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 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
社団法人 日本口腔外科学会
20.08.2019
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Subjects | |
Online Access | Get full text |
ISSN | 0021-5163 2186-1579 |
DOI | 10.5794/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. |
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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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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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