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P.374 Dental implants in children with ectodermal dysplasia
Posters
Prostheses-epitheses, implantology and pre-prosthetic surgery
Results: We monitored complete integration of osteoautotransplants taken from chin area of the patient. Volume of the bone tissue necessary for implants was restored. Dental implants introduced successfully, what was confirmed using x-rays. Metalceramic prostheses were manufactured which provided excellent esthetic and functional results. Conclusion: Mentioned clinical studies and results of the treatment show the possibility to perform in less than 10 months period total restoration of dental arches using dental implants in the area of processus alveolaris defects.
P.374 Dental implants in children with ectodermal dysplasia Ji. Salmeron, L. Garcia Monleon del Amo, A. Thomas, Jl. Barrios, C. Navarro Vila. Hospital General Universitario Gregorio Mara˜no´ n, Madrid, Spain Introduction: Ectodermal dysplasia (ED) is a syndrome characterized by developmental failure of ectodermal structures, usually presenting severe dental abnormalities. We present the reports of two brothers affected by this syndrome and two different ways to solve the lack of alveolar bone. Case reports: A 19-year-old boy with hypohidrotic ED exhibited almost complete anodontia with underdevelopment of alveolar processes. He was managed with otogenous corticocancellous iliac crest bone grafts on the maxilla, bilateral sinus lift and calvarial grafts in the mandible. This allowed the placement of 4 endosseous implants in the maxilla and 4 in the mandible. The younger brother pressented with a more severe atrophy of alveolar processes. He was managed with bilateral sinus lift and vertical distraction of the mandibular symphysis. The mandibular height was increased in 7 mm. These procedures allowed the placement of 2 endosseous implants in the maxilla and 3 in the mandible. Discussion: The ED can be classified in hypohidrotic and hidrotic, being the later the more frequent and severe form. Usually they present with anodontia or hypodontia and a lack of alveolar ridge development. The prosthetic rehabilitation of these patients is difficult because of few remanent teeth and the low alveolar ridge. With the developement of dental implants a new way of rehabilitation can be offered. The deficiency of alveolar ridges can be solved with augmentation procedures: bone grafts or bone distraction. Conclusion: In patients with ED and severe alveolar ridges atrophy, procedures such as alveolar distraction or onlay grafts allow the placement of endosseous implants. This must be carried out as soon as possible to prevent the progression of bone resorption.
P.375 Endosteal dental implantation of lower jaw in osteoplasty V.A. Sharanda, O.P. Chudakov. Belarusian Collaborating Center of EACMFS, Belarusian State Medical University, Minsk, Belarus Objectives: Last years quantity of lower jar traumatic fractures is increased from 67.4% to 85% as well as quantity of this bone new formations. Regardless successes achieved by maxillofacial surgeons in after-tumor defects of lower jaw replacement with allogenic orthotopic transplants, complications as allograft rejection during and after treatment and rehabilitation procedures remain actual. Especially it deals with patients who need the mandibular bone continuity to be restored. Aim is to study effectiveness increase of complex treatment and rehabilitation procedures of the patients with lower jaw defects by osteoplasty with orthotopic allogenic bone tissue transplant combined with endosteal dental titanic implants incorporated inside. Methods: Clinical, experimental, histological, laser holographic interferometry, statistical.
