Complete Oral Rehabilitation of a Postresection Ameloblastoma Patient: A Clinical Case Report
Conventional ameloblastomas are rare, benign, epithelial odontogenic tumors that tend to grow slowly in the mandible or maxilla, but are locally invasive and can be highly destructive of the surrounding dental anatomy. Aggressive resection is the most effective method of eliminating the tumors, but treatment can further contribute to patient deformity and malfunction. Ameloblastomas also have a high rate of recurrence, which significantly diminishes 8 years after resection, but still requires vigilant clinical monitoring. This case report describes the complete oral rehabilitation of a postresection ameloblastoma patient with a mandibular reconstruction plate and partial edentulism. An autogenous graft was taken from the patient's iliac crest, shaped to fit the defect, and attached with bone screws. After graft incorporation, dental implants were successfully placed into the augmented ridge and restored with a fixed partial denture. There was no evidence of tumor recurrence during the 10 months of treatment or 8 years of subsequent clinical monitoring.
Postresection radiograph shows a mandibular reconstruction plate retained by bone screws.
Figure 2. Clinical view of the patient's severely resorbed mandible after tumor resection. Figure 3. Computerized tomography scan illustrates severely atrophic anterior mandible.
Figure 4. Transitional removable partial denture being fabricated for the patient as construction of surgical guide. Figure 5. Postaugmentation radiograph shows the iliac crest autogenous bone graft retained by bone screws. Figure 6. Clinical view after mandibular reconstruction. Figure 7. Clinical view of implant placement into regenerated bone from iliac crest graft.
Figure 8. Radiograph of implants and custom abutments in place. Figure 9. Delivery of the provisional prosthesis at the stage II surgery. Figure 10. Clinical view of the definitive porcelain fused to high noble metal restoration in place. Figure 11. An 8-year postoperative radiograph revealing stable bone.
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