Implant mandibular rehabilitation postoncologic segmental resection: a clinical report

Reconstruction of Severely Atrophied Mandible and Simultaneous Implant Insertion with an Inverted Sandwich Technique

Objectives

To reconstruct and rehabilitate a severely atrophied mandible. Case presentation. A 40-year-old female patient with the chief complaint of denture instability was admitted to our care. In our opinion, the optimum reconstructive method for their severely atrophied mandible (width of 4 mm) was bone grafting with an inverted sandwich technique. 2 split-thickness autogenous calvarial grafts were attained. 4 onlay bone blocks were prepared, placed with an inverted sandwich technique, and fixed with 8 lag screws. 4 implants (Osstem, ⌀4×10 mm) were placed simultaneously, and an immediate post-operation cone beam computed tomography confirmed the proper placement of the grafts and implants. No complications were reported within 4 and 8 months following graft and implant placement. Final impressions for full dental rehabilitation were taken at the 8-month follow-up.

Conclusion

Split-thickness calvarial grafts and simultaneous implant placement seem to be a very efficient and promising approach for major reconstruction of the mandible. However, further studies are recommended.

Postsurgical Prosthetic Rehabilitation after Mandibular Ameloblastoma Resection: A 7-Year Follow-Up Case Report

Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed.

Functional Reconstruction of Nonsegmental Mandibular Defect With Fresh Frozen Bone Graft and Delayed Implants Placement

The loss of teeth and the alveolar bone secondary to resection of mandibular tumors may lead to unfavorable esthetic and functional results with a significant impairment of mastication.The authors report a 53-year-old patient with recurrence of ameloblastoma who was submitted to marginal mandibulectomy. Bone defect was immediately reconstructed using fresh frozen bone graft and 9 months after reconstruction 3 dental implants were inserted in the grafted bone. After 6 months, dental rehabilitation was achieved using a fixed implant-supported prosthesis.The purpose of this clinical report was to show the use of fresh frozen bone graft in the recostruction of mandibular nonsegmental defects.The clinical outcome of bone grafts and dental implants is analyzed retrospectively.

Effects of cisplatin chemotherapy on the osseointegration of titanium implants

PURPOSE

The effect of chemotherapy on the osseointegration of dental implants has received less interest compared with radiotherapy. Thus, the aim of the current study was to investigate the effect of cisplatin chemotherapy on the osseointegration of dental implants in a rabbit model.

MATERIALS AND METHODS

Sixteen New Zealand White rabbits were randomly assigned to two groups of treatment of either cisplatin at 2.5 mg/kg/week for 4 weeks (n = 8) or placebo (n = 8), in which the first dose was administered 2 days prior to the surgical procedure. Each rabbit received one titanium dental implant inserted in the right distal femoral condyle. Four rabbits from each group were sacrificed 4 and 8 weeks after implant insertion. Osseointegration of the dental implants was analysed using micro-computed tomography and histomorphometric evaluation.

RESULTS

Analysis of micro-computed tomography data and histomorphometric data showed that the osseointegration parameters, including the ratio of bone volume to total volume (BV/TV) and bone-implant contact (BIC%) for the cisplatin group, were significantly lower compared to the control group at 4 and 8 weeks. (P ≤ 0.05).

CONCLUSION

Cisplatin chemotherapy had a negative effect on the osseointegration of dental implants when inserted throughout the chemotherapeutic regimens in a rabbit model.