エナメル上皮腫辺縁切除後２回の骨移植によるインプラント治療の１例

抄録

Although ameloblastoma is a benign odontogenic tumor, its tendency to be slow growing, to infiltrate the bone, and in rare cases to recur, means the course of treatment is similar to that of malignant tumors. Often this results in an extensive surgical resection leading to functional and esthetic problems. Recovery of the masticatory function and form utilizing implant treatment is contingent on the provision of optimum placement for implants in the reconstructed mandible. This paper reports implant treatment for a 23-year-old man, based on two-stage bone grafting after a marginal mandibulectomy to remove a benign but partially invasive ameloblastoma. The treatment involved excision of the tumor, reconstruction of the mandible and restoration of the occlusion through a two-stage iliac block bone grafting procedure. For the first graft, autogenous bone material was harvested from the ilium. In the secondary procedure, eighteen months later, width and height around the alveolar ridge at the implant placement area were augmented with a partial thickness, block bone graft taken from the opposite side iliac crest and cortical plate, shaped into a saddle form. After a further twelve months, the patient received three implants in the second premolar and the first and second molar regions at the reconstruction site. A successful final outcome was achieved, with a three-year follow-up period showing satisfactory functional and cosmetic results.