Ortakoglu Kerim, Suer Berkay Tolga, Ozyigit Aykut, Ozen Tuncer, Sencimen Metin
Department of Oral and Maxillofacial Surgery, Center for Dental Sciences, Gulhane Military Medical Academy, Ankara, Turkey.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Oct;102(4):e8-11. doi: 10.1016/j.tripleo.2006.01.020. Epub 2006 Aug 4.
Bone continuity defects in the mandible are caused by tumor surgery, trauma, infection, or osteoradionecrosis. Today, reconstruction of long-span mandibular defects with a free fibular flap is a routine procedure. However the bone height of the mandible after reconstruction is about half that of the dentulous mandible. Therefore, the deficiency in bone height makes implant placement impractical. In our case, because it was necessary to restore the mandibular height, a vertical distraction osteogenesis was performed on the grafted mandible of the patient who was referred to our clinic with a reconstructed mandible owing to a gunshot injury. As a result, the vertical discrepancy between the fibula and the native hemimandible of the patient was corrected. And the placement of dental implants was performed without any complications. In conclusion, we believe that the vertical distraction osteogenesis of free vascularized fibula flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation.
下颌骨的骨连续性缺损由肿瘤手术、外伤、感染或放射性骨坏死引起。如今,采用游离腓骨瓣修复大跨度下颌骨缺损是一种常规手术。然而,重建后下颌骨的骨高度约为有牙下颌骨的一半。因此,骨高度不足使得种植体植入不切实际。在我们的病例中,由于有必要恢复下颌骨高度,对一名因枪伤接受下颌骨重建后转诊至我们诊所的患者的移植下颌骨进行了垂直牵张成骨术。结果,患者腓骨与天然半侧下颌骨之间的垂直差异得到了纠正。并且种植牙植入过程没有出现任何并发症。总之,我们认为游离带血管腓骨瓣的垂直牵张成骨术是一种可靠的技术,可优化种植体定位以实现理想的修复康复。