One-stage jaw reconstruction and prosthetic rehabilitation with an iliac flap: a case report and literature review.

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Maxillofacial Plastic and Reconstructive Surgery Pub Date : 2024-01-17 DOI:10.1186/s40902-024-00413-0
Yi-Fan Kang, Yan-Jun Ge, Xiao-Ming Lv, Meng-Kun Ding, Xiao-Feng Shan, Zhi-Gang Cai
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Abstract

Background: One-stage jaw reconstruction with fibular flap and prosthetic rehabilitation restores bony and dental continuity simultaneously. It was also called as "jaw-in-a-day (JIAD)" technique. However, bone volume and height of fibular flap may be insufficient for dental implant insertion. The provision of a considerable amount of bone makes an iliac flap the ideal choice in these cases. We present the first case report to document the use of one-stage jaw reconstruction and prosthetic rehabilitation with the iliac flap.

Case presentation: We modified the conventional JIAD workflow to make it suitable for iliac flap. Two cases were presented who both underwent segmental mandibulectomy for ameloblastoma. Virtual surgical planning was performed in all cases. The iliac crest was positioned upward to provide cortical bone for achieving primary stability of dental implants. Similar to the "all-on-4" procedure, the iliac bone was placed 12 to 15 mm below the occlusal plane to create adequate space for the implant-retained prosthesis. Immediate implant-based dental rehabilitation was performed at same stage. The surgery was successful in all cases without any short-term complications. In the first postoperative week, patients were given a liquid diet through a nasal feeding tube. The liquid diet is advised until 1 month after the surgery. Thereafter, a soft diet is recommended. Patients were advised to resume routine mastication and normal diet 3 months after the surgery. Peri-implantitis occurred in one patient, and additional gingival graft was required. Postoperative function and esthetics were satisfactory at the last follow-up visit.

Conclusions: One-stage jaw reconstruction and prosthetic rehabilitation with the iliac flap are safe and useful for restoring postoperative function and esthetics. It should be used in more cases with a longer follow-up in further studies.

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使用髂骨皮瓣进行单阶段颌骨重建和假体修复:病例报告和文献综述。
背景:使用腓骨瓣和修复体同时重建下颌,可恢复骨骼和牙齿的连续性。这也被称为 "一日下颌(JIAD)"技术。然而,腓骨瓣的骨量和高度可能不足以植入牙种植体。髂骨瓣能提供大量的骨量,是这些病例的理想选择。我们提交了首例使用髂骨瓣进行单阶段颌骨重建和修复的病例报告:我们修改了传统的 JIAD 工作流程,使其适用于髂骨瓣。病例介绍:我们对传统的 JIAD 工作流程进行了修改,使其适用于髂骨瓣。所有病例都进行了虚拟手术规划。髂嵴的位置向上,以提供皮质骨,实现种植牙的主要稳定性。与 "all-on-4 "手术类似,髂骨被放置在咬合平面下方12至15毫米处,以便为种植体固位修复创造足够的空间。在同一阶段立即进行种植牙修复。所有病例的手术都很成功,没有出现任何短期并发症。术后第一周,患者通过鼻饲管进食流质饮食。建议流质饮食一直持续到术后一个月。此后,建议进食软食。建议患者在术后 3 个月恢复日常咀嚼和正常饮食。一名患者发生了种植体周围炎,需要进行额外的牙龈移植。最后一次复诊时,患者的术后功能和美观效果均令人满意:结论:髂骨瓣一期颌骨重建和修复术对恢复术后功能和美观安全有效。在进一步的研究中,应在更多病例中使用这种方法,并进行更长时间的随访。
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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
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