New regenerative surgical treatment of cystic diseases of the jaw by utilizing grafting of cancellous iliac bone and replanting of patient's teeth.
The authors developed a new regenerative surgical technique for cystic diseases of the jaw. In this surgery, all teeth that are rooted in or located adjacent to the cyst are extracted for replanting, and attached soft tissues, including cystic wall as well as dental pulp, are completely removed. Gingiva is cut open at the alveolar crest and abraded subperiosteally, the jaw on the cystic lesion is widely exposed, and cortical bone on the frontal wall of the cystic lesion is dissected. After the entire cyst is exposed, it is completely removed with scrapers and bars. The defect is reconstructed by the following procedures: the extracted and treated teeth are replanted; cancellous iliac bone (bone marrow) is grafted around the teeth and in the defect; and after thorough washing and making numerous small holes, the frontal wall of the cortical bone is returned to the original position and fixed. Three to 4 months later when the jaw has regenerated and the replanted teeth have taken, a prosthesis is set on the replanted teeth and biting is started. This technique was applied to a 16-year-old male patient who had odontogenic keratocysts on the lower right teeth (numbers 6, 5, 4, 3, 2, and 1), the lower left teeth (numbers 1, 2, 3, and 4), and the upper right teeth (numbers 5, 4, 3, and 2). The patient regained normal biting capability, and the esthetic outcome was also satisfactory. This technique would be a useful treatment method for cystic diseases of the jaw.
Kiyokawa
Kensuke
K
Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Fukuoka, Japan. prsmf@med.kurume-u.ac.jp
Kiyokawa
Munekatsu
M
Tai
Yoshiaki
Y
Tanaka
Shinsuke
S
D000293:Adolescent; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000379:methods*; D006801:Humans; D007570:Jaw Cysts / Q000601:surgery*; D008297:Male; D014081:Tooth Extraction; D014090:Tooth Replantation