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利用牙槽骨牵张成骨术对接受成釉细胞瘤切除术后患者进行咬合重建:病例报告。

Occlusal reconstruction of a patient with ameloblastoma ablation using alveolar distraction osteogenesis: a case report.

机构信息

Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan.

Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

Head Face Med. 2020 Jun 2;16(1):12. doi: 10.1186/s13005-020-00227-1.

Abstract

BACKGROUND

Ameloblastoma is one of the most common benign odontogenic neoplasms. Its surgical excision has the potential to lead to postoperative malocclusion. In this case report, we describe the successful interdisciplinary orthodontic treatment of a patient with ameloblastoma who underwent marginal mandibulectomy.

CASE PRESENTATION

A woman of 20-year-old was diagnosed with ameloblastoma, and underwent marginal mandibulectomy when she was 8 years of age. She had an excessive overjet (11.5 mm) and a mild open bite (- 1.5 mm) with a severely resorbed atrophic edentulous ridge in the area around the mandibular left lateral incisor, canine and first premolar. An alveolar bone defect associated with tumor resection was regenerated by vertical distraction osteogenesis (DO). Subsequently, 3 dental implants were placed into the reconstructed mandible. Orthodontic treatment using implant-anchored mechanics provided a proper facial profile with significantly improved occlusal function. The occlusion appeared stable for a 7-year retention period.

CONCLUSIONS

These results suggest that surgically assisted and implant anchored-orthodontic approaches might be effective for the correction of such malocclusions.

摘要

背景

成釉细胞瘤是最常见的良性牙源性肿瘤之一。其外科切除有导致术后咬合不正的潜在风险。在本病例报告中,我们描述了一名成釉细胞瘤患者经边缘下颌骨切除术治疗后,通过跨学科的正畸治疗获得成功的案例。

病例介绍

一名 20 岁女性被诊断为成釉细胞瘤,在 8 岁时接受了边缘下颌骨切除术。她存在明显的前牙深覆颌(11.5mm)和轻度的开颌(-1.5mm),并且在下颌左侧侧切牙、尖牙和第一前磨牙周围的区域存在严重吸收的牙槽嵴萎缩,导致牙列缺失。通过垂直牵引成骨术(DO)再生了与肿瘤切除相关的牙槽骨缺损。随后,在重建的下颌骨中植入了 3 颗牙种植体。利用种植体支抗的力学原理进行正畸治疗,为患者提供了一个合适的面型,显著改善了咬合功能。在 7 年的保持期内,咬合情况稳定。

结论

这些结果表明,手术辅助和种植体支抗的正畸方法可能是矫正此类咬合不正的有效方法。

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