engleski

Short implants in mandibular reconstruction using free fibular graft

Chondromyxoid fibroma is a rare slow-growing, benign neoplasm. Only about 2% of all reported cases involved mandible. Free fibular graft's low vertical height and tendency to resorb over time have been considered potential drawbacks. Ideal dental implant treatment is not achieved easily in patients who have undergone mandibular reconstruction with a free vascularized fibula flap, because of limited length, height, and width of the bone graft. Short-length implants are considered disadvantage because of more limited surface area to resist occlusal forces. Clinicians have avoided the use of short-length implants in areas of compromised bone. Nevertheless, anecdotal observations find many short implants performing well in different restorative conditions and recent clinical studies indicate that short implants may support most prosthetic restorations quite adequately, but still clinical documentation is sparse. This case report describes the use of short implants-supported partial denture in a vascularized fibular bone graft to reconstruct segmental resected mandible because of recurrent chondromyxoid fibroma, seven years after initial operation. A 28-year-old man presented with bilateral parasymphyseal composite mandibular defect. The residual ridge of the remaining mandible was at a higher level than the grafted bone. Six 3, 5-mm-wide, 8 mm-long implants (Ankylos, Friadent, Germany) were placed into grafted bone. Although one implant did not achieve primary stability, eight months later, all implants were integrated. An arch-bar supported partial denture was processed. No complications occurred, graft showed stability and the result is optimal as is the quality of life of young patient 1.5 year after implant loading. Supported by Grant 065-1080057-0429

short dental implants; mandible; free flap; reconstruction

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