Büyük Boyutlu Odontojenik Fibromanin Anterior İliak Kret ve İmplant Destekli Sabit Protez ile Tedavisi: Olgu Sunumu

Year 2017, Volume: 20 Issue: 1, 1 - 6, 12.05.2017

Emrah Soylu Erdem Kılıç Mustafa Zortuk Alper Alkan

https://doi.org/10.7126/cumudj.307234

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.

Keywords

Odontojenik Fibroma, Rekonstrüksiyon, Dental İmplant, Anterior İliak Greft, Sabit Protez

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

Keywords

Odontogenic Fibroma, Reconstruction, Dental Implant, Anterior Iliac Graft, Fixed Prosthesis

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