engleski

Reconstruction of severely bone defect after enucleation of a large maxillary cyst with titanium mesh in combination with iliac crest bone grafts and dental implants

Implantoprosthetic therapy of the maxillary arch when there are large bone defects or atrophic regions represent a particular clinical challenge in implant dentistry. The need for a major bone grafting is usually due to removal of a large cysts or tumors, traumatic injuries or there is severely atrophied alveolar ridge regions with sinus recesses or the anterior part of the maxilla is close to the nasal cavity.We present a 44-year- old female patient that was referred to our department with complains of four months persisting painless swelling on the right side of maxilla. Clinical and radiographic examinations revealed a well-circumscribed radiolucent mass, located between the maxillary left second incisor and molar area on the right side. The surgical procedure involved a large cyst enucleation on the left side with massive alveolar crest resorption on the facial and palatal walls and the enucleation of smaller cyst in the region 21-23. In the same surgery the reconstrucion of the right maxillary bone defect was made using titanium mesh in combination with illiac crest bone and xenogene material (Cerabone® - Bottis Dental, Germany) and by covering it with a resorbable membrane (Jason Memrane ® - Bottis Dental, Germany). The bony defect in the region 21-23 was reconstructed by ussing illiac crest bloc graft. The laterally horizontal atrophy of the right mandible was also reconstructed with mandibullary chin block grafts. After four months the mesh was removed and five Astra Tech implants were placed in the maxilla and three implants were placed on the posterior part of the right mandible. The prosthetic rehabilitation was completed after five month healing period with two cement-retained bridges on Astra implants and the other two bridges were cemented on the remaining teeth. During the control period of 27 months, no complications developed, and the patient was quite satisfied with the functional and aesthetic result.

odontogenic cyst, bone reconstruction, dental implants

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