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重建下颌骨垂直牙槽骨牵张成骨术及并发症

Vertical alveolar distraction osteogenesis with complications in a reconstructed mandible.

作者信息

Fukuda Masayuki, Iino Mitsuyoshi, Ohnuki Takayoshi, Nagai Hirokazu, Takahashi Tetsu

机构信息

Division of Dentistry and Oral Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.

出版信息

J Oral Implantol. 2003;29(4):185-8. doi: 10.1563/1548-1336(2003)029<0185:VADOWC>2.3.CO;2.

Abstract

We report here a case of vertical alveolar distraction osteogenesis with many complications that required further surgical interventions. A 54-year-old man underwent mandibular resection followed by iliac bone grafting as the result of large mandibular odontogenic keratocyst. Eleven months later, alveolar vertical distraction osteogenesis was applied to the patient for prosthetic rehabilitation. Fracture of the basal bone occurred in the consolidation period, and the fracture was fixed by the titanium miniplate system. Radiographic examination after completion of distraction osteogenesis confirmed a radiolucent area in half of the distracted area between the basal bone and the transport segment, and when the distractor was removed the radiolucent area was filled with fibrous granulation tissue. The granulation tissue was removed and endosteal implants were inserted together with a bone graft. Ultimately, all implants were osseointegrated, and adequate esthetics and function of the implant-supported prosthesis were achieved.

摘要

我们在此报告一例垂直牙槽骨牵张成骨术病例,该病例出现了许多并发症,需要进一步的手术干预。一名54岁男性因巨大下颌牙源性角化囊肿接受了下颌骨切除术,随后进行了髂骨移植。11个月后,对该患者实施牙槽骨垂直牵张成骨术以进行修复重建。在愈合期发生了基底骨骨折,采用钛微型钢板系统对骨折进行了固定。牵张成骨完成后的影像学检查证实,在基底骨与移动段之间的牵张区域的一半出现了透射区,当拆除牵张器时,该透射区充满了纤维肉芽组织。清除肉芽组织后,植入骨内种植体并同时进行骨移植。最终,所有种植体均实现了骨整合,种植体支持的修复体获得了足够的美观和功能。

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