Reconstrução mandibular após ressecção de extenso Ameloblastoma de ramo: uso de prótese de Metilmetacrilato seguido de instalação de prótese de ATM customizada – relato de caso / Mandibular reconstruction after extensive Ameloblastoma resecetion in mandibular ramus: use of a space maintainer of Polymethylmethacrylate followed by custom TMJ prosthesis installation – case report

Authors

  • Eduardo Martins Falcão
  • Paulo José D’Albuquerque Medeiros
  • Danilo Passeado Branco Ribeiro
  • José Renato Moraes Carvalho Barreto Brandão
  • Alan Robert Moreira Schmitt
  • Ramiro Beato Souza

DOI:

https://doi.org/10.34119/bjhrv5n4-087

Keywords:

Ameloblastoma, reconstrução mandibular, Polimetilmetacrilato, prótese articulação temporomandibular.

Abstract

O ameloblastoma é um tumor dentário comum, tem um comportamento localmente agressivo e é capaz de causar um extenso envolvimento das mandíbulas. A lesão freqüentemente afeta a mandíbula, especialmente a região molar e o ângulo mandibular. No exame radiográfico, geralmente tem aspecto radiolúcido e multilocular, apresentando na maioria dos casos, expansão cortical e reabsorção radicular dos dentes adjacentes. O objetivo deste artigo é relatar um caso de um paciente de 72 anos, do sexo masculino, leucodermia, com treta no serviço de Cirurgia Oral e Maxilo-facial do Hospital Pedro Ernesto. Na primeira visita, o paciente teve um aumento assintomático de volume no lado direito da face e intraoral. A tomografia computadorizada, havia imagem hipodensa, multiloculada, com perfuração da cortical, estendendo-se da porção posterior do corpo mandibular até o pescoço do côndilo e o processo coronoide à direita. Foi realizada uma biópsia incisional que mostrou o resultado do ameloblastoma multicístico. A equipe decidiu realizar a ressecção do bloco lesional com desmontagem e reconstrução com prótese TMJ personalizada. Devido à burocracia e ao tempo necessário para a aquisição desta prótese, o tratamento foi necessário para a realização de dois tempos cirúrgicos. Portanto, foi decidido ressecar a lesão e realizar a reconstrução temporária do defeito com placa de reconstrução 2,4mm, parafusos bicorticais e polimetilmetacrilato na porção do ramo mandibular e do côndilo. Aproximadamente 6 meses após a cirurgia da lesão para remover a reconstrução final foi realizada com prótese personalizada da ATM. Atualmente, o paciente está com 5 anos de pós-operatório a segunda cirurgia sem evidência de recidiva ou infecção. Apresenta-se com o contorno facial devolvido e função mastigatória satisfatória.

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Published

2022-07-19

Issue

Section

Original Papers