S261
Results: We checked positive influence of endosteal titanic implants on the reparative osteogenesis while allogenic orthotopic osteoplasty of the body of mandible defects. We received new information about distribution of the functional load in the body of mandible when defects have different localizations, when defect replaced with allogenic orthotopic transplant, when different variants of orthopedic rehabilitation applied. We elaborated new method of complex rehabilitation of patients after osteoplasty of lower jaw defects with allogenic orthotopic transplants with introducing inside of endosteal dental implants. Conclusions: Method of immediate endosteal dental implantation in orthotopic bone alloplasty of the lower jaw provides more favorable conditions for development of valid bone reclaim in the region of mandible defect and earlier effectiveness of orthopedic rehabilitation of patients with lower jar defects. P.376 Fibula flap vertical distraction in a reconstructed mandible G.-Y. Cho Lee, L. Naval G´ıas, F. Rodr´ıguez Campo, M. Mu˜noz Guerra, J. Sastre P´erez, P. Martos D´ıaz, M. Mancha de la Plata, S. Ros´on G´omez, V. Escorial Hern´andez, A. Capote Moreno, F. D´ıaz Gonz´alez. Department of Oral and Maxillofacial Surgery. University Hospital La Princesa, Madrid, Spain Objectives: Free fibular bone flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects (over 6 cm) resulting from trauma, infection or tumour resections. When the reconstruction involves a dentate mandible, the fibula has a limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. We describe a case of vertical distraction osteogenesis of a free vascularized fibula used to reconstruct an hemimandible lost as a result of a mandibular mixoma resection. Methods: A 34-year-old male patient with a mandibular reconstruction by means of an osteocutaneous free fibula graft after a right mandibular mixoma resection that wished to undergo implant placement. Correction of the alveolar bony defect was planned by using distraction osteogenesis with an intraoral alveolar vertical distractor. After a latency period of 10 days, distraction started at a rate of 0.5 mm per day. Results: 17 mm of bone height increase was obtained after 34 days. Increased bone volume was stable during the followup period. After 3 months of consolidation period, 3 osteointegrated implants were inserted in the distracted fibular bone. The prosthesis was successfully inserted months later. Significant improvements masticatory function and facial aesthetics were achieved. Conclusions: Vertical distraction of the fibular bone flap is a reliable method enabling a good prosthetic rehabilitation following the reconstruction of the mandible due to extensive bone defects resulting from tumour resections. P.377 Fibula free-flap distraction and oral implant N. Zwetyenga, M. Gargiulo, S. Parascandolo, F. Siberchicot. Department of Oral and Maxillofacial Surgery – Centre Fran¸cois-Xavier Michelet, Bordeaux, France Objectives: Oral rehabilitation using dental implants in patient underwent a mandibular reconstruction using fibula free-flap is the best objective to resume. Vertical alveolar distraction osteogenesis is a relatively recent technique that allows augmentation of alveolar ridge height with new bone formation and significant increasing of the surrounding soft tissues of the transposed freeflap. The objective was to present results of vertical osteogenic distraction of fibula free-flap before oral implant. Methods: There were 6 patients: 1 operated for an osteosarcoma and 5 for gunshot. Panoramic radiographs were taken before surgery, at the beginning, during the period of distraction and
Prostheses-epitheses, implantology and pre-prosthetic surgery
Results: We monitored complete integration of osteoautotransplants taken from chin area of the patient. Volume of the bone tissue necessary for implants was restored. Dental implants introduced successfully, what was confirmed using x-rays. Metalceramic prostheses were manufactured which provided excellent esthetic and functional results. Conclusion: Mentioned clinical studies and results of the treatment show the possibility to perform in less than 10 months period total restoration of dental arches using dental implants in the area of processus alveolaris defects.
P.374 Dental implants in children with ectodermal dysplasia Ji. Salmeron, L. Garcia Monleon del Amo, A. Thomas, Jl. Barrios, C. Navarro Vila. Hospital General Universitario Gregorio Mara˜no´ n, Madrid, Spain Introduction: Ectodermal dysplasia (ED) is a syndrome characterized by developmental failure of ectodermal structures, usually presenting severe dental abnormalities. We present the reports of two brothers affected by this syndrome and two different ways to solve the lack of alveolar bone. Case reports: A 19-year-old boy with hypohidrotic ED exhibited almost complete anodontia with underdevelopment of alveolar processes. He was managed with otogenous corticocancellous iliac crest bone grafts on the maxilla, bilateral sinus lift and calvarial grafts in the mandible. This allowed the placement of 4 endosseous implants in the maxilla and 4 in the mandible. The younger brother pressented with a more severe atrophy of alveolar processes. He was managed with bilateral sinus lift and vertical distraction of the mandibular symphysis. The mandibular height was increased in 7 mm. These procedures allowed the placement of 2 endosseous implants in the maxilla and 3 in the mandible. Discussion: The ED can be classified in hypohidrotic and hidrotic, being the later the more frequent and severe form. Usually they present with anodontia or hypodontia and a lack of alveolar ridge development. The prosthetic rehabilitation of these patients is difficult because of few remanent teeth and the low alveolar ridge. With the developement of dental implants a new way of rehabilitation can be offered. The deficiency of alveolar ridges can be solved with augmentation procedures: bone grafts or bone distraction. Conclusion: In patients with ED and severe alveolar ridges atrophy, procedures such as alveolar distraction or onlay grafts allow the placement of endosseous implants. This must be carried out as soon as possible to prevent the progression of bone resorption.
