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在边缘性下颌骨切除术中切除口腔鳞状细胞癌,包括部分骨结合种植体。病例报告。

Removal of an oral squamous cell carcinoma including parts of osseointegrated implants in the marginal mandibulectomy. A case report.

作者信息

Meijer Gert J, Dieleman Francois J, Bergé Stefaan J, Merkx Matthias A W

机构信息

Department of Oral and Maxillofacial Surgery 590, Radboud University Nijmegen Medical Center, Geert Grooteplein-Zuid 14, 6525 GA Nijmegen, the Netherlands.

出版信息

Oral Maxillofac Surg. 2010 Dec;14(4):253-6. doi: 10.1007/s10006-010-0208-y.

Abstract

PURPOSE

The incidence of oral squamous cell carcinomas (OSCC) arising around dental implants will increase because of the rising popularity of dental implants. In this case, a novel surgical treatment of an OSCC in the vicinity of endosseous implants is reported.

MATERIALS AND METHODS

In a 69-year-old woman, a recurrent OSCC (cT₂N₀M₀) developed in the floor of the mouth extending to the attached keratinized peri-implant mucosa of both interforaminal-placed dental implants. Radiographically, no bone invasion could be observed.

RESULTS

To radically remove the tumor, a marginal mandibulectomy was performed including the cranial parts of both dental implants by cutting them into two parts. Three years after tumor resection and one year after reimplantation, the patient is disease free and has a good oral function.

CONCLUSIONS

In case of an OSCC, traditional bone and soft margins for oncologic safety are 1.0 cm. If a dental implant is present within this safety zone, on condition, there is no massive bone invasion, and the original mandible has sufficient vertical height; a marginal mandibulectomy including part of the implants can be considered.

摘要

目的

由于牙种植体的日益普及,牙种植体周围发生口腔鳞状细胞癌(OSCC)的发病率将会增加。在此,报告了一种对骨内种植体附近的OSCC进行的新型手术治疗方法。

材料与方法

在一名69岁女性患者中,复发性OSCC(cT₂N₀M₀)发生于口底,延伸至两个孔间种植的牙种植体附着的角化种植体周围黏膜。影像学检查未观察到骨侵犯。

结果

为彻底切除肿瘤,进行了下颌骨边缘切除术,包括将两个牙种植体的颅骨部分切成两部分。肿瘤切除三年后及重新种植一年后,患者无疾病且口腔功能良好。

结论

对于OSCC,为确保肿瘤学安全性,传统的骨和软组织切缘为1.0 cm。如果在该安全区内存在牙种植体,且条件是没有大量骨侵犯,并且原下颌骨有足够的垂直高度,则可考虑进行包括部分种植体的下颌骨边缘切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a192/2988214/2b33dd7d6788/10006_2010_208_Fig1_HTML.jpg

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