Maxillofacial Plastic and Reconstructive Surgery

  • 제30권3호
  • /
  • Pages.241-248
  • /
  • 2008
  • /
  • 2288-8101(pISSN)
  • /
  • 2288-8586(eISSN)
대한악안면성형재건외과학회 (Korean Association of Maxillofacial Plastic and Reconstructive Surgeons)
권호 표지

구강악안면 영역의 재건을 위한 경골 근위부 내측 골이식술의 후향적 분석

A RETROSPECTIVE ANALYSIS OF THE MEDIOPROXIMAL TIBIAL BONE GRAFT FOR ORAL AND MAXILLOFACIAL RECONSTRUCTION

  • 백민규 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 김일규 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 조현영 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 장금수 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 박승훈 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 박종원 (인하대학교 의과대학 치과학교실 구강악안면외과) ;
  • 소경모 (인하대학교 의과대학 치과학교실 구강악안면외과)
  • Baek, Min-Kyu (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Kim, Il-Kyu (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Cho, Hyun-Young (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Chang, Keum-Soo (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Park, Seung-Hoon (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • Park, Jong-Won (epartment of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University) ;
  • So, Kyung-Mo (Department of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, In-Ha University)
  • 발행 : 2008.05.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

키워드

참고문헌

  1. Burchardt H : Biology of bone transplantation. Orthopaedic Clinics of North America 18 : 187, 1987
  2. Adekeye EO : Reconstruction of mandibular defects by autogenous bone grafts:a review of 37 cases. J Oral Surgery 36 : 125, 1978
  3. Younger EM, Chapman MW : Morbidity at bone graft donor sites. J Orthopaedic Trauma 3 : 192, 1989 https://doi.org/10.1097/00005131-198909000-00002
  4. Laurie SWS, Kaban LB, Mulliken JB et al : Donor-site morbidity after harvesting rib and iliac bone. J Plastic and Reconstructive Surgery 73 : 933, 1984 https://doi.org/10.1097/00006534-198406000-00014
  5. Al-Sebaei MO, Papageorge MB, Woo T : Technique for inoffice cranial bone harvesting. J Oral Maxillofac Surg 62 : 120, 2004 https://doi.org/10.1016/j.joms.2003.12.036
  6. Catone GA, Reimer BL, Mcneir D et al : Tibial autogenous cancellous bone as an alternative dornor site in maxillofacial surgery:A preliminary report. J Oral Maxillofac Surg 50 : 1258, 1992 https://doi.org/10.1016/0278-2391(92)90223-M
  7. O'keeffe RM, Riemer BL, Butterfield SL : Harvesting of autogenous cancellous bone graft from the proximal tibial metaphysis:A review of 230 cases. J Orthopaedic Trauma 5 : 469, 1991 https://doi.org/10.1097/00005131-199112000-00014
  8. Kim CH, Lee MH, Kim MS et al : Autogenous cancellous bone graft from the proximal tibial metaphysis, J Kor Oral and Maxillofac Surg 23 :１52, 1997
  9. Jakse N, Seibert FJ, Lorenzoni M et al : A modified technique of harvesting tibial cancellous bone and its use for sinus grafting. Clin Oral Impl Res 12 : 488, 2001 https://doi.org/10.1034/j.1600-0501.2001.120509.x
  10. Marchena JM, Block MS, Stover JD : Tibial bone harvesting under intravenous sedation:morbidity and patient experience. J Oral Maxillofac Surg 60 : 1151, 2002 https://doi.org/10.1053/joms.2002.34990
  11. Lee BS, Lee DW, Lee SC et al : Iliac and tibial bone harvesting for implant surgery under local anesthesia. J Kor Maxillofac Plast and Reconst 26 : 310, 2004
  12. Mazock JB, Schow SR, Triplett RG : Proximal tibia bone harvest : review of technique, complications, and use in maxillofacial surgery. Int J Oral Maxillofac Implants 19 : 586, 2004
  13. Lezcano FJB, Cagigal BP, Cantera JMG et al : Technical note:Medial approach for proximal tibia bone graft using a manual trephine. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 20 : 1, 2007
  14. van Damme PA, Merkx MAW : A Modification of the tibial bone-graft-harvesting technique. Int J Oral Maxillofac Surg 25 : 346, 1996 https://doi.org/10.1016/S0901-5027(06)80027-5
  15. Herford AS, King BJ, Audia F et al : Medial approach for tibial bone graft: anatomic study and clinical technique. J Oral Maxillofac Surg 61 : 358, 2003 https://doi.org/10.1053/joms.2003.50071
  16. Nam W, Park WS, Jeong HG et al : Three dimensional linear measurement of proximal tibia in medial and lateral approach for bone harvesting. J Kor Oral and Maxillofac Surg 33 : 307, 2007
  17. Hernandez-Alfaro F, Marti C, Biosca MJ et al : Minimally invasive tibial bone harvesting under intravenous sedation. J Oral Maxillofac Surg 63 : 464, 2005 https://doi.org/10.1016/j.joms.2004.07.020
  18. Kim SG, Yeo HH, Kim SM : An experimental study on the bone regeneration of tibial bone defect. J Kor Maxillofac Plast and Reconst 20 : 275, 1998
  19. Hughes CW, Revington PJ : The proximal tibia donor site in cleft alveolar bone grafting:experience of 75 consecutive cases. Journal of Cranio-Maxillofacial Surgery 30 : 12, 2002 https://doi.org/10.1054/jcms.2001.0268
  20. Besley W, Booth W : Technique for harvesting tibial cancellous bone modified for use in children. British Journal of Oral and Maxillofacial Surgery 37 : 129, 1999 https://doi.org/10.1054/bjom.1998.0433
  21. Thor A, Farzad P, Larsson S : Fracture of the tibia: complication of bone grafting to the anterior maxilla. British Journal of Oral and Maxillofacial Surgery 44 : 46, 2006 https://doi.org/10.1016/j.bjoms.2005.02.011
  22. Alt V, Meeder PJ, Seligson D et al : The proximal tibia metaphysis:a reliable donor site for bone grafting? Clinical Orthopaedic and Related Research 414 : 315, 2003 https://doi.org/10.1097/01.blo.0000079261.91782.df