Literature DB >> 12149731

Severely resorbed mandible: predictable reconstruction with soft tissue matrix expansion (tent pole) grafts.

Robert E Marx1, Thomas Shellenberger, James Wimsatt, Pedro Correa.   

Abstract

PURPOSE: Attempts to reconstruct the severely resorbed mandible (<or=6 mm) have historically been unsuccessful and often been complicated by fracture, fistulas, and neurosensory loss. In the past, bone grafts to these severely resorbed mandibles have rapidly resorbed due to a soft tissue volume deficiency that contracts about the graft.
MATERIAL AND METHODS: A novel surgical approach using dental implants as "tent poles," along with bone grafting, is described, and the long-term follow-up of 64 cases is presented.
RESULTS: The results revealed that all 64 grafts maintained 15 mm of bone height, with a follow-up ranging from 3 to 10 years and a mean follow-up of 4.9 years. The starting bone heights ranged from 3 to 6 mm, with a mean height of 4.8 mm. The mean bone height gain was 10.2 mm, with a range of 9 to 13 mm. All patients progressed to a functional denture that remained in function at the time of their follow-up. Short-term paresthesia (<or=3 weeks) was noted in 17.1% of patients, but no permanent neurosensory disturbance was noted. In these 64 cases, 356 dental implants were placed and 354 were osseointegrated (99.5%) and functioning at the time of follow-up (>or=3 years).
CONCLUSIONS: The novel strategy of this surgery whereby bone grafts consolidate and maintain their volume by dental implants that creates a tenting effect offers predictable long-term reconstruction of the severely resorbed mandible without the complications observed with other approaches. Copyright 2002 American Association of Oral and Maxillofacial Surgeons.

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Year:  2002        PMID: 12149731     DOI: 10.1053/joms.2002.33856

Source DB:  PubMed          Journal:  J Oral Maxillofac Surg        ISSN: 0278-2391            Impact factor:   1.895


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