MANDİBULANIN PATOLOJİK KIRIK NEDENLERİ VE KRİTİK BOYUT DEFEKTİ KAVRAMI

Mandibula kırıkları, maksillofasiyal bölgede burun,orbita,zigomadan sonra dördüncü en sık görülen kırıklardır. Patolojik kırıklar ise genellikle osteomyelitis, osteoradyonektoz, BRONJ bulunan bölgelere ya da kistik lezyonlar, benign, malign veya metastatik tümörlerin bulunduğu bölgelere yapılan cerrahi müdahalelerden (üçüncü molar diş çekimi, implant uygulaması, kist tümör operasyonu gibi) sonra meydana gelir. Kemik defektleri yaygın ve birçok klinik durumda ortaya çıkabilen bir durumdur. Kritik boyut defektleri kendi haline bırakıldığında veya cerrahi olarak stabilize edildiğinde spontan iyileşme gösteremeyen, kemik dolumu gerçekleşmeyen fibröz doku ile iyileşme gösteren boyuttaki defektler olarak adlandırılırlar. Hekimlerin patolojik kırık oluşma nedenleri ve defektlerin yönetimi konusunda bilgi sahibi olması risk faktörlerinin azaltılması ve uygun tedavi planlamasının belirlenmesi açısından oldukça önem arz etmektedir.

Anahtar Kelimeler:

