TREATMENT OF A HUGE ODONTOGENIC FIBROMA WITH ANTERIOR ILIAC CREST AND IMPLANT SUPPORTED FIXED PROSTHESIS: A CASE REPORT

Emrah Soylu; Erdem Kılıç; Mustafa Zortuk; Alper Alkan

doi:10.7126/cumudj.307234

TR EN

Büyük Boyutlu Odontojenik Fibromanin Anterior İliak Kret ve İmplant Destekli Sabit Protez ile Tedavisi: Olgu Sunumu

Öz

Giriş: Odontojenik fibroma (OF) çenelerin benign odontojenik tümörleri içerisinde yer almaktadır. Periferal (POF) ve santral (SOF) olmak üzere iki tipi bulunmaktadır. SOF tipi ise epitelden zengin (Kompleks) ve epitelden fakir (Basit) olmak üzere iki alt tipe ayrılmaktadır. OF nin tedavisi cerrahi eksizyondur, ancak büyük ölçekli bir eksizyon sonrasında defekt onarımı gerekebilmektedir. Bu vaka raporunun amacı, basit tip SOF eksizyonu sonrasında oluşan geniş defektin anterior iliak greft ve dental implantlarla yapılan tedavisini sunmaktır.

Vaka Raporu: 39 yaşındaki erkek hasta anterior maksilladaki ağrısız şişlik şikâyeti ile kliniğimize başvurdu. Yapılan insizyonel biopsi sonucunda lezyonun basit tip SOF olduğu anlaşıldı. Genel anestezi altında lezyon eksize edildi ve oluşan defekt anterior iliak kemikten alınan otojen greft ile greftlendi. Anterior maksillaya 8 ay sonra 3 adet dental implant yerleştirildi. 3 ay sonra implant destekli sabit protez ile hastanın tedavisi tamamlandı.

Tartışma: OF nadir görülen iyi huylu odontojenik bir tümördür ve tüm odontojenik tümörler içinde %0,5 - %5 lik görülme oranına sahiptir. OF nin tedavisi cerrahi eksizyon ve takiben kavitenin küretajını içermektedir fakat büyük ölçekli eksizyonlarda oluşan defektin tamiri zor olabilmektedir. Anterior iliak greft, yeterli miktarda kemik sağlayabilmesi ve implant yerleştirilmesine imkan sağlaması nedeniyle maksillofasiyal defektlerin tamirinde altın standart olarak kabul edilmektedir.

Sonuç: SOF gibi geniş boyutlara ulaşabilen lezyonların eksizyonu sonucunda oluşan çene defektlerin tamirinde anterior iliak greftle beraber dental implant uygulanması başarılı bir tedavi yöntemidir.

Anahtar Kelimeler

Odontojenik Fibroma,Rekonstrüksiyon,Dental İmplant,Anterior İliak Greft,Sabit Protez

TREATMENT OF A HUGE ODONTOGENIC FIBROMA WITH ANTERIOR ILIAC CREST AND IMPLANT SUPPORTED FIXED PROSTHESIS: A CASE REPORT

Abstract

Purpose: Odontogenic fibroma (OF) is a rare benign odontogenic neoplasm and classified as central (COF) and peripheral (POF) type and COF has two sub groups; epithelium-poor (simple) type and epithelium-rich (WHO or complex) type. Treatment modality of OF is surgical excision. However, after large-scaled excision, reconstruction of the defect may be required.

Case Report: 39 year old male patient referred with complain of a painless swelling in anterior maxilla. Incisional biopsy showed that the lesion is simple type OF. Under general anesthesia, lesion enucleated and defect reconstructed with anterior iliac graft. After 8 months, 3 dental implants were placed and final reconstruction was done with implant supported fixed prosthesis.

Dıscussıon: OF is a benign and very rare odontogenic neoplasm accounting for 0-5.5% of odontogenic tumors. Treatment modality of OF is enucleation and curettage, but after enucleation of huge OF, reconstruction may be challenging by the size of the defect. Anterior iliac graft is a gold standard among all autologous bone graft sources and it also provides adequate bone for the reconstruction of the maxillofacial defects, otherwise it is possible to place implants with acceptable resorption rates.

Conclusion: Reconstruction of the jaw defects with anterior iliac graft and implant supported fixed prosthesis after enucleation of huge size tumors such as COF, is a feasible method

Keywords

Odontogenic Fibroma,Reconstruction,Dental Implant,Anterior Iliac Graft,Fixed Prosthesis

References

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Case Report

Authors

Emrah Soylu
Türkiye

Erdem Kılıç

Mustafa Zortuk

Alper Alkan

Publication Date

May 12, 2017

Submission Date

April 20, 2017

Acceptance Date

May 15, 2016

Published in Issue

Year 2017 Volume: 20 Number: 1

DOI

https://doi.org/10.7126/cumudj.307234

IZ

https://izlik.org/JA37LP47ZY

Cite

RIS / Bibtex

EndNote

Soylu E, Kılıç E, Zortuk M, Alkan A (May 1, 2017) TREATMENT OF A HUGE ODONTOGENIC FIBROMA WITH ANTERIOR ILIAC CREST AND IMPLANT SUPPORTED FIXED PROSTHESIS: A CASE REPORT. Cumhuriyet Dental Journal 20 1 1–6.