自家脛骨骨髄海綿骨細片とカスタムメイド・チタンメッシュトレーを用いて下顎骨再建を行った1例

In our department, we have performed mandibular reconstruction using autogenous particulate cancellous bone and marrow (PCBM) harvested from the posterior iliac crest and a custom-made titanium mesh tray for extended mandibular defects caused by tumor resection and so on. However, harvesting PCBM fr...

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Published in日本口腔外科学会雑誌 Vol. 65; no. 8; pp. 545 - 550
Main Authors 雨宮, 剛志, 濱田, 良樹, 長谷部, 充彦, 堀内, 俊克, 山田, 秀典, 中岡, 一敏
Format Journal Article
LanguageJapanese
Published 社団法人 日本口腔外科学会 20.08.2019
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ISSN0021-5163
2186-1579
DOI10.5794/jjoms.65.545

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Abstract In our department, we have performed mandibular reconstruction using autogenous particulate cancellous bone and marrow (PCBM) harvested from the posterior iliac crest and a custom-made titanium mesh tray for extended mandibular defects caused by tumor resection and so on. However, harvesting PCBM from the posterior iliac crest has a disadvantage of postural changes during surgery. On the other hand, we can safely and easily harvest a sufficient quantity of PCBM from the tibia. The patient was a 56-year-old man who underwent immediate mandibular reconstruction using PCBM harvested from the tibia and a custom-made titanium mesh tray after segmental mandibular resection for an extended odontogenic keratocyst in the right mandible. We could harvest approximately 50 g (approx. 49 mL) of PCBM from the unilateral tibia and achieve successful mandibular reconstruction with a natural configuration. Finally, the bone quality of the reconstructed mandible become good. Eleven months later, dental implant placement was performed, and the final occlusal reconstruction with a bone-anchored bridge was completed. The postoperative course has been functionally and aesthetically uneventful for 5 years after mandibular reconstruction. In addition, there were no complications, such as gait disturbance associated with PCBM harvested from the tibia.
AbstractList In our department, we have performed mandibular reconstruction using autogenous particulate cancellous bone and marrow (PCBM) harvested from the posterior iliac crest and a custom-made titanium mesh tray for extended mandibular defects caused by tumor resection and so on. However, harvesting PCBM from the posterior iliac crest has a disadvantage of postural changes during surgery. On the other hand, we can safely and easily harvest a sufficient quantity of PCBM from the tibia. The patient was a 56-year-old man who underwent immediate mandibular reconstruction using PCBM harvested from the tibia and a custom-made titanium mesh tray after segmental mandibular resection for an extended odontogenic keratocyst in the right mandible. We could harvest approximately 50 g (approx. 49 mL) of PCBM from the unilateral tibia and achieve successful mandibular reconstruction with a natural configuration. Finally, the bone quality of the reconstructed mandible become good. Eleven months later, dental implant placement was performed, and the final occlusal reconstruction with a bone-anchored bridge was completed. The postoperative course has been functionally and aesthetically uneventful for 5 years after mandibular reconstruction. In addition, there were no complications, such as gait disturbance associated with PCBM harvested from the tibia.
Author 中岡, 一敏
山田, 秀典
雨宮, 剛志
長谷部, 充彦
堀内, 俊克
濱田, 良樹
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References 14) Kim LK, Cho HY, et al : Tibial bone fractures occurring after medioproximal tibial bone grafts for oral and maxillofacial reconstruction. J Korean Assoc Oral Maxillofac Surg 39: 257-262, 2013.
15) Hughes CW, Revington PJ, et al : The proximal tibia donor site in cleft alveolar bone grafting : experience of 75 consecutive cases. J Craniomaxillofac Surg 30: 12-16, 2002.
5) Speight P, Devilliers P, et al : Odontogenic keratocyst. In El-Naggar AK, Chan JKC, eds ; WHO Classification of Head & Neck Tumours. 4th Edition, IARC Press, Lyon, 2017, p235-236.
10) Marx RE : Tibia bone grafting for sius augmentation. jensen OT : The Sinus bone graft second edition. Quintessence, Chicago, 2006, p147-156.
2) 濱田良樹, 中岡一敏, 他:カスタムメイド・チタンメッシュトレーと自家海綿骨骨髄細片を用いた下顎骨再建.頭頸部癌 39: 422-429, 2013.
12) Burk T, Del Valle J, et al : Maximum quatity of bone available for harvest from the anterior iliac crest, posterior iliac crest, and proximal tibia using a standardized surgical approach : a Cadaveric Study. J Oral Maxillofac Surg 74: 2532-2548, 2016.
