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Revista odontológica mexicana
versión impresa ISSN 1870-199X
Rev. Odont. Mex vol.12 no.2 Ciudad de México jun. 2008
https://doi.org/10.22201/fo.1870199xp.2008.12.2.15680
Casos clínicos
Reconstrucción del segmento anterior mandibular con injerto microvascular de peroné en doble barra. Reporte de un caso
Mandibular anterior zone reconstruction with fibular microvascularized graft in double barrel. Case report
* Alumna de la Especialidad de Cirugía Oral y Maxilofacial de la División de Estudios de Postgrado e Investigación de la Facultad de Odontología de la UNAM. México.
§ Profesor de la División de Estudios de Postgrado e Investigación de la Facultad de Odontología de la UNAM. México.
II Adscrito del Servicio de Cirugía Plástica y Reconstructiva Hospital Manuel Gea González. México.
La reconstrucción mandibular tiene dos propósitos principales: reestablecer la función y la estética. Para lograrlo, se emplean injertos óseos autógenos no vascularizados e implantes aloplásticos que presentan algunas complicaciones como la reabsorción o exposición. Los injertos óseos vascularizados se utilizan principalmente en el tratamiento de defectos en pacientes con inadecuadas condiciones del lecho receptor. El injerto microvascular de peroné en doble barra ofrece una altura ósea adecuada, restableciendo la continuidad del borde basal y del proceso alveolar mandibular.
Objetivo
Demostrar el uso del injerto microvascular de peroné en doble barra para la reconstrucción mandibular en el segmento anterior.
Material y métodos
Se trata de paciente masculino de 43 años de edad, con antecedentes de secuelas por herida de arma de fuego, tratado de manera convencional en un primer tiempo quirúrgico, no obteniendo resultados favorables para su función y estética, por lo que se decide la colocación de injerto microvascularizado de peroné en doble barra.
Conclusión
La calidad del peroné y el rico aporte sanguíneo hacen que este injerto en el sector anterior mandibular presente menor morbilidad. Colocado en doble barra es una alternativa que ofrece estabilidad, altura y espesor óseo con la finalidad de lograr una reconstrucción mandibular funcional que ofrezca un adecuado soporte para la colocación de implantes osteointegrados y su consecuente rehabilitación protésica.
Palabras clave: Reconstrucción mandibular; injerto microvascular; cirugía microvascular; injerto vascularizado; injerto libre microvascularizado
Mandibular reconstruction has two main purposes: to reestablish function and aesthetics. To achieve this purposes, autogenous non vascularized osseous grafts and alloplastic implants that present some complications such as reabsorption and exposition are used. Osseous vascularized grafts are mainly used for treatment in patients with inappropriate conditions of the graft bed. The fibular microvascularized graft in double barrel offers an adequate bone height, re-establishing the continuity of the basal border and the mandibular alveolar process.
Objective
To demonstrate the use of the fibular microvascularized graft in double barrel for mandibular reconstruction of the anterior segment.
Materials and methods
The surgical procedure was carried out in a 43 year old male patient with fire guns wounds antecedents, the first time treated with a conventional surgical intervention without improvement in function and aesthetic results; that is why it was decided to use the fibular microvasculared graft in double barrel.
Conclusions
Fibular quality and rich blood supply allow the graft located in the anterior mandibular area to present less morbidity. Graft located in double barrel is an alternative that offers stability, height, and bone thickness to achieve a functional mandibular reconstruction that provides an adequate support to place osteointegrate implants and its consecutive prosthetic rehabilitation.
Key words: Mandibular reconstruction; microvascularized graft; microvascular surgery; vascularized graft; microvascularized free graft
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