Reconstruction of comminuted jaw with iliac crest graft and implant-supported prostheses – case report
Keywords:Autologous graft; Comminuted fractures; Dental implants; Mandibular reconstruction.
Comminuted jaw fractures represent a challenge in terms of treatment. The advancement of fixation techniques and materials has contributed to the surgeon providing faster treatment and less complication. Even so, cases that present severe mandibular fragmentation require additional therapies, such as the use of bone grafts and dental implants, in order to recover function, aesthetics and anatomy of the mandible. This work aims to report a case of comminuted mandibular body fracture, which was treated with reconstruction, initially by rigid internal fixation, and secondly, by iliac bone graft and implant-supported oral rehabilitation. Although studies in the literature demonstrate that autogenous grafts show significant resorption, they are still considered the gold standard, and allow an ideal basis for obtaining osseointegration of dental implants. Thus, we concluded that the use of the autogenous bone graft coming from the iliac crest and rehabilitation with implants can be a satisfactory option for functional and aesthetic repair of patients who presented high impact fractures, and developed significant bone defects.
Abreu, M. E., Viegas, V. N., Ibrahim, D., Valiati, R., Heitz, C., Pagnoncelli, R. M., & Silva, D. N. (2009). Treatment of comminuted mandibular fractures: a critical review. Medicina oral, patologia oral y cirugia bucal, 14(5), E247–E251.
Alpert, B., Tiwana, P. S., & Kushner, G. M. (2009). Management of comminuted fractures of the mandible. Oral and maxillofacial surgery clinics of North America, 21(2), 185–v. https://doi.org/10.1016/j.coms.2008.12.002
Bahuguna, R., Anand, B., Kumar, D., Aeran, H., Anand, V., & Gulati, M. (2013). Evaluation of stress patterns in bone around dental implant for different abutment angulations under axial and oblique loading: A finite element analysis. National journal of maxillofacial surgery, 4(1), 46–51. https://doi.org/10.4103/0975-5950.117882
Cunha, G., Rocha, A., Filho, V., Gabrielli, M., & Gabrielli, M. (2018). Atrophic Maxilla Reconstruction With Autogenous Iliac Graft and Guided Dental Implants. The Journal of craniofacial surgery, 29(8), 2218–2219. https://doi.org/10.1097/SCS.0000000000005023
Ellis, E., 3rd, Muniz, O., & Anand, K. (2003). Treatment considerations for comminuted mandibular fractures. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 61(8), 861–870. https://doi.org/10.1016/s0278-2391(03)00249-0
Finn R. A. (1996). Treatment of comminuted mandibular fractures by closed reduction. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 54(3), 320–327. https://doi.org/10.1016/s0278-2391(96)90753-3
Grassmann, J. P., Schneppendahl, J., Hakimi, A. R., Herten, M., Betsch, M., Lögters, T. T., Thelen, S., Sager, M., Wild, M., Windolf, J., Jungbluth, P., & Hakimi, M. (2015). Hyperbaric oxygen therapy improves angiogenesis and bone formation in critical sized diaphyseal defects. Journal of orthopaedic research: official publication of the Orthopaedic Research Society, 33(4), 513–520. https://doi.org/10.1002/jor.22805
Hof, M., Tepper, G., Semo, B., Arnhart, C., Watzek, G., & Pommer, B. (2014). Patients' perspectives on dental implant and bone graft surgery: questionnaire-based interview survey. Clinical oral implants research, 25(1), 42–45. https://doi.org/10.1111/clr.12061
Jain, A., & Baliga, S. (2015). Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases. Journal of dentistry (Tehran, Iran), 12(7), 542–549.
Jensen, A. T., Jensen, S. S., & Worsaae, N. (2016). Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral and maxillofacial surgery, 20(2), 115–122. https://doi.org/10.1007/s10006-016-0551-8
Kazanjian V. H. & Converse J. M. (1974). Surgical treatment of facial injuries. New York: Baltimore (MD): Williams & Wilkins Co. Third edition. p. 1482.
Kumar, B. P., Venkatesh, V., Kumar, K. A., Yadav, B. Y., & Mohan, S. R. (2016). Mandibular Reconstruction: Overview. Journal of maxillofacial and oral surgery, 15(4), 425–441. https://doi.org/10.1007/s12663-015-0766-5
Lee, K., Yoon, K., Park, K. S., Cheong, J., Shin, J., Bae, J., Ko, I., & Park, H. (2014). Treatment of extensive comminuted mandibular fracture between both mandibular angles with bilateral condylar fractures using a reconstruction plate: a case report. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 40(3), 135–139. https://doi.org/10.5125/jkaoms.2014.40.3.135
Maiorana, C., Poli, P. P., Mascellaro, A., Ferrario, S. & Beretta, M. (2019). Dental implants placed in resorbed alveolar ridges reconstructed with iliac crest autogenous onlay grafts: A 26-year median follow-up retrospective study. Journal of Craniomaxillofacial Surgery. 47(5), 805-814. https://doi.org/10.1016/j.jcms.2019.02.002
Miloro, M., Ghali, G. E., Larsen, P. E. & Waite, P. D. (2016). Princípios de cirurgia bucomaxilofacial de Peterson. 3 ed. São Paulo: Santos Editora. p. 1344.
Nyström, E., Ahlqvist, J., Gunne, J., & Kahnberg, K. E. (2004). 10-year follow-up of onlay bone grafts and implants in severely resorbed maxillae. International journal of oral and maxillofacial surgery, 33(3), 258–262. https://doi.org/10.1006/ijom.2003.0512
Putters, T. F., Wortmann, D. E., Schortinghuis, J., van Minnen, B., Boven, G. C., Vissink, A., & Raghoebar, G. M. (2018). Morbidity of anterior iliac crest and calvarial bone donor graft sites: a 1-year randomized controlled trial. International Journal of Oral and Maxillofacial Surgery, 47(11), 1474-1480. https://doi.org/(...)6/j.ijom.2018.06.002
Sakkas, A., Wilde, F., Heufelder, M., Winter, K., & Schramm, A. (2017). Autogenous bone grafts in oral implantology-is it still a "gold standard"? A consecutive review of 279 patients with 456 clinical procedures. International journal of implant dentistry, 3(1), 23. https://doi.org/10.1186/s40729-017-0084-4
Sönmez, T. T., Prescher, A., Salama, A., Kanatas, A., Zor, F., Mitchell, D., Zaker Shahrak, A., Karaaltin, M. V., Knobe, M., Külahci, Y., Altuntas, S. H., Ghassemi, A., & Hölzle, F. (2013). Comparative clinicoanatomical study of ilium and fibula as two commonly used bony donor sites for maxillofacial reconstruction. The British journal of oral & maxillofacial surgery, 51(8), 736–741. https://doi.org/10.1016/j.bjoms.2013.07.010
Souza C. S. V., Ortega-Lopes, R., Barreno, A. C., de Moraes, M., Albergaria-Barbosa, J. R. & Nóia, C. F. (2019). Analysis of the Survival of Dental Implants Installed in Reconstructed Maxilla With Autogenous Iliac Crest Graft: 7- to 9-Year Follow-Up. Journal of Oral Implantology, 45(6), 427‐436. https://doi.org/10.1563/aaid-joi-D-18-00321
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Copyright (c) 2020 Camila Fernanda Vasconcelos; Andressa Bolognesi Bachesk; José Henrique Santana Quinto ; Willian Pecin Jacomacci ; Caio Cesar Santos Patron Luiz ; Angelo José Pavan
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