Hakan OCAK, Emrah SOYLU, Hasan Önder GÜMÜŞ, Hasan H. KOCAAĞAOĞLU, Osman A. ETÖZ, Alper ALKAN

MARSUPYALİZASYON VE ENÜKLEASYON SONRASINDA OLUŞAN ALVEOL DEFEKTİN OTOJEN GREFT VE DENTAL İMPLANT İLE REKONSTRÜKSİYONU: OLGU SUNUMU

Gü nümü zdedentalimplantlarkısmiyadatamdişeksikliklerinintedavisinde sıklıkla tercih edilir hale gelmiş- lerdir.Implantlarınbaşarılıolarakdeğerlendirilebilmesi ve uzun sü re ağızda fonksiyon gö rebilmesi için yeterli yü ksekliktevegenişliktekemiğeihtiyaçvardır.Travma, diş kaybı, yaş, kist enü kleasyonu vb. nedenlerle alveol kemikte oluşan defekt implant yerleştirilmesini zorlaş- tırmaktadır. Marsupyalizasyonbü yü kkistiklezyonlarınboyutlarının kü çü ltü lmesinde ve enü kleasyon sonrası gö rülebilecek olan kemik defektleri ya da sinir yaralanmalarının ö nlenmesinde etkilibiryö ntemdir.Busayedeçevreanatomikyapıların korunmasıile birlikteiyileşen bölgelerde kemikoluşumudabeklenmektedir. Otojengreftleriisesahipolduklarıosteoindü ktif,osteokonduktifve osteojenik potansiyel nedeniyle, alveol defektlerin tamirinde sıklıklar kullanılmakta ve altın standartolarakkabuledilmektedirler. Bumakalede alt çene anterior bölgedeki kistenü kleasyonusonrasında oluşan kemik defektinin sim iz bölgesinden alınanotojengreftvedentalimplantilerehabilitasyonu sunulmaktadır.

ALVEOLAR RECONSTRUCTION WITH AUTOGENOUS BONE GRAFT AND DENTAL IMPLANT AFTER MARSUPIALIZATION AND CYST ENUCLEATION: A CASE REPORT

Dental implants became very popular and have a great ield in the treatment of partial or total edentulous patients. Adequate bone amount of the residual alveolus is an important criteria for obtaining long survival rate and also to de ine a dental implant as successful. Resorption of the alveolar crest due to trauma, bone loss, periodontal infection, age or cyst enucleation can cause alveolar defects and it becomes complicated for the placement of dental implants. Marsupialization is a feasible method for the treatment of large cysts by providing the reduction of the cyst size and also prevention from possible bone defects and nerve damage. Autogenous bone grafts are the irst choice and also the gold standard for the reconstruction of the alveolar defects due to osteoinductive, osteoconductive, and osteogenic properties. The aim of this report is to present the treatment of the alveolar defect which occurs after the enucleation of the dentigerous cyst with symphysis graft and dental implant.

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1. Stavola LD, Tunkel J. Results of vertical bone augmentation with autogenous bone block grafts and the tunnel technique: A clinical prospective study of 10 consecutively treated patients. Int J Periodontics Restorative Dent 2013; 33: 651659.
2. Schwartz-Arad D, Toti P, Levin L, et al. A comparative volumetric study of symphysis donor defects, un illed or illed with bone substitute. Clin Implant Dent Relat Res 2013; 15: 684-691.
3. Bü yü kakyü z N, Oztü rk M. The solution of aesthetic problems by hard and soft tissue grafts in oral implantology. Istanbul Univ Dis Hekim Fak Derg 2012; 46: 74-82.
4. Adell R, Lekholm U, Rockler B, et al. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981; 10: 387-416.
5. Misch CE. Contemporary Implant Dentistry. 3rd ed. St.Louis, MO: CV Mosby, 2008: pp 9751012.
6. Borden M, Attawia M, Khan Y, et al. Tissue- engineered bone formation in vivo using a novel sintered polymeric microsphere matrix. J Bone Joint Surg Br 2004; 86: 12001208.
7. Klijn RJ, Meijer GJ, Bronkhorst EM, et al. Sinus loor augmentation surgery using autologous bone grafts from various donor sites: A meta-analysis of the total bone volume. Tissue Eng Part B Rev 2010; 16: 295303.
8. Zouhary KJ. Bone graft harvesting from distant sites: concepts and techniques. Oral Maxillofac Surg Clin North Am 2010; 22: 301316.
9. Manzano-Moreno FJ, Rodrı́guez-Martı́nez JB, Ramos- Torrecillas J, et al. Proliferation and osteogenic differentiation of osteoblast-like cells obtained from two techniques for harvesting intraoral bone grafts. Clin Oral Invest 2013; 17: 13491356
10.Schwartz-Arad D, Levin L. Symphysis revisited: Clinical and histologic evaluation of newly formed bone and reharvesting potential of previously used symphysial donor sites for onlay bone grafting. J Periodontol 2009; 80: 865869.
11. Montazem A, Valauri DV, St-Hilaire H, et al. The mandibular symphysis as a donor site in maxillofacial bone grafting: A quantitative anatomic study. J Oral Maxillofac Surg 2000; 58: 13681371.
12. Schwartz-Arad D, Levin L. Intraoral autogenous block onlay bone grafting for extensive reconstruction of atrophic maxillary alveolar ridges. J Periodontol 2005; 76: 636641.
13. Yahara Y, Kubota Y, Yamashiro T, et al. Eruption prediction of mandibular premolars associated with dentigerous cysts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 2831.
14. Zhao Y, Liu B, Han Q, et al. Changes in bone density and cyst volume after marsupialisation of mandibular odontogenic keratocysts (keratocystic odontogenic tumors). J Oral Maxillofac Surg 2010; 69: 13611366.