后，观察到长期HRQoL的有利趋势，尽管长期估计值应谨慎解读。这些数据可能有助于为患者咨询提供关于预期恢复轨迹的信息。

英文摘要

BACKGROUND: Data on health-related quality-of-life (HRQoL) is indispensable in understanding patient outcomes following jaw reconstruction. This study aims to evaluate long-term HRQoL using validated patient-reported outcome measures (PROMs) following jaw reconstruction using buried skin grafts to facilitate implant-retained dental prosthetic rehabilitation.
METHODS: A cohort study of all patients that underwent prelamination as described by Rohner or the Sydney Modified-Alberta Reconstruction Technique (SM-ART) from October 2012 to June 2023 at Chris O'Brien Lifehouse, Sydney, Australia with HRQoL data was conducted. HRQoL was assessed using the FACE-Q Head and Neck Cancer Module, MD Anderson Dysphagia Inventory (MDADI), and Speech Handicap Index (SHI) at one-year intervals from baseline to 5 years post-operatively.
RESULTS: Twenty-eight cases (Rohner technique; n = 19 or SM-ART; n = 9) were included (median age, 52 years). Six dental implant losses were recorded across five patients (median time to implant loss, 21.5 months). Three patients required denture removal; however, all had an implant-retained prosthesis at end of follow-up. While cross-sectional HRQoL scores were lower across most subscales at 12 months post-operatively as compared with baseline, mean scores among available respondents showed favourable trends towards baseline by 60 months. Appearance distress notably improved beyond baseline (mean difference [MD] +19.9, 95% confidence interval [CI] -4.1 to 43.9), while oral competence (MD -16.6, 95% CI -53.4 to 20.2) and eating distress (MD -8.5, 95% CI -50.3 to 33.3) suggested a more persistent deficit.
CONCLUSIONS: Favourable trends in long-term HRQoL were observed following these reconstructive techniques to optimise dental rehabilitation, although long-term estimates should be interpreted cautiously. These data may help inform patient counselling regarding the anticipated trajectory of recovery.