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Abstract
The treatment of repeated pathologic fractures of the mandible has long taxed the
ingenuity of surgeons. The complexity of the problem increases with the recognition
of a metabolic defect that renders the facial bones hypoplastic. In the case presented,
a tentative diagnosis of familial facial osteodystrophy was made at the National Institutes
of Health. Since that time, the patient has undergone autogenous onlay grafting, which
has completely resorbed. Because of continuous resorption, a number of pathologic
fractures have occurred. The most recent fracture was treated by means of a freeze-dried
rib, which acted as a floor and as a splint to the fracture site. Hydroxylapatite
and a marrow mixture were placed on the floor to gain height, strength, and durability.
Subsequently, hydroxylapatite augmentation was performed to gain a more anatomic alveolar
ridge. The patient's 12-month follow-up has shown the mandible to be intact with no
noticeable change in either vertical or horizontal dimensions.
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Reference
- A method for augmenting the severely atophic maxilla using hydroxylapatite.J Oral Maxillofac Surg. 1985; 43: 57-60
- Autogenous rib graft—hydroxylapatite augmentation of the severely atrophic mandible.J Oral Maxillofac Surg. 1986; 44: 606-608
- Long-term radiographic evaluation of hydroxylapatite-augmented mandibular alveolar ridges.J Oral Maxillofac Surg. 1984; 42: 793-796
- Long-term ridge augmentation with rib graft.J Maxillofac Surg. 1975; 3: 103-106
- Long-term follow-up of transoral rib grafts for mandibular alveolar ridges.J Oral Maxillofac Surg. 1984; 42: 606-609
Article info
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Copyright
© 1987 The C. V. Mosby Company. Published by Elsevier Inc.
