下顎骨經放射線治療後以骨牽引術合併人工植牙失敗－病例報告

本病例報告一名五十二歲男性於右側臼齒頰側牙齦區罹患口腔鱗狀上皮細胞癌，切除病灶區及頸部淋巴手術合併放射線治療，六個月後病患要求口腔功能重建，經討論後選擇以垂直成骨牽引術來修復缺損的齒槽骨脊，使用骨內牽引器術後一個月發現右側下顎骨造成病理性骨折，再經六個月後以腓骨血管瓣同時合併人工植體手術來完成病患的口腔咀嚼功能修復。三年的追蹤觀察顯示病人的狀況良好。本文提出一經過放射治療後的顎骨以垂直成骨牽引術合併人工植體的病例並作文獻回顧。

關鍵字

垂直成骨牽引術；骨整合；人工植體

並列摘要

A 52 y/o ma le patient was presented and was diagnosed of Oral Squamous Cell Carcinoma of the right molar buccal gingival area. Treatment consists of neck dissection with tumor excision and radiotherapy (4600 cGy). 6 months post operatively, the patient asked for oral functional reconstruction. Suggested treatment of choice is Vertical Distraction Osteogenesis but due to patient's financial consideration, we opted for Intra-osseo Vertical Distraction Device. Unfortunately, one month post-operative follow up using the Intra-osseo Vertical Distraction Device, presence of pathologic fracture of the right mandible was noted. Six months post-operatively, the patient underwent Fibular Osteoseptocutaneous Flap combined with simultaneous dental implants to reconstruct the defect area. After 3 years of follow up periods, the patient's condition is well and good with no ill signs and symptoms. In this case report, we further discuss the effects of post-radiotherapy to the mandible, the use of vertical distraction osteogenesis for reconstruction and its effect on the implant osseointegration.

並列關鍵字

vertical distraction ； osseointegration ； dental implant

延伸閱讀

何政昇（2000）。骨嵴劈裂術合併立即植牙：文獻回顧與病例報告。中華民國牙周病醫學會雜誌，5(4)，205-217。https://www.airitilibrary.com/Article/Detail?DocID=10279962-200012-5-4-205-217-a
吳和泰、賴泓璋、黃傳貴、雷文天、高壽延、吳政憲（2010）。下顎骨埋伏智齒拔除後併發慢性骨髓炎－病例報告。臺灣口腔顎面外科學會雜誌，21(3)，224-233。https://doi.org/10.7104/TJOMS.201009.0224
Chang, C. W., Yin, T. Y., Hsu, P. C., Lin, C. Y., & Lai, Y. L. (2015). 應用異體移植骨塊之骨再生術及植體重置於植體失敗之上顎前牙區的病例報告. 臺灣牙周病醫學會雜誌, 20(1), 39-47. https://doi.org/10.6121/TAP.2015.20.1.05
Ho, N. E., & Chang, H. H. (2018). Mandible Reconstruction with Distraction Osteogenesis by Using a Multi-directional Device-A Case Report. 臺灣口腔顎面外科學會雜誌, 29(4), 303-316. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201812-201901110007-201901110007-303-316
Lin, L. C., Tung, C. L., Ho, C. M., Lin, W. T., & Lin, H. C. (2018). External Skeletal Fixation in Mandibular Reconstruction After Resection-Report of Two Cases and Literature Review. 臺灣口腔顎面外科學會雜誌, 29(2), 123-133. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201806-201807310018-201807310018-123-133

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下顎骨經放射線治療後以骨牽引術合併人工植牙失敗－病例報告

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