Ugurlu F, Basel B, Sener B Cem, Sertgöz A
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University Nişantaşı Kampuşı, Büyük Çiftlik Sokak No. 6, Nişantaşı, Şişli, 34365 Istanbul, Turkey.
Case Rep Dent. 2012;2012:816572. doi: 10.1155/2012/816572. Epub 2012 May 31.
Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4 × 6 × 3 cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.
由于上颌结节区域的病变导致的严重骨丢失，在手术和修复方面都是一个具有挑战性的问题。由于该区域骨质结构精细且存在上颌窦，大块骨移植的存活率较低。我们的病例报告描述了一种在一名45岁男性患者中，采用水平牵引成骨技术重建上颌结节严重骨缺损的新技术。在左上颌磨牙区发现一个4×6×3厘米的囊肿并进行了摘除。术后三个月，该区域出现严重骨缺损，向上延伸至颧突，向后延伸至翼钩切迹。三个月后，将包括右上第二前磨牙的骨段进行截骨并水平牵引。骨段向远中牵引了15毫米。在骨段巩固后，拆除牵引器时植入种植体。三个月后在种植体上安装固定义齿。通过骨段牵引成骨可以重建延伸至颅底的完全性牙槽骨缺失。将邻近骨缺损的牙槽骨段向远中移位是重建此类严重缺损的一种简便方法。