kritik boyut defekti, mandibula, patolojik kırık

PDF

___

1. Peterson’s Principles of Oral and Maxillofacial Surgery. Michael Miloro, G.E. Ghali, Peter Larsen, Peter Waite, 3rd edition, 2012(pg. 408-433)
2. Anatomic distribution of mandibular fractures. (From Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg 1990;48:926–932.)
3. Coletti D, Ord RA. Treatment rationale for pathological fractures of the mandible: a series of 44 fractures. Int J Oral Maxillofac Surg 2008;37:215–22.
4. Choi BJ, Choi SC, Kwon YD. Aneurysmal bone cyst causing a pathologic fracture of the mandibular condyle. J Oral Maxillofac Surg 2011;69:2995–3000.
5. Gerhards F, Kuffner HD, Wagner W. Pathological fractures of the mandible. A review of the etiology and treatment. Int J Oral Maxillofac Surg 1998;27:186–90.
6. Algahtani M, Alqudah M, Alshehri S, Binahmed A, Sandor GK. Pathologic fracture of the mandible caused by metastatic follicular thyroid carcinoma. J Can Dent Assoc 2009;75:457–60.
7. Boffano P, Roccia F, Gallesio C, Berrone S. Pathological mandibular fractures: a review of the literature of the last two decades. Dent Traumatol. 2013 Jun;29(3):185-96. doi: 10.1111/edt.12028. Epub 2013 Jan 7. PMID: 23294978.
8. Wagner KW, Otten JE, Schoen R, Schmelzeisen R. Pathological mandibular fractures following third molar removal. Int J Oral Maxillofac Surg 2005;34:722–6.
9. Komerik N, Karaduman AI. Mandibular fracture 2 weeks after third molar extraction. Dent Traumatol 2006;22:53–5.
10. Kao YH, Huang IY, Chen CM, Wu CW, Hsu KJ, Chen CM. Late mandibular fracture after lower third molar extraction in a patient with Stafne bone cavity: a case report. J Oral Maxillofac Surg 2010;68:1698–700.
11. Soehardi A, Meijer GJ, Manders R, Stoelnga PJ. An inventory of mandibular fractures associated with implants in atrophic edentulous mandibles: a survey of Dutch oral and maxillofacial surgeons. Int J Oral Maxillofac Implants 2011;26:1087–93.
12. Lamas Pelayo J, Pe~narrocha Diago M, Martı Bowen E,Pe~narrocha Diago M. Intraoperative complications during oral implantology. Med Oral Patol Oral Cir Bucal 2008;13:E239–43.
13. Ezsias A, Sugar AW. Pathological fractures of the mandible: a diagnostic and treatment dilemma. Br J Oral Maxillofac Surg 1994;32:303–6.
14. Goddard R, Patel N. Aneurysmal bone cyst masquerading as unknown mandibular metastatic deposit causing pathological fracture. Dent Update 2007;34:230–2.
15. Jia J, Zhang WF, Liu B, Zhao YF. Pathological fracture of condyle from metastatic breast adenocarcinoma. Oral Oncol Extra 2006;42:98–100
16. Boffano P, Viterbo S, Barreca A, Berrone S. Pathologic mandibular fracture as the presenting manifestation of multiple myeloma. J Craniofac Surg 2011;22:1312–5.
17. Ogasawara T, Sano K, Hatsusegawa C, Miyauchi K, Nakamura M, Matsuura H. Pathological fracture of the mandible resulting from osteomyelitis successfully treated with only intermaxillary elastic guiding. Int J Oral Maxillofac Surg 2008;37:581–3.
18. Rice N, Polyzois I, Ekanayake K, Omer O, Stassen LF. The management of osteoradionecrosis of the jaws--a review. Surgeon. 2015 Apr;13(2):101-9. doi: 10.1016/j.surge.2014.07.003. Epub 2014 Jul 30. PMID: 25084627.
19. Støre G, Boysen M. Mandibular osteoradionecrosis: clinical behaviour and diagnostic aspects. Clin Otolaryngol Allied Sci. 2000 Oct;25(5):378-84. doi: 10.1046/j.1365-2273.2000.00367.x. PMID: 11012651.
20. Otto S, Pautke C, Hafner S, Hesse R, Reichardt LF, Mast G, Ehrenfeld M, Cornelius CP. Pathologic fractures in bisphosphonate-related osteonecrosis of the jaw-review of the literature and review of our own cases. Craniomaxillofac Trauma Reconstr. 2013 Sep;6(3):147-54. doi: 10.1055/s-0033-1343776. Epub 2013 May 31. PMID: 24436752; PMCID: PMC3773037.
21. Nauth A, McKee MD, Einhorn TA, et al. Managing bone defects. J Orthop Trauma. 2011;25:462–466.
22. Keating JF, Simpson AH, Robinson CM. The management of fractures with bone loss. J Bone Joint Surg Br. 2005;87:142–150.
23. Sanders DW, Bhandari M, Guyatt G, et al. Critical-sized defect in the tibia: is it critical? Results from the SPRINT trial. J Orthop Trauma. 2014;28:632–635.
24. Schemitsch EH. Size Matters: Defining Critical in Bone Defect Size! J Orthop Trauma. 2017 Oct;31 Suppl 5:S20-S22. doi: 10.1097/BOT.0000000000000978. PMID: 28938386.
25. Anderson ML, Dherl \VJ, De Bruijn JD, el al. Critical size defect in the goat’s os ilium: a model to evaluate bone grafts and sııbstilutes. Clin Orthop. 1999; 364: 231-9.
26. Schmitz JP, Hollinger JO. The critical size defect as an experimental model for craniomandibulofacial nonunions. Clin Orthop. 1986; 205: 299-308.
27. Awadeen MA, Al-Belasy FA, Ameen LE, Helal ME, Grawish ME. Early therapeutic effect of platelet-rich fibrin combined with allogeneic bone marrow-derived stem cells on rats' critical-sized mandibular defects. World J Stem Cells. 2020 Jan 26;12(1):55-69. doi: 10.4252/wjsc.v12.i1.55. PMID: 32110275; PMCID: PMC7031757.
28. Al-Fotawei R, Ayoub AF, Heath N, Naudi KB, Tanner KE, Dalby MJ, McMahon J. Radiological assessment of bioengineered bone in a muscle flap for the reconstruction of critical-size mandibular defect. PLoS One. 2014 Sep 16;9(9):e107403. doi:10.1371/journal.pone.0107403. PMID: 25226170; PMCID: PMC4167331.
29. Santos PS, Cestari TM, Paulin JB, Martins R, Rocha CA, Arantes RVN, Costa BC, Dos Santos CM, Assis GF, Taga R. Osteoinductive porous biphasic calcium phosphate ceramic as an alternative to autogenous bone grafting in the treatment of mandibular bone critical-size defects. J Biomed Mater Res B Appl Biomater. 2018 May;106(4):1546-1557. doi: 10.1002/jbm.b.33963. Epub 2017 Jul 29. PMID: 28755493.