以髂骨移植合併骨牽引重建下顎垂直骨缺損後植體贋復－病例報告

Use Iliac Bone Graft and Distraction Procedure for Oral Implant Rehabilitation-A Case Report

賴俊臣(Chun-Chen Lai) ； 王東堯(Tong-Yiu Wang)

《臺灣口腔顎面外科學會雜誌》 28卷1期 (2017/03) Pp. 48-60

摘要

顱顏面的重建以及咬合功能的恢復一直都是口腔顎面外科醫師必須努力，在腫瘤切除前要去思考；或是切除後要去面對的問題。人工牙根的發明，讓口腔咬合的重建變成相對簡單且高成功率的方法。但是植牙也是有他的限制，特別是在嚴重骨缺陷的部位。不適當的骨無法承受咬合壓力以及種植人工植體，或是必須種植短植體形成不良的根冠比。如何選擇合適的方法來修復骨缺陷，將會對整個口腔的重建造成重大影響。本篇的目的是敘述如何重建因爲腫瘤切除而造成的骨缺損，利用骨移植以及骨牽引創造可以植牙的有利條件。病患爲一49歲女性，民國98年因爲自覺下顎腫大而至外院求診，診斷爲骨性纖維分化不良，接受腫瘤切除，髂骨移植，鈦金屬骨板及鈦網重建。隔年因感染導致腫痛而至本院求診。我們重新利用髂骨移植，牽引骨生成來重建整體骨高度，併用植牙重新恢復美觀跟咬合功能。

關鍵字

髂骨移植 ； 引導骨再生 ； 牽引骨生成 ； 植牙

並列摘要

How to reconstruction the outcome and functional occlusion is the issue which oral maxillofacial surgeon have to think and deal with before and after tumor excision. The invention of dental implant make rehabilitation more easier the usual，but still have limitation, especially in case of sever vertical bone defect. Inadequacy bone make implantation impossible or poor crown root ratial due to the use of short implant. How to use the property technic to repair defect will greatly affect total outcome of rehabilitation. This case report is descripting how to reconstruct defect by using distraction and iliac bone graft. This patient is a case of 49 years old female who went to other medical center and diagnostic fibrous dysplasia because of mandibular mass. She receives segmental mandibulectomy, reconstruction plate repair and iliac bone graft. But outcome infection and pain so turn to ask for our help. We use iliac bone graft, guild bone regeneration and distraction procedure to recover total alveolar high. Final rehabitaion facial beauty and occlusion by dental implant.

並列關鍵字

Iliac bone graft ； Guided bone regeneration ； Distraction osteogenesis ； Implant