Five-Year Follow-up of Modified Implant-Supported Overdenture in an Iliac Crest Autograft Failure

Abstract

The treatment of extensive pathologic lesions in the jaw, most of the time, can generate rehabilitation problems to the patient. The solid ameloblastoma is a locally invasive odontogenic tumor with a high recurrence rate. Its treatment is aggressive and accomplished through resection with safety margin. The criterion standard for reconstruction is autogenous bone, but it can provide a high degree of resorption, causing inconvenience to the patient because of lack of rehabilitative option. This study aimed to describe a patient with ameloblastoma treated through resection and reconstruction with autogenous bone graft, in which, after an extensive resorption of the graft was made, a modified bar was applied to support a prosthetic implant overdenture.

Implant-supported prosthetic rehabilitation after Ameloblastomas treatment: a systematic review

“…Most articles were published after 2013 (25: 71.4%). Four (24%) studies were conducted in India [ 42 , 44 , 55 , 58 ], Turkey [ 27 , 32 , 47 , 49 ] and Brazil [ 37 , 46 , 52 ], 3 (18%) in the USA [ 30 , 35 , 41 ], Spain [ 31 , 50 , 57 ], China [ 28 , 33 , 43 ], Korea [ 38 , 39 , 53 ], 2 (12%) in Italy [ 36 , 48 ], Finland [ 29 , 40 ] and other studies (6%) in Japan [ 54 ], Colombia [ 59 ], Iran [ 56 ], Taiwan [ 25 ], Austria [ 26 ] and Romania [ 45 ] (Tables 2 and 4 ).…”

“…It was also observed that 94% of patients had conventional/multicystic AM [ 25 , 27 – 30 , 32 – 49 , 51 – 59 ], and only 4 (6%) cases were diagnosed as unicystic type AM [ 26 , 31 , 42 , 50 ]. The most common histologic variant was the plexiform type (11%) [ 26 , 37 , 39 , 49 ], followed by the follicular variant (8%) [ 26 , 34 , 38 , 45 , 46 ]. The most affected anatomical region was the mandible (94%) [ 25 , 27 – 49 , 51 – 56 , 58 , 59 ], mainly the posterior (58.3%) and left side of the face (42%), followed by the posterior maxilla (75%) [ 26 , 50 , 57 ].…”

“…The treatment of choice was surgical resection of the tumor (100%) [ 25 – 59 ], with segmental mandibulectomy being the most frequent procedure (77%) [ 25 , 28 – 47 , 49 , 50 ]. For reconstruction of the resulting bone defect, 41% of the cases were reconstructed by fibula free-flap [ 25 , 28 , 32 , 34 , 36 , 41 , 55 , 57 , 58 ], followed by iliac bone graft (31.2%) [ 26 , 27 , 31 , 33 , 35 , 37 , 38 , 42 , 45 , 47 , 49 , 56 ]. Finally, the mean time after maxillofacial reconstruction for dental implant placement was 23.00 ± 34.00 months, equivalent to 1.9 years (Tables 2 and 4 ).…”

“…After implant placement, 38.3% were conventionally loaded [ 28 , 30 , 31 , 33 , 36 – 40 , 43 , 45 , 48 , 54 , 56 , 58 ], followed by the immediate loading protocol (28%) [ 25 , 34 , 35 , 41 , 42 , 52 ]. In total, 62 implant-supported restorations were placed, of which 79% corresponded to fixed dentures [ 25 , 28 , 29 , 31 – 36 , 38 , 39 , 41 – 44 , 46 – 52 , 54 – 59 ] and 21% to removable dentures [ 26 , 27 , 30 , 33 , 37 , 40 , 45 , 53 ]. Regarding fixed prostheses, the most used types were hybrid prostheses (53%) [ 43 , 49 , 52 , 56 – 59 ], followed by cemented restorations (27%) [ 35 , 42 , 44 , 55 ].…”

“…Regarding fixed prostheses, the most used types were hybrid prostheses (53%) [ 43 , 49 , 52 , 56 – 59 ], followed by cemented restorations (27%) [ 35 , 42 , 44 , 55 ]. Of the removable prosthesis, metal bar retention was the most frequently used anchorage system (86%) [ 26 , 27 , 30 , 33 , 37 , 55 ]. The most commonly used biomaterials for the construction of prosthetic devices were metal-ceramic (55%) [ 34 , 35 , 42 , 44 – 46 ] for the fixed systems and acrylic resin (27.3%) for the removable systems [ 30 , 33 , 55 ] (Tables 3 and 4 ).…”