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Mandible reconstruction

Keisuke Sugahara, Yoshiharu Katsumi, Masahide Koyachi, Yu Koyama, Satoru Matsunaga, Kento Odaka, Shinichi Abe, Masayuki Takano, Akira Katakura
Background: Along with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. However, while models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
Kohei Okuyama, Masashi Yamashiro, Atsushi Kaida, Aya Kawamata, Miho Mizutani, Yasuyuki Michi, Narikazu Uzawa, Tomoyuki Yano, Rei Tohyama, Satoshi Yamaguchi
For young growing children before the end of skeletal maturity, the growth activity of the grafted bone after hemimandibulectomy is not well-known. After an adolescence, such a patient may have facial deformity because the anterior growth point of the mandible is in the condylar neck. A 13-year-old boy was performed hemimandibulectomy with immediate mandibular reconstruction by fibula free flap (FFF) because of a huge ameloblastic fibroma. The authors evaluated the length of FFF on the images of computed tomography (CT) at 5 and 60 months after the operation and compared them by calculating growth rates...
March 8, 2018: Journal of Craniofacial Surgery
Adekunle Elegbede, Silviu C Diaconu, Colton H L McNichols, Michelle Seu, Yvonne M Rasko, Michael P Grant, Arthur J Nam
Three-dimensional printing of patient-specific models is being used in various aspects of craniomaxillofacial reconstruction. Printing is typically outsourced to off-site vendors, with the main disadvantages being increased costs and time for production. Office-based 3-dimensional printing has been proposed as a means to reduce costs and delays, but remains largely underused because of the perception among surgeons that it is futuristic, highly technical, and prohibitively expensive. The goal of this report is to demonstrate the feasibility and ease of incorporating in-office 3-dimensional printing into the standard workflow for facial fracture repair...
March 8, 2018: Journal of Craniofacial Surgery
D Pauchet, J-L Pigot, F Chabolle, C-A Bach
Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned...
March 2, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Nima Khavanin, Edward H Davidson, Diana Y Lee, Patrick Byrne, Amir H Dorafshar
Concomitant temporomandibular joint (TMJ) transplantation is an obvious advancement in the reconstructive armamentarium for face transplantation in scenarios involving TMJ ankylosis. This study investigates the fidelity of mandibular morphology and explores the feasibility of bilateral mandibular condyle transfer in facial vascularized composite allotransplantation. Geometric analysis was performed on 100 skeletally mature maxillofacial computed tomography scans. Exclusion criteria included mandibular trauma and dentoalveolar disease...
March 1, 2018: Journal of Craniofacial Surgery
Wei-Fa Yang, Wing Shan Choi, Yiu Yan Leung, Justin Paul Curtin, Ruxu Du, Chun-Yu Zhang, Xian-Shuai Chen, Yu-Xiong Su
BACKGROUND: Surgical plates have been extensively used in head and neck reconstruction and conventional plates are mass-produced with universal configurations. To overcome disadvantages of conventional surgical plates, we have been exploring patient-specific surgical plates using the three-dimensional (3D) printing technology. We hypothesized that the application of 3D-printed patient-specific surgical plates in head and neck reconstruction is feasible, safe and precise. METHODS: We are conducting a prospective clinical trial to assess the feasibility, safety and accuracy of applying 3D-printed patient-specific surgical plates in head and neck reconstruction...
March 2018: Oral Oncology
Vinay V Kumar, Bonney L James, Manuela Ruß, Stefan Mikkat, Amritha Suresh, Peer W Kämmerer, Michael O Glocker
AIM: The aim of this study was to determine whether intra-oral de novo regenerated mucosa (D) that grew over free fibula flap reconstructed-mandibles resembled the donor tissue i.e. external skin (S) of the lateral leg, or the recipient site tissue, i.e. keratinized oral mucosa (K). MATERIALS AND METHODS: Differential proteome analysis was performed with ten tissue samples from each of the three groups: de novo regenerated mucosa (D), external skin (S), and keratinized oral mucosa (K)...
