Mandibulectomy

PURPOSE: The purpose of this study was to geometrically evaluate the effect of prosthetic rehabilitation on the facial appearance of mandibulectomy patients. MATERIALS AND METHODS: Facial scans (with and without prostheses) were performed for 16 mandibulectomy patients using a noncontact three-dimensional (3D) digitizer, and 3D images were reconstructed with the corresponding software. The 3D datasets were geometrically evaluated and compared using 3D evaluation software...

A 24-year-old womanpresented with ameloblastic fibrosarcoma arising from ameloblastic fibroma. The delayed presentation accounted for the extensive destruction of the mandible and complete occlusion of her oral cavity. This resulted in an inability to eat and maintain oral hygiene. A multidisciplinary team management approach involved nutritional optimisation, segmental mandibulectomy, reconstruction with a reconstructive plate and a free anterolateral thigh flap to line the the floor of mouth. Functional and aesthetic outcome was acceptable, and the patient is planned for secondary free fibular flap bony reconstruction...

PURPOSE: Although free fibula flaps are widely used for mandibular reconstruction, 3-dimensional (3D) position is difficult to control in angle-to-angle mandibular defects. The present study describes a revised approach for angle-to-angle mandibular reconstruction with fibula flaps by using mandibular fixation device and surgical navigation. METHODS: Preoperative maxillofacial and fibular computed tomography (CT) scans were acquired, and CT data were imported into ProPlan CMF software...

BACKGROUND: A significant percentage of patients who undergo segmental mandibulectomy for head and neck cancer will develop a new or recurrent cancer or osteoradionecrosis, necessitating a second mandibulectomy and reconstruction. In this scenario, many surgeons are reluctant to perform a reconstruction with an osseous flap because of the presumed increased morbidity and complexity. The purpose of this study was to evaluate the safety and efficacy of performing a second free fibula flap reconstruction after repeated segmental mandibulectomy...

Cherubism is a rare autosomal dominant condition affecting the jaws and caused by mutations in the gene encoding for the adapter protein SH3BP2 that maps to chromosome 4p16.3. Cherubism is characterized by symmetrically developing bone lesions in the maxilla and mandible. The lesions have been radiographically and histopathologically well-described. Here, we present a family with cherubism with two of its members featuring odontogenic tumorous proliferations in association with persistent central giant cell lesions (CGCL)...

OBJECTIVE: To describe the application of 3-dimensional (3D) printing in advanced oral and maxillofacial surgery (OMFS) and to discuss the benefits of this modality in surgical planning, student and resident training, and client education. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned dogs (n = 28) and cats (n = 4) with 3D printing models of the skulls. METHODS: The medical records of 32 cases with 3D printing prior to major OMFS were reviewed...

Spontaneous regeneration of bone tissue after mandibular resection is rare in adults, although it does often take place in children. Periosteum conservation appears to play a major role in this healing process. We here report regarding a 5-year-old boy who exhibited a large mandibular trabecular juvenile ossifying fibroma. The lesion was treated by mandibulectomy, with careful preservation of the periosteal layer and immediate reconstruction with a costal graft by an intraoral approach. Monitoring over the course of a year revealed spontaneous mandibular regeneration, and it allowed for a series of measurements of the graft to be made...

Many dental procedures allow for implant placement in partially or totally edentulous patients. Despite the availability of various implant and abutment types on the market, it often becomes quite challenging to achieve the biological and esthetic goals in a patient who has ridge deficiencies. Where problems will arise is from the lack of adequate bone quality and quantity.1,2 Soft tissue form and maintenance is also a consideration to evaluate.3 Primary reconstructive techniques following segmental mandibulectomy is evolving and improves quality of life...

OBJECTIVE: Squamous cell carcinoma (SCC) of the retromolar trigone is uncommon, accounting for 1.4% of all oral cancer cases in Japan. Few studies have examined the optimal treatment for this cancer. The aim of this study was to evaluate the outcome of treatment for primary SCC of the retromolar area. METHODS: We retrospectively analyzed the outcome and prognosis of 45 patients (38 men, 7 women) with SCC of the retromolar trigone who underwent treatment in our department between July 1992 and March 2011...

BACKGROUND: Retromolar trigone squamous cell carcinoma is relatively uncommon and due to its complex anatomy has always remained a challenge in terms of loco-regional control and survival. Surgery, radiotherapy, and chemotherapy as combined modalities have been used but high recurrence rates result in poor outcome. METHODS: We have retrospectively evaluated records of 62 patients treated in Head and Neck Oncology unit of Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan from 2004 to 2014 who were included based on the criteria of histopathological proven squamous cell carcinoma of retromolar trigone (RMT) treated with radical intent...

