TITLE:
Minimally Invasive Maxillofacial Surgery Using Digital Work Surgery: A Case of Alveolar Ridge Reconstruction after Maxillary Cystectomy
AUTHORS:
Toshiyuki Kataoka, Kei Amemiya, Erika Tajima, Akira Nose, Toshihiro Okamoto
KEYWORDS:
Alveolar Ridge Reconstruction, Digital Work Surgery, Iliac Cancellous Bone Graft, Minimally Invasive Surgery
JOURNAL NAME:
Open Journal of Stomatology,
Vol.13 No.10,
September
27,
2023
ABSTRACT: Introduction: Iliac particulate cancellous bone and marrow (PCBM) is commonly used as a high-quality reconstruction material; however, PCBM cannot be extracted in sufficient amounts to meet demand. To determine the appropriate amount of iliac PCBM to be collected, we used digital technology to measure the volume required for jaw reconstruction before surgery. Clinical Case: The patient, a 23-year-old man, underwent surgery for a calcifying odontogenic cyst. A maxillary cyst occupied the left anterior-premolar region (tooth 21 - 25) and the deciduous canine remained; a permanent canine was included in the cyst. We planned to preserve the teeth except for the impacted canine, completely excise the maxillary cyst, and preserve the alveolar ridge morphology. Preoperative digital imaging was used to determine the amount of alveolar ridge reconstruction required and accordingly determine the amount of iliac cancellous bone to be harvested. We used a titanium mesh tray and grafts of iliac particulate cancellous bone and marrow to reconstruct the alveolar ridge. The amount of iliac cancellous bone that needed to be collected was clarified and the supply amount could be collected in just the right amount; thus, the cortical bone of the iliac inner plate could be preserved. The alveolar bone morphology was reconstructed to allow the placement of dental implants as per the preoperative digital surgery. Three years after the operation, no sign of recurrence has been observed. Conclusion: Minimally invasive surgery was performed by clarifying the amount of iliac cancellous bone graft that needs to be harvested, which improved the accuracy of surgery.