Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 5)

Intraosseous focal venous malformation of the mandibular body: cone beam computed tomography planning followed by piezoelectric knife resection and free bone graft reconstruction

Authors:
Živorad S. Nikolić, Drago B. Jelovac, Melvil Šabani, Jelena V. Jeremić, Ivan Boričić

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Introduction. Intraosseous vascular malformation could be life-threatening due to uncontrolled hemorrhage after tooth ex-traction. According to biological behavior of this lesion, ade-quate diagnostic and treatment strategies are necessary in order to avoid possible complications. We reported cone beam com-puted tomography (CBCT) planning of an urgent en bloc re-section of an intraosseous venous malformation by piezoelec-tric knife. Case report. A 55-year-old man was submitted to CBCT planning followed by piezoelectric knife resection of an intraosseous focal venous malformation of the mandibular body. Immediate reconstruction of the defect using iliac bone free graft was performed. The surgical treatment was unevent-ful and a 2-year follow-up revealed no signs of recurrence. Conclusion. Piezoelectric knife could provide precise, safe and bloodless procedure which is especially important in this pa-thology. Advantages of this technique are: lower risk of damag-ing soft tissue structures, precise osteotomy and bloodless sur-gery. Moreover, using piezosurgery bone knife, blood transfu-sion and blood transmitted diseases could be avoided. This case highlights the importance of CBCT as planning tool for resection of the mandible, using piezoelectric knife as safe method to achieve bloodless surgery