하악구치부 보철공간을 위한 상악구치부의 분절골절단 및 상방 정위
Surgical Repositioning of the Extruded Dento-alveolar Segments by the Single-Stage Posterior Maxillary Segmental Osteotomy
김명래, 김충, 김형섭,
소속 상세정보
김명래 ( Kim Myung-Rae ) - 이화여자대학교 의과대학 치과학교실 구강외과, 보철과
김충 ( Kim Choong ) - 이화여자대학교 의과대학 치과학교실 구강외과, 보철과
김형섭 ( Kim Hyung-Sub ) - 이화여자대학교 의과대학 치과학교실 구강외과, 보철과
KMID : 0360120010230040338
Abstract
Purpose: This is to review the cases of posterior maxillary segmental osteotomies to regain the interarch spaces for dental implants in the posterior mandible.
Materials & Methods: Seven patients who presented with alveolar extrusion of upper posterior molars underwent segmental osteotomies by single-stage Kufner’s buccal approach under the intravenous sedation and local anesthesia. The posterior maxillary dento-alveolar segments were repositioned upward using prefabricated palato-occlusal resin splints and immobilized with osteosynthesis microplates and screws. Dental implants were installated simultaneously. The regained spaces, tooth vitality, periodontal healing, relapse, tenderness on function, and complications including maxillary sinus involvements were evaluated periodically for over one year after the surgeries.
Results: The single-tage procedures were completed within 80 minutes without any surgical complications. The posterior maxillary segments were repositioned upward to regain the interarch spaces ranging from 2.5 to 5.5mm. All teeth involved in the procedures keep their vitalities. The repositioned segments were maintained showing neither evidence of periodontal break-down nor tenderness to function. One patient whose segments had not been immobilized by osteosynthesis plate resulted in 2mm down-ward relapse in post-operative 8 months. A case of postoperative nasal bleeding from the posterior-lateral wall resulted in oroantral fistula and chronic maxillary sinusitis later.
Conclusions: The extruded dento-alveolar segments of the posterior maxilla were repositioned properly by Kufner’s one-stage segmental osteotomies. One microplate can be of help to keep the position until the osseous healing enough to support the masticatory force.
키워드
Segmental Osteotomy;Alveolar extrusion;Interarch space regaining
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