9) Zouhary KJ : Bone graft harvesting from distant sites:Concepts and techniques. Oral Maxillofacial Clin North Am 22: 301-306, 2010.
6) 野池淳一, 柴田晢伸, 他:角化囊胞性歯原性腫瘍の臨床的検討.口腔腫瘍 24: 147-154, 2012.
16) Lim CT, Ng DQK, et al : A biomechanical study of proximal tibia bone grafting through the lateral approach. J Injury 47: 2407-2414, 2016.
1) 濱田良樹, 山田浩之, 他:カスタムメイド・チタンメッシュトレーと自家腸骨/脛骨海綿骨骨髄細片による下顎骨再建の臨床的有用性.口腔腫瘍 26: 78-88, 2014.
7) Marx RE : Mandibular reconstruction. J Oral Maxillofac Surg 51: 466-479, 1993.
13) Engelstad ME and Morse T : Anterior iliac crest, posterior iliac crest, and proximal tibia donor sites : A comparison of cancellous bone volumes in fresh cadavers. J Oral Maxillofac Surg 68: 3015-3021, 2010.
3) Yamada H, Nakaoka K, et al : Clinical usefulness of mandibular reconstruction using custom-made titanium mesh tray and autogenous particulate cancellous bone and marrow harvested from tibia and/or ilia. J Craniofac Surg 27: 586-592, 2016.
4) Yamada H, Nakaoka K, et al : Mandibular reconstruction using custom-made titanium mesh tray and particulate cancellous bone and marrow harvested from bilateral posterior ilia. J Plast Surg Hand Surg 48: 183-190, 2014.
8) Dumbach J, Rodemer H, et al : Mandibular reconstruction with cancellous bone, hydroxylapatite and titanium mesh. J Craniomaxillofac Surg 22: 151-155, 1994.
11) Ko EC, Chang CM, et al : Tibial cancellous bone grafting in jaw reconstruction : 10 years of experience in Taiwan. Clinical Implant Dentistry and Related Research 17: 321-331, 2015.
References_xml – reference: 10) Marx RE : Tibia bone grafting for sius augmentation. jensen OT : The Sinus bone graft second edition. Quintessence, Chicago, 2006, p147-156.
– reference: 14) Kim LK, Cho HY, et al : Tibial bone fractures occurring after medioproximal tibial bone grafts for oral and maxillofacial reconstruction. J Korean Assoc Oral Maxillofac Surg 39: 257-262, 2013.
– reference: 9) Zouhary KJ : Bone graft harvesting from distant sites:Concepts and techniques. Oral Maxillofacial Clin North Am 22: 301-306, 2010.
– reference: 7) Marx RE : Mandibular reconstruction. J Oral Maxillofac Surg 51: 466-479, 1993.
– reference: 11) Ko EC, Chang CM, et al : Tibial cancellous bone grafting in jaw reconstruction : 10 years of experience in Taiwan. Clinical Implant Dentistry and Related Research 17: 321-331, 2015.
– reference: 3) Yamada H, Nakaoka K, et al : Clinical usefulness of mandibular reconstruction using custom-made titanium mesh tray and autogenous particulate cancellous bone and marrow harvested from tibia and/or ilia. J Craniofac Surg 27: 586-592, 2016.
– reference: 6) 野池淳一, 柴田晢伸, 他:角化囊胞性歯原性腫瘍の臨床的検討.口腔腫瘍 24: 147-154, 2012.
– reference: 8) Dumbach J, Rodemer H, et al : Mandibular reconstruction with cancellous bone, hydroxylapatite and titanium mesh. J Craniomaxillofac Surg 22: 151-155, 1994.
– reference: 1) 濱田良樹, 山田浩之, 他:カスタムメイド・チタンメッシュトレーと自家腸骨/脛骨海綿骨骨髄細片による下顎骨再建の臨床的有用性.口腔腫瘍 26: 78-88, 2014.
– reference: 13) Engelstad ME and Morse T : Anterior iliac crest, posterior iliac crest, and proximal tibia donor sites : A comparison of cancellous bone volumes in fresh cadavers. J Oral Maxillofac Surg 68: 3015-3021, 2010.
– reference: 4) Yamada H, Nakaoka K, et al : Mandibular reconstruction using custom-made titanium mesh tray and particulate cancellous bone and marrow harvested from bilateral posterior ilia. J Plast Surg Hand Surg 48: 183-190, 2014.
– reference: 5) Speight P, Devilliers P, et al : Odontogenic keratocyst. In El-Naggar AK, Chan JKC, eds ; WHO Classification of Head & Neck Tumours. 4th Edition, IARC Press, Lyon, 2017, p235-236.
– reference: 15) Hughes CW, Revington PJ, et al : The proximal tibia donor site in cleft alveolar bone grafting : experience of 75 consecutive cases. J Craniomaxillofac Surg 30: 12-16, 2002.
– reference: 12) Burk T, Del Valle J, et al : Maximum quatity of bone available for harvest from the anterior iliac crest, posterior iliac crest, and proximal tibia using a standardized surgical approach : a Cadaveric Study. J Oral Maxillofac Surg 74: 2532-2548, 2016.
– reference: 2) 濱田良樹, 中岡一敏, 他:カスタムメイド・チタンメッシュトレーと自家海綿骨骨髄細片を用いた下顎骨再建.頭頸部癌 39: 422-429, 2013.
– reference: 16) Lim CT, Ng DQK, et al : A biomechanical study of proximal tibia bone grafting through the lateral approach. J Injury 47: 2407-2414, 2016.
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SubjectTerms インプラント
カスタムメイド・チタンメッシュトレー
下顎骨再建術
脛骨
骨髄海綿骨細片
Title 自家脛骨骨髄海綿骨細片とカスタムメイド・チタンメッシュトレーを用いて下顎骨再建を行った1例
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