機能回復を目指した上顎再建−インプラントと顎補綴を含めて−

抄録

The maxilla has an anatomically complex structure, and therefore recovery of morphology and function is not easily achieved in patients who have lost maxillary bone and surrounding soft tissue due to maxillary cancer. Prosthetic approaches have traditionally been used to treat these defect sites by using jaw dentures to achieve functional recovery. Jaw dentures are a useful means of enhancing intraoral stability by maintaining residual teeth and obturator appliances and of quickly improving chewing, swallowing, and speech functions. Meanwhile, recent advancements in reconstructive surgery have led to the active implementation of closure of defect sites by means of various skin flaps and bony reconstruction of the maxilla using grafts such as vascularized iliac flaps or vascularized fibular flaps.

　Various debates are ongoing over which criteria should be used to select the maxillary prosthetic treatment and reconstructive surgical method for maxillary defects after tumor resection. Due to their respective advantages and disadvantages, the treatment method should be chosen with consideration for the patient’s general condition and the state of the defects. Depending on the patient, a combination of both prosthetic treatment and reconstructive surgery may be necessary; the advantages of both treatments should be exploited as much as possible.

　Dental implants have been used in recent years to improve the therapeutic effects of both of these treatments with good outcomes.