Büyük Boyutlu Odontojenik Fibromanin Anterior İliak Kret ve İmplant Destekli Sabit Protez ile Tedavisi: Olgu Sunumu
Abstract
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.
References
- Referans1. Watt-Smith SR, Ell-Labban NG, Tinkler SM. Central odontogenic fibroma. Int J Oral Maxillofac Surg 1988; 17:87–91.
- Referans2. Hrichi R, Gargallo-Albiol J, Berini-Aytés L, Gay-Escoda C. Central odontogenic fibroma: Retrospective study of 8 clinical cases. Med Oral Patol Oral Cir Bucal 2012; 17:e50-5.
- Referans3. Veeravarmal V, Nirmal MR, Mohamed NM, Amsaveni R. Central odontogenic fibroma of the maxilla. Oral Maxillofac Pathol 2013; 17: 319-26.
- Referans4. Chiapasco M, Abati S, Ramundo G, Rossi A, Romeo E, Vogel G. Behavior of implants in bone grafts or free flaps after tumor resection. Clin Oral Impl Res 2000; 11: 66–75.
- Referans5. Boven GC, Meijer HJA, Vissink A, Raghoebar GM. Reconstruction of the extremely atrophied mandible with iliac crest onlay grafts followed by two endosteal implants: a retrospective study with long-term follow-up. Int J Oral Maxillofac. Surg 2014; 43: 626–32.
- Referans6. ChhaBra V, ChhaBra A. Central odontogenic fibroma of the mandible. Contemp Clin Dent 2012; 2: 230-33.
- Referans7. Dunlap CL, Barker BF. Central odontogenic fibroma of the WHO type. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1984; 57: 390-4.
- Referans8. Heimdal A, Isaacson G, Nilsson L. Recurrent odontogenic fibroma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1980; 50: 140-5.
- Referans9. Svirsky JA, Abbey LM, Kaugars GE. A clinical review of central odontogenic fibroma: With addition of 3 new cases. J Oral Med 1986; 41: 51-4.
- Referans10. Jones GM, Eveson JW, Shepherd JP. Central odontogenic fibroma. A report of two controversial cases illustrating diagnostic dilemmas. Br J Oral Maxillofac Surg 1989; 27:406-11.
- Referans11. Fasolis M, Boffano P, Ramieri G. Morbidity associated with anterior iliac crest bone graft. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 586-591.
- Referans12. Burstein FD, Simms C, Cohen SR, Work F, Paschal M. Iliac crest bone graft harvesting techniques: a comparison. Plast Reconstr Surg 2000; 105: 34-9.
- Referans13. Rawashdeh MA, Telfah H. Secondary alveolar bone grafting: the dilemma of donor site selection and morbidity. Br J Oral Maxillofac Surg 2008; 46: 665-70.
- Referans14. Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau WJ, Neukam FW. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedures: A prospective study. Int J Oral Maxillofac Surg 2004; 33:157-63.
- Referans15. Kalk WW, Raghoebar GM, Jansma J, Boering G. Morbidity from iliac crest bone harvesting. J Oral Maxillofac Surg 1996; 54:1424-9.
- Referans16. Chiapasco M, Colletti G, Romeo E, Zaniboni M, Brusati R. Long-term results of mandibular reconstruction with autogenous bone grafts and oral implants after tumor resection. Clin. Oral Impl. Res 2008; 19: 1074–80.
- Referans17. Ghassemi A, Ghassemi M, Modabber A, Knobe M, Fritz U, Riediger D, et al. Functional long-term results after the harvest of vascularised iliac bone grafts bicortically with the anterior superior iliac spine included. Br J Oral Maxillofac Surg 2013; 5:e47-50.
- Referans18. Shpitzer T, Neligan PC, Gullane PJ, Boyd BJ, Gur E, Rotstein LE, et al. The free iliac crest and fibula flaps in vascularized oromandibular reconstruction: comparison and long-term evaluation. Head Neck 1999; 21: 639–47.
- Referans19. Fasolis M, Boffano P, Ramieri G. Morbidity associated with anterior iliac crest bone graft. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:586-591.
