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Maxillary tuberosity reconstruction with transport distraction osteogenesis.

Ugurlu F, Basel B, Sener BC, Sertgöz A - Case Rep Dent (2012)

Bottom Line: A 4 × 6 × 3 cm cyst was discovered in the left maxillary molar region and enucleated.A fixed denture was loaded over the implants after 3 months.Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University Nişantaşı Kampuşı, Büyük Çiftlik Sokak No. 6, Nişantaşı, Şişli, 34365 Istanbul, Turkey.

ABSTRACT
Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4 × 6 × 3 cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.

No MeSH data available.


Related in: MedlinePlus

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fig1: Ct scan view.

Mentions: A 45-year-old man, who suffered from pain in the left posterior maxilla and a bad smell from the nose, was referred to our department. A 4 × 6 × 3 cm cyst was found in the left maxillary molar region on radiological examination (Figure 1). After treating the acute infection, the patient underwent cyst enucleation under general anaesthesia (Figure 2). Six months postoperatively, the area had a severe bony defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. After computed tomography (CT) and model analysis of the defect, we decided to reconstruct it using transport distraction. Under general anaesthesia, a vestibular incision was made and a mucoperiosteal flap was raised to expose the lateral wall of the maxilla. The bone between the number 23 and the number 25 maxillary teeth was cut vertically with a saw and then connected to a horizontal bone cut 5 mm above the apex of the second premolar running posteriorly on the buccal side. The bone on the palatinal side was cut horizontally with curved osteotomes, gently to avoid damaging the palatal mucosa. Before mobilising the transport segment including number 25, the distractor was adapted to its stabilising plates with screws, and then the segment was mobilised using osteotomes (Figure 3). Before suturing the surgical site, the distractor was checked to ensure that the transport segment was being moved into the proper position.


Maxillary tuberosity reconstruction with transport distraction osteogenesis.

Ugurlu F, Basel B, Sener BC, Sertgöz A - Case Rep Dent (2012)

Ct scan view.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369494&req=5

fig1: Ct scan view.
Mentions: A 45-year-old man, who suffered from pain in the left posterior maxilla and a bad smell from the nose, was referred to our department. A 4 × 6 × 3 cm cyst was found in the left maxillary molar region on radiological examination (Figure 1). After treating the acute infection, the patient underwent cyst enucleation under general anaesthesia (Figure 2). Six months postoperatively, the area had a severe bony defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. After computed tomography (CT) and model analysis of the defect, we decided to reconstruct it using transport distraction. Under general anaesthesia, a vestibular incision was made and a mucoperiosteal flap was raised to expose the lateral wall of the maxilla. The bone between the number 23 and the number 25 maxillary teeth was cut vertically with a saw and then connected to a horizontal bone cut 5 mm above the apex of the second premolar running posteriorly on the buccal side. The bone on the palatinal side was cut horizontally with curved osteotomes, gently to avoid damaging the palatal mucosa. Before mobilising the transport segment including number 25, the distractor was adapted to its stabilising plates with screws, and then the segment was mobilised using osteotomes (Figure 3). Before suturing the surgical site, the distractor was checked to ensure that the transport segment was being moved into the proper position.

Bottom Line: A 4 × 6 × 3 cm cyst was discovered in the left maxillary molar region and enucleated.A fixed denture was loaded over the implants after 3 months.Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University Nişantaşı Kampuşı, Büyük Çiftlik Sokak No. 6, Nişantaşı, Şişli, 34365 Istanbul, Turkey.

ABSTRACT
Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4 × 6 × 3 cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.

No MeSH data available.


Related in: MedlinePlus