Yoshimura Hitoshi, Ohba Seigo, Nakamura Mikiko, Sano Kazuo
Lecturer, Division of Dentistry and Oral Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
J Oral Maxillofac Surg. 2013 Dec;71(12):2176-88. doi: 10.1016/j.joms.2013.04.034. Epub 2013 Jul 25.
Ossifying fibromas are bone-related benign neoplasms that are characterized by well-demarcated lesions composed of fibrocellular tissue and mineralized material with varying appearances. Although small lesions are asymptomatic, they may cause enlargement of the affected jaw and rarely require reconstructive or restorative treatments for aesthetic and functional problems. In this study, we report a 35-year-old woman who underwent multidisciplinary treatment for a large ossifying fibroma of the mandible. A segmental mandibular resection was performed, and immediate reconstruction was performed using iliac bone and great auricular nerve grafts. After consolidation of the grafted bone, oral rehabilitation was fulfilled using osseointegrated implants and a fixed prosthesis. There was no evidence of recurrence ten years after the resection of the tumor. The range of mouth opening and motion of the temporomandibular joint provided a functional mandible. The neurosensory examination revealed the recovery of sensibility of the mental region and pulpal sensitivity of the teeth. The prosthesis was stable, and no clinical or radiographic signs of implant failure were observed. Our results demonstrate that the proper combination of reconstructive and restorative treatments could result in appropriate aesthetic and functional outcomes for a period of ten years.
骨化性纤维瘤是一种与骨相关的良性肿瘤，其特征是界限清晰的病变，由纤维细胞组织和外观各异的矿化物质组成。虽然小的病变没有症状，但它们可能导致患侧颌骨增大，并且很少因美观和功能问题而需要进行重建或修复治疗。在本研究中，我们报告了一名35岁女性，她因下颌骨巨大骨化性纤维瘤接受了多学科治疗。进行了下颌骨节段性切除，并使用髂骨和耳大神经移植进行了即刻重建。移植骨愈合后，使用骨整合种植体和固定义齿完成了口腔修复。肿瘤切除十年后没有复发迹象。开口范围和颞下颌关节活动度提供了一个功能正常的下颌骨。神经感觉检查显示颏部感觉和牙齿牙髓敏感性恢复。义齿稳定，未观察到种植体失败的临床或影像学征象。我们的结果表明，重建和修复治疗的适当组合可在十年内带来合适的美观和功能效果。
