非节段性下颌骨切除术后即刻游离髂骨移植及延期种植体植入：病例系列
Immediate free iliac bone graft after nonsegmental mandibular resection and delayed implant placement: a case series.
作者信息
Kim Andrew, Kar Kian, Nowzari Hessam, Cha Hyun-Suk, Ahn Kang-Min
机构信息
*Resident, Department of Advanced Periodontology, University of Southern California, Los Angeles, CA. †Associate Professor, Department of Advanced Periodontology, University of Southern California, Los Angeles, CA. ‡Private Practice, Department of Periodontics, Beverly Hills, CA. §Associate Professor, Department of Prosthodontics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea. ‖Associate Professor, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea.
出版信息
Implant Dent. 2013 Oct;22(5):438-43. doi: 10.1097/ID.0b013e31829f1ed0.
BACKGROUND
Resection of mandibular tumors without proper reconstruction may lead to unfavorable esthetic and function results. The purpose of this case series was to describe clinical results and a technique to prevent tissue loss using nonvascular iliac grafts immediately following tumor resection and long-term stability of the implants.
MATERIALS AND METHODS
Three female patients presented with oral neoplasms (2 ameloblastoma and 1 ossifying fibroma). The mandibular reconstruction was performed with nonvascularized iliac grafts simultaneous with tumor removal. Subsequently, 10 dental implants were placed 6 to 9 months after reconstruction and restored. Survival and success of the implants were evaluated.
RESULTS
Marginal mandibulectomy in 1 patient and buccal bone resection in 2 patients was performed; the resection sites were reconstructed with an immediate nonvascularized iliac graft. All implants survived and were successful during follow-up periods between 44 and 105 months. Mean marginal bone loss of 10 implants was 0.09 mm.
CONCLUSIONS
Immediate reconstruction with nonvascularized iliac grafts following tumor resection may be a viable treatment option for nonsegmental inlay osseous defects. In these case series, the resorption of the iliac bone was minimal after 6 to 9 months consolidation periods.
背景
下颌肿瘤切除后若未进行适当重建，可能导致不良的美学和功能结果。本病例系列的目的是描述临床结果以及一种在肿瘤切除后立即使用非血管化髂骨移植来防止组织缺失的技术，以及植入物的长期稳定性。
材料与方法
三名女性患者患有口腔肿瘤（2例成釉细胞瘤和1例骨化纤维瘤）。在切除肿瘤的同时，使用非血管化髂骨移植进行下颌骨重建。随后，在重建后6至9个月植入10颗牙种植体并进行修复。对种植体的存活和成功情况进行评估。
结果
1例患者进行了下颌骨边缘切除术，2例患者进行了颊侧骨切除术；切除部位用即刻非血管化髂骨移植进行重建。所有种植体在44至105个月的随访期内均存活且成功。10颗种植体的平均边缘骨吸收为0.09毫米。
结论
肿瘤切除后立即用非血管化髂骨移植进行重建可能是治疗非节段性嵌体骨缺损的一种可行选择。在这些病例系列中，经过6至9个月的巩固期后，髂骨的吸收最小。
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