P.375 Endosteal dental implantation of lower jaw in osteoplasty V.A. Sharanda, O.P. Chudakov. Belarusian Collaborating Center of EACMFS, Belarusian State Medical University, Minsk, Belarus Objectives: Last years quantity of lower jar traumatic fractures is increased from 67.4% to 85% as well as quantity of this bone new formations. Regardless successes achieved by maxillofacial surgeons in after-tumor defects of lower jaw replacement with allogenic orthotopic transplants, complications as allograft rejection during and after treatment and rehabilitation procedures remain actual. Especially it deals with patients who need the mandibular bone continuity to be restored. Aim is to study effectiveness increase of complex treatment and rehabilitation procedures of the patients with lower jaw defects by osteoplasty with orthotopic allogenic bone tissue transplant combined with endosteal dental titanic implants incorporated inside. Methods: Clinical, experimental, histological, laser holographic interferometry, statistical.
S261
Results: We checked positive influence of endosteal titanic implants on the reparative osteogenesis while allogenic orthotopic osteoplasty of the body of mandible defects. We received new information about distribution of the functional load in the body of mandible when defects have different localizations, when defect replaced with allogenic orthotopic transplant, when different variants of orthopedic rehabilitation applied. We elaborated new method of complex rehabilitation of patients after osteoplasty of lower jaw defects with allogenic orthotopic transplants with introducing inside of endosteal dental implants. Conclusions: Method of immediate endosteal dental implantation in orthotopic bone alloplasty of the lower jaw provides more favorable conditions for development of valid bone reclaim in the region of mandible defect and earlier effectiveness of orthopedic rehabilitation of patients with lower jar defects. P.376 Fibula flap vertical distraction in a reconstructed mandible G.-Y. Cho Lee, L. Naval G´ıas, F. Rodr´ıguez Campo, M. Mu˜noz Guerra, J. Sastre P´erez, P. Martos D´ıaz, M. Mancha de la Plata, S. Ros´on G´omez, V. Escorial Hern´andez, A. Capote Moreno, F. D´ıaz Gonz´alez. Department of Oral and Maxillofacial Surgery. University Hospital La Princesa, Madrid, Spain Objectives: Free fibular bone flap is considered the treatment of choice in mandibular reconstruction for extensive bone defects (over 6 cm) resulting from trauma, infection or tumour resections. When the reconstruction involves a dentate mandible, the fibula has a limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. We describe a case of vertical distraction osteogenesis of a free vascularized fibula used to reconstruct an hemimandible lost as a result of a mandibular mixoma resection. Methods: A 34-year-old male patient with a mandibular reconstruction by means of an osteocutaneous free fibula graft after a right mandibular mixoma resection that wished to undergo implant placement. Correction of the alveolar bony defect was planned by using distraction osteogenesis with an intraoral alveolar vertical distractor. After a latency period of 10 days, distraction started at a rate of 0.5 mm per day. Results: 17 mm of bone height increase was obtained after 34 days. Increased bone volume was stable during the followup period. After 3 months of consolidation period, 3 osteointegrated implants were inserted in the distracted fibular bone. The prosthesis was successfully inserted months later. Significant improvements masticatory function and facial aesthetics were achieved. Conclusions: Vertical distraction of the fibular bone flap is a reliable method enabling a good prosthetic rehabilitation following the reconstruction of the mandible due to extensive bone defects resulting from tumour resections. P.377 Fibula free-flap distraction and oral implant N. Zwetyenga, M. Gargiulo, S. Parascandolo, F. Siberchicot. Department of Oral and Maxillofacial Surgery – Centre Fran¸cois-Xavier Michelet, Bordeaux, France Objectives: Oral rehabilitation using dental implants in patient underwent a mandibular reconstruction using fibula free-flap is the best objective to resume. Vertical alveolar distraction osteogenesis is a relatively recent technique that allows augmentation of alveolar ridge height with new bone formation and significant increasing of the surrounding soft tissues of the transposed freeflap. The objective was to present results of vertical osteogenic distraction of fibula free-flap before oral implant. Methods: There were 6 patients: 1 operated for an osteosarcoma and 5 for gunshot. Panoramic radiographs were taken before surgery, at the beginning, during the period of distraction and