repartimiiento

Revista Odontológica Mexicana
Enero-Marzo 2013
Manejo protésico-quirúrgico del paciente hemimandibulectomizado
Prosthetic and surgical treatment of patient previously subjectedto hemi-mandibulectomy
Jorge Ernesto Sistos Ramírez,* René Jiménez Castillo,Alejandro Benavides Ríos

ABSTRACT
In general terms, the best rehabilitation options for patientspreviously subjected tohemi-mandibulectomy are far beyond their financial possibilities. For this reason surgical-prosthetic reconstructive approach is mainly restricted to the use of more affordable materials such asKirschner wire and methyl-methacrylate immediate prostheses. The latter are widely recom mended due to their low cost, ease of handling, and because they prevent soft tissue atrophy. A clinical case isreported in this article: 25 year old male patient seeking treatment at the Oncology Service of the Hospital General de Mexico (Mexico’s General Hospital) due to the presence of a volume increase in thearea of the left mandibular angle. Microscopic l analysis revealed presence of mixed malign tumor (fi nal histopathological diagnosis). It was decided to perform hemi-mandibulectomy of involved area,with reconstruction of lost bone segment by means of positioning an immediate methyl methacrylate prosthesis (thermosetting methyl). The prosthesis was fi xated with osteosynthesis wire at bothresection margins, at 3 mm above the cortex.

RESUMEN
Por lo general las mejores opciones de rehabilitación para el paciente hemimandibulectomizado quedan fuera del alcance del poder adquisitivo de lamayoría de ellos, esto hace que el abordaje reconstructivo protésico- quirúrgico para éstos se tenga que restringir al uso de materiales más accesibles tales como el clavo de Kirschner y las prótesisinmediatas de metilmetacrilato, siendo estas últimas las más recomendables por su bajo costo, fácil manejo, por evitar la rotación mandibular y por prevenir la atrofia de los tejidos blandos. Se...