INTRODUCTION: Mastication is one of the essential stomatognathic functions and is impaired when mandibulectomy is performed for removal of head and neck lesions. AIM: The purpose of this study was to investigate the correlation between perceived chewing ability {Masticatory Score (MS)} and objective mixing ability (∆E) in patients who had undergone marginal mandibulectomy. MATERIALS AND METHODS: Twenty normal dentate subjects as control group and twenty mandibulectomy patients who had undergone marginal mandibulectomy and wearing a dentomaxillary prosthesis were enrolled...

INTRODUCTION: Clear cell odontogenic carcinoma (COCC) is a rare tumor described by Hansen et al. in 1985. The clinical and radiological manifestations are multiple and the diagnosis is histological. OBSERVATION: A 64-year-old patient consulted us for a right mandibular osteolytic lesion associated to a homolateral labial hypoesthesia. A biopsy was performed under local anesthesia. Histology was consistent with a metastatic lesion of clear kidney cell carcinoma, COCC, or odontogenic squamous tumor...

BACKGROUND: Odontogenic myxoma is a rare benign neoplasm that originates from odontogenic ectomesenchyme. There is no standard of care and recurrences are frequent after conservative surgical procedures. MATERIAL AND METHODS: A retrospective study conducted at a single cancer center, with analysis of medical records of all patients diagnosed with odontogenic myxoma from 1980 to 2010, along with a literature review. RESULTS: There were 14 patients with diagnosis of odontogenic myxoma (OM)...

BACKGROUND: The principle reconstructive modality for segmental mandibulectomy defects is the osteocutaneous free fibula flap. Preoperative CT angiography has been recommended to assess the quality of arterial inflow to the flap and donor limb. However, the impact of the venous system on flap viability has not been explored. METHODS: A retrospective review of all patients undergoing free fibula flap mandible reconstruction was performed at a single tertiary cancer center from 2002 to 2015...

The gold standard following segmental mandibulectomy is vascularized autologous bone graft in the form of the fibula flap. However, in bone reconstruction the use of autogenous bone does not always guarantee a successful outcome. The aim of the present investigation was to develop a novel biologically active bone (BAB) graft, and to use it for the reconstruction of large size defects of the mandible bone following tumor resection. In the first part of the present study, biologically active bone graft was developed by using human freeze-dried bone marrow stem cells (BMSCs) paracrine factors and three-dimensional bone scaffold derived from cancellous bovine bone following decellularization...

BACKGROUND: A double island free fibula (DIFF) flap can be used for reconstruction of through-and-through or complex mandibulectomy defects, but prospective studies are lacking. METHODS: Prospective analysis of all double skin paddle fibula flaps performed from 2010 to 2016. RESULTS: Overall, 16 patients underwent reconstruction with a DIFF flap (average age: 59.1 years). One patient, who underwent a DIFF flap and developed osteoradionecrosis, requiring a second flap...

RATIONALE: A pedicle pectoralis major musculocutaneous (PMMC) flap is one of the strategies for head and neck reconstruction. Seldom studies reported the case in which the skin area of previous modified radical mastectomy (MRM) had been used as a PMMC flap in head and neck reconstruction. PATIENT CONCERNS: An 84-year-old female who had suffered from left breast cancer and undergone a left modified radical mastectomy (MRM) more than 20 years earlier. DIAGNOSES: She had squamous cell carcinoma of the tongue and had undergone partial glossection and left modified radial neck dissection...

BACKGROUND: Plate-related complications following head and neck cancer ablation and reconstruction remains a challenging problem often requiring further management and reconstructive surgeries. We aim to identify an association between surgical site infections (SSI) and plate exposure. METHODS: A retrospective study between 1997 and 2014 was performed to study the association between postoperative SSI and plate exposures. Eligible patients included those with a history of oral squamous cell carcinoma who underwent surgical resection, neck dissection, and free tissue reconstruction...

This step-by-step feature provides a pictorial description of the commissurotomy procedure. Commissurotomy can be performed to increase surgical access to the caudal oral cavity for procedures such as total mandibulectomy, caudal mandibulectomy, and surgical access to the mandibular ramus.

STATEMENT OF PROBLEM: Several factors affect the prosthetic outcome of patients with mandibular defects. However, it is questionable whether fixed or removable implant-supported prostheses meet the expectations and satisfaction of the patients. The perspectives of these patients are important in managing the prosthetic treatment strategies. PURPOSE: The purpose of this prospective clinical study was to evaluate the satisfaction and oral health-related quality of life of patients with marginal mandibulectomies with implant-retained overdentures and fixed metal-acrylic resin prostheses...