생 유리골 이식 및 골 유착성 임프란트를 이용한 기능적 악안면 재건

Functional mandibular reconstruction by vascularized iliac bone graft with osseointegrated implants

The ideal goal of the maxillofacial reconstruction is a rehabilitation of the anatomic, esthetic, psychologic and functional problems. We present our experience with a case of functional mandiblar reconstruction with the combination of vascularized iliac bone graft and simultaneouse grafting of the osseointegrated implants. This patient was a 28-year old man with a discontinuity defect of the mandible from right parasymphysis area to the right condylar neck portion secondary to en-block resection of ameloblastoma. Prosthetic rehabilitation was not possible due to loss of alveolar ridge. Doner graft was prepared with a vascularized iliac crest bone by the technique described by Taylor (1979). Graft bone was contoured to establish the bony arch and 2 titanium implants were integrated into the graft bone and deliverd to the recipient site and secured by miniplate fixation. Pedicled vessels were microsurgically anastomosed with the vessels in the recipient bed. We had a plane to construct the prosthesis 3 months after grafting procedure. Now we observe that the vascularized iliac bone graft seem to have very little tendency to atrophy in contrast to nonvascularized free iliac bone, and this method of simultaneouse grafting of vascularized bone and osseointegrated implants must be a time saving technique for the functional jaw bone reconstruction procedure.