고압증기 소독한 자가골 재이식술을 이용한 하악골의 즉시 재건술
Immediate mandibular reconstruction with autoclaved autogenous reimplant
김일규, 오성섭,
소속 상세정보
김일규 ( ) - 인하대학교
오성섭 ( ) - 인하대학교
KMID : 0355619950210040641
Abstract
Three cases of mandible reconstruction by immediate reimplanting, either with or without PMCB graft, of autoclaved autogenous bone obtained by partial mandiblectomy were experienced. In one case, reconstruction failed because of oral mucosa
perforation
and exposure of the graft leading to the lysis of the graft. However, in two other cases, we obtained a good functional and esthetic result without foreign body reaction Harding described in 1957. At two years after reimplantation, the graft
incorporation looked good radiographically. During the procedure of metal removal performed 2 years after reimplantation, a clinically good graft incorporation without bony bleeding from the graft were observed. However, microscopically the
grafted
bone
tissue appeared necrotic and osteoporotic without ingrowth of new bone tissue three and a half years after reimplantation, respectively. Based on these results, autoclaved grafts might remodel themselves without foreign body reaction although
remodeling
takes longer than in fresh autogenous grafts. It appears that autogenous reimplantating as used here has the advantage of providing the framework, whose shape could be tailored bo fit the mandibular defecy, for new bone growth to take place in
it.
In
combination with PMCB and rigid fixation, autoclaved autogenous reimplants may be useful in cases where structural mandibular defects need to be corrected minimizing loss of the patient's previous mandibular contour.
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