多孔質アパタイトブロックを用いて右下顎即時再建術を行った1例

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A 19 year old female came to our clinic complaing of right cheek swelling. As a result of X-ray examination, a polycystic bone resorption image with clear cut boundary extending over nearly the entire region of mandibular ramus from the diaphysis in the area corresponding to the 5 root apex to the articular process and the coronoid process inclusion, was seen. The 6 root resorption was also found. Histopathological examination, revealed a diagnosis of ameloblastoma. In the selection of the type of operation and rebuilding material, in consideration of the fact that she was a young unmarried female, an intraoral method was selected and immediate rebuilding operation with an artificial bone of porous hydroxylapatite ceramic block was chosen.<BR>The porous hydroxylapatite ceramic block with 50% porosity was made with the cooperation of the Asahi Optical Co., Ltd.<BR>The operation was performed, under general anesthesia, GOF, by the intraoral method, dissecting the right mandibular bone from the 3 region and extirpating the coronoid process and the articular process inclusive, with the periosteum preserved intact since no tumor infiltration was observed. The artificial jaw bone of porous hydroxylapatite ceramic block was nearly equivalent to the extirpated right mandible inclusive of the articular process. This was made by referring beforehand to the cephalogram and pantomogram and was fixed to the cut end of the left mandible, the periosteum and mucosa were sutured and continuous suction was performed for 6 days after operation to avoid dead space. The intermaxillary fixation was performed for approximately 2 months following the operation. Up to the present, about 2 years and 4 months have elapsed and the course has been uneventful. In the right mandibuar vacant tooth portion, the prothesis using a swing lock attachment was mounted, to the satisfaction of the patient from a functional and also from cosmetic point of view.
社団法人日本口腔外科学会の論文

多孔質アパタイトブロックを用いて右下顎即時再建術を行った1例

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