上下顎に広範な発育を呈した外骨症に対して補綴装置を想定したモデルサージャリーを行った１例

exostosis

北海道歯学会

北海道歯学雑誌

Exostoses in jaws can be problematic when performing prosthetic treatment. It is common to either remove an exostosis or fabricate a prosthesis that avoids it when making dentures. Osteotomy is performed if exostosis occupies the space of prosthesis or prevents a complete denture from accomplishing tight suction. With local resection, patients may wear dentures as conventional after osteotomy. Wit h extensive resection, however, it is necessary to formulate a treatment plan considering the dentures. We report a case of prosthetic treatment after osteotomy for extensive exostoses in the maxilla and the mandible. A 65-year-old woman complained of swelling of the left mandibular gingiva. The mucosal lesion was diagnosed as oral lichen planus and treated for two years. Five years after her first visit, she returned with a chief complaint of difficulty in wearing dentures. Several distentions of bone-like hardness with normal mucosal surfaces and clear boundaries were observed on the median palate, the buccal side of the maxillary molars and the lingual side of the mandible. The denture spaces in the mandible were narrowed by the protruding molar teeth on the maxilla. The diagnosis was buccal exostosis hindering wearing of denture, associated aesthetic disorder. Preoperative planning for prosthetic treatment was instigated f or extensive osteotomy with Hokkaido University Hospital Department of Oral Diagnosis and Medicine. Study casts were shaved to ensure sufficient denture spaces in planning postoperative jaw ridges. To reproduce planning during surgery, surgical guides were made from an acrylic thermoplastic sheet. All remaining maxillary teeth were extracted and osteotomy was performed under general anesthesia. After wound stability was confirmed, new dentures were fitted.