RESUMO
INTRODUCTION: The microvascular iliac crest flap is preferred for repair of segmental mandibular defects. Its viability and constant size are regarded as a great advantage for oral rehabilitation. PATIENTS: Two patients with oral cancer and recurrent keratocyst underwent mandibular reconstruction with an iliac crest transplant. Wound healing was uneventful. RESULTS: Several years after reconstruction we noticed complete absence of cancellous bone in the transplants. The cortical aspect consisted of vital bone. CONCLUSION: Secondary to changes in the blood supply after tissue transfer, microvascular bone transplants may develop complete medullary resorption. Substitution of this central bone is variable and may not happen at all.
Assuntos
Reabsorção Óssea/etiologia , Transplante Ósseo/efeitos adversos , Mandíbula/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Retalhos Cirúrgicos/irrigação sanguínea , Anastomose Cirúrgica/efeitos adversos , Carcinoma de Células Escamosas/reabilitação , Feminino , Humanos , Ílio/transplante , Cistos Maxilomandibulares/reabilitação , Masculino , Doenças Mandibulares/reabilitação , Neoplasias Mandibulares/reabilitação , Pessoa de Meia-IdadeRESUMO
Different methods are recommended for the surgical reconstruction of the resected mandible. The advantages for implant stabilised prostheses in restoring the occlusion are recognised but few papers provide adequate data to identify the successful outcome of treatment. The literature is reviewed and the advantages of imaging together with the use of digitised data is highlighted by a case requiring rehabilitation with enhanced planning methods.
Assuntos
Simulação por Computador , Prótese Dentária Fixada por Implante , Mandíbula/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos , Tomografia Computadorizada por Raios X/métodos , Transplante Ósseo/métodos , Implantação Dentária Endóssea , Feminino , Humanos , Imageamento Tridimensional , Cistos Maxilomandibulares/reabilitação , Cistos Maxilomandibulares/cirurgia , Mandíbula/diagnóstico por imagem , Doenças Mandibulares/reabilitação , Doenças Mandibulares/cirurgia , Pessoa de Meia-Idade , Modelos Anatômicos , Modelos Dentários , Planejamento de Assistência ao Paciente , Resultado do TratamentoRESUMO
The problem of how to compensate bone defects after Cystectomy is not new. However, phosphatic ceramics (hydroxyapatite and three-calcium phospate) called attention to this problem recently. On the basis of previous experience in minor bone tissue defects the results of application of phosphatic ceramics presented in this article. The patients were clinically and roentgenologically examined. The results showed the usage of phosphatic ceramics in the preservation of the shape and function of the bone tissue. The surgical technique and some details about the application of phosphatic ceramics are also emphasized.