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
References
- Referans1. Watt-Smith SR, Ell-Labban NG, Tinkler SM. Central odontogenic fibroma. Int J Oral Maxillofac Surg 1988; 17:87–91.
- Referans2. Hrichi R, Gargallo-Albiol J, Berini-Aytés L, Gay-Escoda C. Central odontogenic fibroma: Retrospective study of 8 clinical cases. Med Oral Patol Oral Cir Bucal 2012; 17:e50-5.
- Referans3. Veeravarmal V, Nirmal MR, Mohamed NM, Amsaveni R. Central odontogenic fibroma of the maxilla. Oral Maxillofac Pathol 2013; 17: 319-26.
- Referans4. Chiapasco M, Abati S, Ramundo G, Rossi A, Romeo E, Vogel G. Behavior of implants in bone grafts or free flaps after tumor resection. Clin Oral Impl Res 2000; 11: 66–75.
- Referans5. Boven GC, Meijer HJA, Vissink A, Raghoebar GM. Reconstruction of the extremely atrophied mandible with iliac crest onlay grafts followed by two endosteal implants: a retrospective study with long-term follow-up. Int J Oral Maxillofac. Surg 2014; 43: 626–32.
- Referans6. ChhaBra V, ChhaBra A. Central odontogenic fibroma of the mandible. Contemp Clin Dent 2012; 2: 230-33.
- Referans7. Dunlap CL, Barker BF. Central odontogenic fibroma of the WHO type. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1984; 57: 390-4.
- Referans8. Heimdal A, Isaacson G, Nilsson L. Recurrent odontogenic fibroma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1980; 50: 140-5.
- Referans9. Svirsky JA, Abbey LM, Kaugars GE. A clinical review of central odontogenic fibroma: With addition of 3 new cases. J Oral Med 1986; 41: 51-4.
- Referans10. Jones GM, Eveson JW, Shepherd JP. Central odontogenic fibroma. A report of two controversial cases illustrating diagnostic dilemmas. Br J Oral Maxillofac Surg 1989; 27:406-11.
- Referans11. Fasolis M, Boffano P, Ramieri G. Morbidity associated with anterior iliac crest bone graft. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 586-591.
- Referans12. Burstein FD, Simms C, Cohen SR, Work F, Paschal M. Iliac crest bone graft harvesting techniques: a comparison. Plast Reconstr Surg 2000; 105: 34-9.
- Referans13. Rawashdeh MA, Telfah H. Secondary alveolar bone grafting: the dilemma of donor site selection and morbidity. Br J Oral Maxillofac Surg 2008; 46: 665-70.
- Referans14. Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau WJ, Neukam FW. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedures: A prospective study. Int J Oral Maxillofac Surg 2004; 33:157-63.
- Referans15. Kalk WW, Raghoebar GM, Jansma J, Boering G. Morbidity from iliac crest bone harvesting. J Oral Maxillofac Surg 1996; 54:1424-9.
- Referans16. Chiapasco M, Colletti G, Romeo E, Zaniboni M, Brusati R. Long-term results of mandibular reconstruction with autogenous bone grafts and oral implants after tumor resection. Clin. Oral Impl. Res 2008; 19: 1074–80.
- Referans17. Ghassemi A, Ghassemi M, Modabber A, Knobe M, Fritz U, Riediger D, et al. Functional long-term results after the harvest of vascularised iliac bone grafts bicortically with the anterior superior iliac spine included. Br J Oral Maxillofac Surg 2013; 5:e47-50.
- Referans18. Shpitzer T, Neligan PC, Gullane PJ, Boyd BJ, Gur E, Rotstein LE, et al. The free iliac crest and fibula flaps in vascularized oromandibular reconstruction: comparison and long-term evaluation. Head Neck 1999; 21: 639–47.
- Referans19. Fasolis M, Boffano P, Ramieri G. Morbidity associated with anterior iliac crest bone graft. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:586-591.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Case Reports |
| Authors | |
| Publication Date | May 12, 2017 |
| Submission Date | April 20, 2017 |
| Published in Issue | Year 2017Volume: 20 Issue: 1 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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