Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain.
Med Oral Patol Oral Cir Bucal. 2011 Jul 1;16(4):e532-6. doi: 10.4317/medoral.16.e532.
Odontogenic fibromyxomas are benign odontogenic tumors of mesenchymal origin of rare presentation in the oral cavity, which exhibit locally aggressive behavior and are prone to local recurrence. The controversy has mainly been on therapeutic management with recommendations varying, depending on the clinical cases, from simple curettage of lesion to segmental bone resection. We present a case report describing the reconstruction of an osseous defect in the maxilla and the restoration with dental implants in a 32 year old female patient after radical surgical excision due to an odontogenic fibromyxoma with locally aggressive behavior. The primary reconstruction of maxillary discontinuity defect was carried out by an immediate non-vascularized cortico-cancellous iliac crest graft. Using a computer-guided system for the implant treatment-planning, three dental implants were secondary placed in the bone graft by means of flapless implant surgery. The patient was subsequently restored with an implant-supported fixed prosthesis that has remained in continuous function for a period of three years. The surgical, reconstructive and restorative treatment sequence and techniques are discussed.
牙源性纤维黏液瘤是一种罕见的口腔来源的间叶性良性牙源性肿瘤，具有局部侵袭性，且易局部复发。主要的争议在于治疗管理，根据临床病例的不同，建议从简单的病变刮除到节段性骨切除不等。我们报告了一例病例，该患者为 32 岁女性，因具有局部侵袭性的牙源性纤维黏液瘤而行根治性手术切除后，我们对其进行了上颌骨骨缺损的重建，并通过牙种植体进行了牙齿修复。采用即刻非血管化骼骨皮质-松质骨移植进行上颌连续性缺损的初步重建。使用计算机引导系统进行种植治疗规划，通过无瓣种植手术将 3 颗种植体二次植入骨移植物中。随后，患者通过种植体支持的固定义齿修复，该义齿在连续使用三年后仍保持功能完好。讨论了手术、重建和修复治疗的顺序和技术。
