Restoration of oral function after maxillectomy with osseous integrated implant retained maxillary obturators.
This study assesses the success rate of osseous integrated implantation in assisting the prosthetic obturation of maxillectomy defects. Twenty-three patients received a total of 85 osseous integrated implants used for retaining maxillary obturators between 1985 and 1993. Defects include 13 radical maxillectomies, 5 premaxillary resections, 4 subtotal maxillectomies, and 1 soft-palate resection. Thirteen patients (50 implants) received a radiation dose ranging from 5,040 to 7,940 cGy. Implants can be placed at the time of ablation or subsequently. Efforts were made to spare uninvolved segments of the maxilla, especially premaxillary segments and tuberosities, at the time of ablation. Following a 6-month period of integration, implants were uncovered and utilized in prosthetic rehabilitation. Specific implant sites reveal variable success rates, with the anterior maxilla being 86% successful compared with the posterior maxilla being 57% successful. Radiation reduces the success rate from 80% to 55%, although it does not eliminate a patient from being a candidate for implantation. Prosthetic rehabilitation of large maxillary defects can be greatly facilitated with the use of osseous integrated implants in the remaining midfacial skeleton.
Department of Plastic and Reconstructive Surgery, City of Hope National Medical Center, Duarte, California 91010.
J A
JA
Lorant
E
E
Roumanas
R
R
Nishimura
J
J
Beumer
L D
LD
Wagman
D016301:Alveolar Bone Loss / Q000150:complications; D016025:Bone Transplantation; D006801:Humans; D008437:Maxilla / Q000601:surgery*; D008439:Maxillary Diseases / Q000150:complications; D008441:Maxillary Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000601:surgery; D008447:Maxillofacial Prosthesis; D019736:Prostheses and Implants; D016896:Treatment Outcome