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Mandibular Reconstruction (mandibular + reconstruction)
Selected AbstractsUsing Stereolithographic Models to Plan Mandibular Reconstruction for Advanced Oral Cavity CancerTHE LARYNGOSCOPE, Issue 4 2007Eric Y. Ro MD No abstract is available for this article. [source] Mandibular reconstruction after resection of benign tumours using non-vascularised methods in a series of patients that did not undergo radiotherapyORAL SURGERY, Issue 1 2009D. Mehrotra Abstract Aim:, A case series analysis of 52 consequent subjects of immediate mandibular reconstruction after tumour resection using non-vascularised methods, undertaken at U.P. King George's University of Dental Sciences and King George's Medical University, is being reported. To assess the success of reconstruction on subjective and objective evaluation based upon Mandibular Reconstruction Assessment Scale (MRAS) questionnaire. Methods:, Patients with benign mandibular tumours irrespective of age, sex, site and socio-economic status were included. Primary reconstruction was carried out after resection in two surgical units on surgeon's choice using stainless steel wire (6/52; 12%), stainless steel reconstruction plate (10/52; 19%) or titanium reconstruction plate (36/52; 69%) without bone graft (23/52; 44%) or with bone graft (29/52; 56%). Bone grafts were harvested from iliac crest (21/52; 40%), rib (2/52; 4%) and an additional pectoralis major myocutaneous flap with iliac crest bone graft (6/52; 12%) to provide cover to the reconstruction plate was also used. Results:, The primary outcome measurements were wound healing, mouth opening, chewing efficiency, jaw movements, cosmetic achievement and speech on a five-point scale, all of which improved significantly after surgery. The overall complication rate was 17%. Three patients (6%) had loosening of the screw, two (4%) showed dehiscence of the plate, two (4%) showed tumour recurrence and one (2%) had infection of the graft that was subsequently removed. Conclusion:, Titanium reconstruction plates with iliac crest graft provided good result in the absence of microvascular reconstruction because of unavailable long operating time and lack of expertise. Long-term satisfactory rehabilitation can be achieved using removable dentures or prosthesis on dental implants on the contraption provided by the non-vascularised tissue despite non-calcified bone visible on the skiagram. [source] Efficacy of small reconstruction plates in vascularized bone graft mandibular reconstruction,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2006D. Gregory Farwell MD, FACS Abstract Background: Utilization of vascularized bone grafts rigidly fixated with titanium reconstruction plates is the method of choice for reconstruction of segmental mandibular defects. We hypothesized that the use of the newer 2.0-mm locking reconstruction plate (LRP) is not associated with higher rates of complications when compared with larger, previously used plating systems. Methods: A retrospective case series of 184 patients undergoing 185 vascularized bone graft reconstruction procedures of the mandible was conducted. Results: There were 37 plate complications. There was no significant difference in complication rates for the 2 most used plate types (14.5% with the 2.0-mm LRP and 22.2% with the 2.4-mm LRP). Conclusions: Use of the smaller 2.0-mm LRP was not associated with an increase in the complications of plate fracture, exposure, infection, or nonunion. Because of its lower profile and ease of application, the 2.0-mm LRP is our plate of choice for mandibular reconstruction. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source] Rehabilitation by means of osseointegrated implants in oral cancer patients with about four to six years follow-upJOURNAL OF ORAL REHABILITATION, Issue 3 2006J. SEKINE summary, This paper describes the reconstruction of mandibular defects in four oral cancer patients using iliac crest bone grafts and osseointegrated implants. In three patients, reconstructive surgery using a reconstruction plate and free forearm skin flap was performed following tumour and segmental mandibular resection. After 7,9 months, mandibular reconstruction with a free iliac bone graft was carried out. In one patient, reconstructive surgery was performed with vascularized iliac bone grafting with an anterolateral thigh flap at the same time as the tumour resection. Fixtures were placed in the transplanted bone, and abutments were connected 6,9 months later together with vestibuloplasty. Gingival grafts were used to replace the skin flap around abutments. All implants survived throughout the approximately 4,6 years observation time. Marginal bone loss of the graft was originally several millimetres but less than 1·5 mm. Bone loss as well as management of peri-implant soft tissue was also discussed. [source] Mandibular reconstruction after resection of benign tumours using non-vascularised methods in a series of patients that did not undergo radiotherapyORAL SURGERY, Issue 