Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
The Use of Dental Implants to Treat Post-Surgical Jaw Defects: Cohort Study
Ameliyat Sonrası Oluşan Çene Defektlerini Tedavi Etmek İçin Dental İmplantların Kullanılması: Kohort Çalışması
Başak KESKİN YALÇINa, Metin Berk KASAPOĞLUa, Erol CANSIZa, Sırmahan ÇAKARERa
aDepartment of Oral and Maxillofacial Surgery, İstanbul University Faculty of Dentistry, İstanbul, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(3):519-25
doi: 10.5336/dentalsci.2021-87705
Article Language: EN
Full Text
ABSTRACT
 Objective: Many studies have documented spontaneous bone repair after the excision of benign jaw lesions, however implant placement after lesional removal has received less attention. Following bone pathology enucleation, bone defects may arise. Reconstruction techniques with various bone grafting materials are preferred in order to promote bone healing and to support alveolar bone. Another option is to initially allow physiological healing of the cavity without using any graft materials. In this study, it was planned to rehabilitate the patients by using dental implants after the physiological healing of the postoperative defects. Material and Methods: This study included patients with benign lesions greater than 5 mm in diameter and patients who underwent dental implants without any grafting procedures. Data from 18 patients who received dental implants after complete removal of benign pathological lesions were evaluated. We included 8 males and 10 females aged 16-78 years. A total of 41 implants were placed. Implants were applied 18-36 months after removal of the lesions. Eight of the 41 implants (19.5%) were placed in the maxilla. Thirteen of the 18 (72.2%) lesions were (histopathologically) odontogenic cysts; the remaining lesions comprised odontogenic fibromyxomas, an arteriovenous malformation, and a central giant cell granuloma. Results: Most of the lesions in the present study were localized in the posterior mandible and the pathological fracture was not reported following cyst enucleation nor dental implant placement. Conclusion: No implant failed during 2 years of follow-up. It was observed that the dental implants were found usefull for the reconstruction of post-surgical defects.

Keywords: Dental implant; mouth neoplasm; mandibular reconstruction
ÖZET
 Amaç: Birçok çalışma, iyi huylu çene lezyonlarının eksizyonundan sonra spontan kemik iyileşmesinin gerçekleştiğini göstermiştir, ancak lezyon çıkarıldıktan sonra dental implant yerleştirilmesi literatürde daha az ilgi görmüştür. Kemiklerdeki patolojilerin enükleasyonunu takiben kemik defektleri oluşabilmektedir. Kemik iyileşmesini hızlandırmak ve alveolar kemiği desteklemek için çeşitli kemik greft materyalleri ile rekonstrüksiyon teknikleri tercih edilmektedir. Diğer seçenek ise oluşan kavitenin, herhangi bir greft materyali kullanmadan fizyolojik iyileşmesine izin vermektir. Bu çalışma, ameliyat sonrası oluşmuş defektlerin fizyolojik iyileşmesi sonrası dental implant desteğiyle hastaları tedavi etmeyi planlanmıştır. Gereç ve Yöntemler: Çalışmaya, çapı 5 mm'den büyük benign lezyonları olan ve cerrahi sonrası herhangi bir greftleme yapılmadan dental implant uygulanan tüm hastalar dâhil edilmiştir. Çalışmada, iyi huylu patolojik lezyonların tamamen çıkarılmasından sonra dental implant uygulanan 18 hastanın verileri değerlendirilmiştir. Çalışmaya, 16-78 yaşları arasında 8 erkek ve 10 kadın dâhil edilmiştir ve toplam 41 adet dental implant uygulanmıştır. İmplantlar, lezyonların çıkarılmasından 18-36 ay sonrasında uygulanmıştır. Kırk bir implantın 8'i (%19,5) üst çeneye yerleştirilmiştir. Yapılan histopatolojik incelemelerde, 18 lezyonun 13'ü (%72,2) odontojenik kist, diğer lezyonlar ise odontojenik fibromiksoma, arteriyovenöz malformasyon ve santral dev hücreli granülom olarak bildirilmiştir. Bulgular: Bu çalışmadaki lezyonların çoğu, posterior mandibulada yer almaktadır ve kist enükleasyonunu veya dental implant yerleştirilmesini takiben patolojik kırık rapor edilmemiştir. Sonuç: 2 yıllık takip süresince hiçbir implantta başarısızlık gözlenmemiştir. Dental implantların, ameliyat sonrası oluşan defektlerin rekonstrüksiyonunda kullanılmasının uygun olduğu gözlenmiştir.

Anahtar Kelimeler: Diş implantasyonu; ağız neoplazileri; mandibular rekonstrüksiyon
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