[Reconstruction of occlusal function with osseointegrated implant following mandibular resection].

Abstract

We succeeded satisfactorily to restore the occlusal function by use of an osseointegrated implant following iliac bone grafting and partial mandibulectomy in 4 patients who underwent surgical resection of odontgenic cyst and benign or malignant tumor of the oral cavity. Case 1: The patient was a 19-year-old man. Partial resection of the mandible was carried out under the diagnosis of odontgenic keratocyst of the left lateral incisor to the 1st premolar region. Iliac bone grafting was performed as secondary surgery. After confirmation of the fusion of the grafted bone, the occlusal function was restored by use of an osseointegrated implant. Case 2: The patient was a 36-year-old man. After segmental resection of the mandible under the diagnosis of ameloblastoma of the left 2nd premolar to the right 2nd premolar region, mandibular reconstruction was carried out with an A-O plate. Iliac bone grafting was performed as secondary surgery. After fusion of the grafted bone had been confirmed, the A-O plate was remounted and the fixture was immediately implanted. Five months later, vestibuloplasty by free skin grafting and attachment of the abutment were carried out. A superstructure was mounted. Case 3: The patient was a 22-year-old woman. The histopathologically confirmed odontogenic myxoma in the right mandible posteriorly from the second premolar was resected. Immediate reconstruction of the mandible was carried out by use of an iliac bone graft. After confirmation of the fusion of the grafted bone, the occlusal function was restored by use of an osseointegrated implant. Case 4: The patient was a 57-year-old woman with carcinoma of the right lingual margin and mouth floor. The tumor was resected with the mandibular margin. Immediate reconstruction of the tongue and mouth floor with a major pectoral muscle skin flap was carried out. In the absence of evidence of recurrence, restoration of the occlusal function was attempted with an osseointegrated implant.