인공치아수복을 위한 기능 형태학적 하악골 재건술

Implants can be installed for prosthetic re habilization simultane ously or secondarily with mandibular reconstruction. In case of extensive mandibular continuity defect, free or vascularized iliac bone, rib bone, c ranial bone, clavicle and fibular have been used as the donor of au togenic bone graft in our clinic . Vestibuloplasty have been performed majority of the cases for improvement of soft tissue condition overlying the reconstructed alveolar ridge area. In this report, we have experienced 18 cases, 66 fixtures of osseointegrated surgery follow ing man dibular reconstruction since 1990. So our research focused on acceptability of the osseointegrated surgery and quality and quantity of the bone graft accoding various the donor bones. And the followings are the brief results of this study, 1. Anatomical contour of the reconstructed alveolar ridge for implant installation was more acceptable with the iliac bone than other donor bone in mandibular reconstruction. 2. No significant difference of bony quality between the various donor bones could found in our cases. 3. The bony quantity for implant fixture installation was most effective in the mandibular reconstruction with iliac bone. 4. Morphological reconstruction of long mandibular continuity defect could be most effectively performed with vascularized fibular flap. 5. Vestibuloplasty have been done simultaneously with implant 2nd stage operation effectively 6. Crestal bone resorption around implant fixtures was observed 2 year after occlusal loading. 1.4mm loss in vascularized bone, 1.6mm loss in free bone. Therefore, contour of mandibular arch, bony quality and bony quantity (height and width) is important factor in the choice of graft donor bone. It is necessary for vestibuloplasty to improve soft tissue condition around implant fixtures. We observed no significant difference between graft bone and normal alveolar bone in crestal bone resorption around implant fixtures.