Anterior mandibular defect reconstruction

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Posted on By Sormani Queiroz In Bio-modifiers: BMP-2 / PRGF

This 57 years female ipatient removed a glandular odontogenic cyst one year ago.A 2.4 reconstruction plate was placed in the mandibular base to prevent fracture and a 2.0 plate was placed in the alveolar region to keep the space under the soft tissue for the reconstruction of the bone (top plate exposed in the oral cavity). One year later, surgery was performed to reconstruct the bone defect. A "visor" osteotomy was made ​​with piezo and the lingual segment was fixed superiorly. The gaps were filled with Infuse associated with Biooss in the ratio of 50% / 50%.A bioabsorbable mesh was placed over the graft and soft tissue closure was achieved through vestibuloplasty ("lip switch").

Initial clinical and cbct.
Exposure of the defect and demarcation of the osteotomy.

Osteotomy performed with piezo.
Lingual segment fixated.


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2 Comments

Sormani; very tough case. Thanks for sharing. Not a fan of BioOss with BMP-2. Has not worked we'll for me. Why did you select a collagen barrier here rather than a non- restorable or Ti-mesh for space maintenance? Thanks and regards Maurice


Reply

Dr.Salama,
Thank you a lot for your comments. This is the second case i used bmp+biooss, i saw some encouraging literature to use it. The barrier used here is a 1.5mm PLLA mesh (Inion) that is as rigid as a ti-mesh as a space mantainer.
Regards,
Sormani.


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