Surgical management of ossifying fibroma in the maxilla and its challenges associated with an immediate reconstructive approach with autogenous graft, an unusual case report / Manejo quirúrgico del fibroma osificante en el maxilar y sus desafíos asociados con un enfoque reconstructivo inmediato con el injerto autógeno, un informe de caso inusual

Ossifying Fibroma is a gingival mass in which calcified foci are found. It is a nodular lesion that involves the inserted and interdental gum. There is a predilection for the female sex and for the anterior region of the maxilla. This work aims to report the surgical management of a Ossifying Fibroma in the maxilla and the immediate reconstructive with autogenous graft. Female patient, in the third decade of life, presenting Ossifying Fibroma in the region between maxillary incisors and premolars. She was treated surgically by means of marginal resection of the lesion under general anesthesia and immediate reconstruction with autologous iliac crest graft. Followed up for 12 months with no signs of recurrence.

El Fibroma osificante es una masa gingival en la que se encuentran focos calcificados. Es una lesión nodular que involucra la encía adherida e interdentaria. Hay una predilección por el sexo femenino y por la región anterior del maxilar. Este trabajo tiene como objetivo informar sobre el manejo quirúrgico de un fibroma osificante periférico en el maxilar y su reconstrucción inmediata con injerto autógeno. Paciente de sexo femenino, en la tercera década de vida, presenta un Fibroma osificante en la región entre incisivos maxilares y premolares. Fue tratada quirúrgicamente por medio de una resección marginal de la lesión bajo anestesia general y reconstrucción inmediata con injerto de cresta ilíaca autóloga. Seguimiento durante 12 meses sin signos de recurrencia.

Retrospective study of bone grafting procedures before implant placement.

AIM: The aim of this retrospective study was to evaluate morbidity and possible complications in augmentation procedures before implant placement. METHODS: Records from 93 consecutive patients with indication for autogenous bone grafting before implant placement, treated at Department of Oral and Maxillofacial Surgery and Implantology of Uberlândia Federal University, in a 7-year period (July 2000 until July 2007), were reviewed. The need for bone grafting was defined by the impossibility of installing implants of adequate length or diameter to fulfill prosthetic requirements or for aesthetic reasons. RESULTS: A total of 136 bone grafting procedures were performed. The mandibular external oblique line and ascending ramus were the most frequently used donor areas (59.64%) and block grafts (67.64%) were the most frequently used type of graft, frequently from the mandibular external oblique line/ascending ramus (52.18%). Platelet-rich plasma was used in 20.1% of all procedures, usually associated with particulate bone grafts. Maxillary procedures represented the majority of surgeries (75%), but with fewer complications compared with the mandible. Sinus mucosa perforation was the most frequent complication in maxillary procedures, whereas graft exposure was the most common complication in mandible. CONCLUSIONS: Alveolar reconstruction using autogenous bone followed by implant placement is a reliable treatment for patients with insufficient bone. Complications and morbidity were frequently observed. However, in only 6.6% of all procedures, the final rehabilitation with dental implants was not possible.