1 2009D. Mehrotra Abstract Aim:, A case series analysis of 52 consequent subjects of immediate mandibular reconstruction after tumour resection using non-vascularised methods, undertaken at U.P. King George's University of Dental Sciences and King George's Medical University, is being reported. To assess the success of reconstruction on subjective and objective evaluation based upon Mandibular Reconstruction Assessment Scale (MRAS) questionnaire. Methods:, Patients with benign mandibular tumours irrespective of age, sex, site and socio-economic status were included. Primary reconstruction was carried out after resection in two surgical units on surgeon's choice using stainless steel wire (6/52; 12%), stainless steel reconstruction plate (10/52; 19%) or titanium reconstruction plate (36/52; 69%) without bone graft (23/52; 44%) or with bone graft (29/52; 56%). Bone grafts were harvested from iliac crest (21/52; 40%), rib (2/52; 4%) and an additional pectoralis major myocutaneous flap with iliac crest bone graft (6/52; 12%) to provide cover to the reconstruction plate was also used. Results:, The primary outcome measurements were wound healing, mouth opening, chewing efficiency, jaw movements, cosmetic achievement and speech on a five-point scale, all of which improved significantly after surgery. The overall complication rate was 17%. Three patients (6%) had loosening of the screw, two (4%) showed dehiscence of the plate, two (4%) showed tumour recurrence and one (2%) had infection of the graft that was subsequently removed. Conclusion:, Titanium reconstruction plates with iliac crest graft provided good result in the absence of microvascular reconstruction because of unavailable long operating time and lack of expertise. Long-term satisfactory rehabilitation can be achieved using removable dentures or prosthesis on dental implants on the contraption provided by the non-vascularised tissue despite non-calcified bone visible on the skiagram. [source] Mandibular ameloblastoma: clinical experience and literature reviewANZ JOURNAL OF SURGERY, Issue 10 2009Eric Sham Abstract Background:, Ameloblastoma is a locally aggressive odontogenic tumour of the mandible and maxilla that, if neglected, can cause severe facial disfigurement and functional impairment. A thorough understanding of its clinicopathological behaviour is essential to avoid recurrence associated with inadequately treated disease. Currently, wide resection and immediate reconstruction is the treatment of choice in most cases of mandibular ameloblastoma. We present our experience in the management of this disease and review the current status of the literature. Method:, Retrospective review of all patients between 1996 and 2006 with histologically confirmed ameloblastoma. A literature review on the current understanding of this disease and its management is then presented. Results:, Six patients were identified, ranging between 23 and 54 years old. All were females. Two tumours involved the angle and posterior body of the mandible, one the angle and ramus, one the body and two the anterior mandibular. Four patients underwent mandibular reconstruction with free tissue transfer and two by non-vascularized bone grafts. All procedures were successful. One patient developed deep vein thrombosis requiring anticoagulation. Another developed a collection at the mandibular surgical site requiring drainage. Satisfactory union was achieved in all cases with no evidence of recurrence. All patients had adequate cosmesis, masticatory efforts and speech. Conclusion:, Management of ameloblastoma remains a challenge and requires a thorough understanding of the behaviour of its different clinicopathological variants. We have found segmental mandibulectomy and immediate reconstruction to be an excellent treatment option in our series of patients. [source] HN09P ASSESSMENT OF FREE FIBULAR BONE IN THE RECONSTRUCTED MANDIBLE USING THREE-DIMENSIONAL COMPUTER GENERATED IMAGESANZ JOURNAL OF SURGERY, Issue 2007H. Nabi We report the preliminary results of the Royal Adelaide Hospital experience with multidimensional simulated views of the fibula-flap reconstructed mandible. The free fibular flap is a well recognised option for mandibular reconstruction. What is not well understood however is how the fibula behaves in comparison to the dentate mandible. To date, skeletal remodelling and bone atrophy has only been assessed using standard orthopantogram films. For many years three-dimensional (3D) computer generated models using data from CT scans have been utilised for craniofacial reconstruction. We proposed that these images will enable us to more accurately visualise the integration of the transplanted graft within the mandible. We recalled and CT scanned patients from 2004 to 2006 that underwent free fibular flaps for reconstruction of mandibular malignancy and performed 3D reconstruction of these images. This is the first reported series of multidimensional computer generated images to assess bone in the reconstructed mandible. [source] | ||||||||||