由于可能诊断上颌骨和下颌骨的牙源性囊肿和肿瘤,因此牙髓源性病变的很大一部分需要手术治疗。骨化性纤维瘤是一种良性纤维骨性病变,通常表现为无痛,生长缓慢,和扩张性病变,表现为清晰的病变,在X线摄影上具有不同程度的内部钙化。治疗导致大的骨缺损,利用移植物来填充空隙加速愈合并防止可能由宿主反应导致的填充失败引起的并发症。
■在进行牙髓手术后,通过引导组织再生术放置骨移植材料以填充缺损,以加速健康的26岁女性患者的缺损填充。一例讨论了根管显微手术后下颌骨前部骨化性纤维瘤的一步治疗,并伴有根尖的逆行填充,然后用双相硫酸钙(BondApitte®)进行部位光栅,用于与病变相关的骨缺损的再生和手术。
■组织学,骨化性纤维瘤以结缔组织为主,含有富含细胞的区域,有少量纤维化片段。此外,在结缔组织中,观察到许多海绵状和致密骨的小碎片,存在部分坏死区域,并观察到大量的炎症细胞。手术切除囊肿并彻底刮除骨壁和移植缺损可提供可预测的愈合和所需的临床结果。双相硫酸钙移植材料的使用允许消除在皮瓣之前用膜覆盖该区域的需要,这是由于其硬定形和防止软组织在愈合阶段向内生长到移植材料中。此外,硬设置的材料允许隆起的区域,以保持所需的体积和脊的轮廓。取决于置于宿主骨的体积的移植材料的转化在3-6个月的时间内发生。
■提交的病例报告,以及作者的经验,模拟了双相硫酸钙作为骨移植材料的文献,并且是修复由于上颌骨和下颌骨的肿瘤和囊肿的去除而导致的骨缺损的有效方法。骨化纤维瘤的治疗是使用该双相硫酸钙材料的理想应用,其允许在囊肿去除后产生的缺损上隆起手术部位,而不需要可再吸收的胶原膜。这简化了其使用并且降低了可能妨碍患者接受治疗而不降低预期临床结果的材料成本。
A significant percentage of lesions of endodontic origin require surgical management due to the possible diagnosis of odontogenic cysts and tumors in the maxilla and mandible. Ossifying fibroma is a benign fibro-osseous lesion that typically presents as a painless, slow-growing, and expansile lesion that appears as a well-demarcated lesion with a variable degree of internal calcification on radiography. Treatment results in a large osseous defect, utilization of a graft to fill the void accelerates healing and prevents complications that may result from failure to fill by the host response.
UNASSIGNED: Following endodontic surgery placement of osseous graft material via Guided Tissue Regeneration to fill the defect aids to accelerate fill of the defect on a healthy 26-year-old female patient. A
case discussing the one-step treatment of an ossifying fibroma of the anterior part of the mandible following endodontic microsurgery with associated retrograde fill of the apex, then site grating with biphasic calcium sulfate (Bond Apatite®) used in regeneration of the osseous defect related to the lesion and resulting surgery.
UNASSIGNED: Histologically, the ossifying fibroma is dominated by connective tissue containing cell rich areas with a few fragments of fibrosis. Moreover, in the connective tissue numerous small fragments of spongy and compact bone with areas of partial necrosis present and a significant number of inflammatory cells are observed. Surgical removal of the cyst with thorough curettage of the osseous walls and grafting of the defect provides predictable healing and the desired clinical results sought. Utilization of the biphasic calcium sulfate graft material allows the elimination of the need to overlay the area with a membrane before the flap due to its hard set and the prevention of soft tissue ingrowth into the graft material during the healing phase. Additionally, the hard set of the material allows tenting of the area to maintain the desired volume and ridge contour. Conversion of the graft material depending on the volume placed to host bone occurs over a 3-6 month period.
UNASSIGNED: The
case report presented, as well as the authors experience mimics the literature on biphasic calcium sulfate in its use as an osseous graft material and is an effective method for the repair of osseous defects that result from the removal of tumors and cysts of the maxilla and mandible. Treatment of an ossifying fibroma is an ideal application of the use of this biphasic calcium sulfate material allowing tenting of the surgical site over the defect created after cyst removal without the need for resorbable collagen membranes. This simplifies its use and decreases material costs that may hamper patient acceptance of treatment without a decrease in expected clinical results.