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采用定制钢板进行下颌骨重建治疗药物相关性颌骨坏死——病例系列

Mandible Reconstruction With Custom-Made Plates in Medication-Related Osteonecrosis of the Jaw-A Case Series.

作者信息

Mitate Eiji, Demura Taichi, Yamauchi Youta, Sawai Yasuhisa, Hasumoto Miho, Wada Satoshi, Nakano Hiroyuki, Demura Noboru

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa 920-0293, Japan.

Dentistry and Oral Surgery, Kouseiren Takaoka Hospital, 5-10 Eiraku-cho, Takaoka, Toyama 933-8555, Japan.

出版信息

Case Rep Dent. 2024 Oct 24;2024:9251185. doi: 10.1155/2024/9251185. eCollection 2024.

Abstract

: Restoration of the mandibular region after segmental resection surgery is crucial for masticatory function and facial aesthetics. The precision of three-dimensional printers has advanced in recent years, enabling the development of fully customized reconstruction plates. In recent years, three-dimensional printing technology has been applied in the field of dental and oral surgery. Among these, the selective laser melting method has been developed. This case report was aimed at exploring the utility in restoring mandibular morphology. Patients diagnosed with medication-related osteonecrosis of the jaw (MRONJ) in Oral and Maxillofacial Surgery at Kanazawa Medical University Hospital who underwent mandibular disarticulation and immediate completely customized reconstruction plate (COSMOFIX) were included. Case 1 involved a female in her 70s with MRONJ on the right side of the mandible. Case 2 involved a female who received bisphosphonates for extensive metastatic breast cancer, resulting in MRONJ affecting the bilateral mandible. Case 3 involved a woman who developed MRONJ on the right side of the mandible during alendronate treatment for osteoporosis. Completely customized reconstruction plates were used for reconstruction after segmental resections. The three patients adapted to the remaining bone. The reconstructed and preoperative mandibular morphologies were similar. : In conclusion, the use of completely customized reconstruction plates obviates the need for bending and other adaptations, reduces surgical time, and improves postoperative aesthetics. Of significance, preparing completely customized reconstruction plate requires about 3 weeks; thus, careful case selection and scheduling are indispensable.

摘要

节段性切除手术后下颌区域的修复对于咀嚼功能和面部美观至关重要。近年来,三维打印机的精度有所提高,使得完全定制的重建板得以开发。近年来,三维打印技术已应用于口腔颌面外科领域。其中,选择性激光熔化方法已经得到发展。本病例报告旨在探讨其在恢复下颌形态方面的效用。纳入了在金泽医科大学医院口腔颌面外科被诊断为药物相关性颌骨坏死(MRONJ)并接受下颌关节离断术及即刻完全定制重建板(COSMOFIX)的患者。病例1为一名70多岁的女性,右侧下颌骨患有MRONJ。病例2为一名女性,因广泛转移性乳腺癌接受双膦酸盐治疗,导致双侧下颌骨发生MRONJ。病例3为一名女性,在使用阿仑膦酸钠治疗骨质疏松症期间右侧下颌骨发生MRONJ。节段性切除术后使用完全定制的重建板进行重建。这三名患者均适应了剩余的骨骼。重建后的下颌形态与术前相似。总之,使用完全定制的重建板无需弯曲和其他调整,减少了手术时间,并改善了术后美观度。重要的是,制备完全定制的重建板大约需要3周时间;因此,仔细的病例选择和安排是必不可少的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dcc/11527530/b75723978f6c/CRID2024-9251185.001.jpg

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