March 2018: Oral Oncology
Eman Shaheen, Abdulhadi Alhelwani, Elke Van De Casteele, Constantinus Politis, Reinhilde Jacobs
Objectives: To assess the effect of two of the most commonly used sterilization techniques on 3D printed clinical objects. Materials & Methods: The two sterilization methods used in our hospital and investigated in this paper are: Steam heat and Gas plasma. Three objects were printed and tested in this study: a tooth replica, an orthognathic final splint, a surgical cutting guide for the purpose of mandible reconstruction. For each of the 3 objects, 4 copies were made: one original STL object, one copy of the object pre-sterilization, one copy of post-steam heat sterilization, and one copy of post-gas plasma sterilization...
2018: Open Dentistry Journal
Leslie E Cohen, Kerry A Morrison, Erin Taylor, Julia Jin, Jason A Spector, Salvatore Caruana, Christine H Rohde
BACKGROUND: Traditional free flap reconstruction of complex intraoral defects often uses large lip-splitting incisions. To reduce morbidity and preserve aesthetics, we have adopted a more technically demanding visor technique obviating an incision through the lower lip through which the resection and reconstruction are performed. METHODS: A retrospective review was performed of patients who underwent free flap reconstruction of intraoral defects over 7 years by a single plastic surgeon (C...
February 28, 2018: Annals of Plastic Surgery
Dize Li, Zhiqiang Yang, Tao Chen, Chao Guan, Feilong Wang, Ethan L Matz, Yuanyuan Zhang, Ping Ji
Cone beam computed tomography (CBCT) has obvious advantages over regular radiography in diagnosis of complex diseases. Objective of this study is to report a case of a mandibular jaw ameloblastoma recurring cyst, which represents a benign tumor of odontogenic epithelium, using CBCT imaging technology. CBCT examination of the patient suffering with recurrent lower jaw cyst (relapsing four years after surgery) showed a decrease in irregular bone density and appearance of a honeycomb pattern (3.5 cm×2.5 cm×1...
2018: Journal of X-ray Science and Technology
Liyun Bai, Linlin Li, Kexin Su, Anthony Bleyer, Yuanyuan Zhang, Ping Ji
Maxillofacial injuries can be complex and are clinically important due to their functional and cosmetic significance. Maltreated and missed fractures might cause deformity of the face; thus, accurate evaluation of the fracture provided by X-ray images is critical. In this study, we explore the application of cone-beam computed tomography (CBCT) for diagnosis of severe maxillofacial traumas. A patient with a complex fracture that affects the maxilla, mandible, wall of the maxillary sinus, zygoma, zygomatic arch and nasal bone was diagnosed using 3D reconstruction of CBCT images...
2018: Journal of X-ray Science and Technology
H Ulutürk, E Yücel, B Okur, O Akinci, M S Atac
Bifid condyle is a rare entity with a difficult diagnosis and usually identified as an incidental finding on routine radiographic examination. The etiology is not well known, possible causes may be developmental, traumatic, vascular, abnormal muscle pulling, nutritional, endocrinal, teratogenic, and infections. The orientation of the condylar heads can behelpful for the etiological diagnosis.This case report describes a 56-year-old woman who suffered from a unilateral, progressively increasing, radiating pain which intensified with the movement of the mandible and includes information about the diagnosis, management, radiographic and three-dimensional model features and review of the literature...
February 2018: Nigerian Journal of Clinical Practice
Marco A Rendón-Medina, Laura Andrade-Delgado, Jose E Telich-Tarriba, Antonio Fuente-Del-Campo, Carlos A Altamirano-Arcos
Rapid prototyping models (RPMs) had been extensively used in craniofacial and maxillofacial surgery, especially in areas such as orthognathic surgery, posttraumatic or oncological reconstructions, and implantology. Economic limitations are higher in developing countries such as Mexico, where resources dedicated to health care are limited, therefore limiting the use of RPM to few selected centers. This article aims to determine the dimensional error of a low-cost fused deposition modeling 3D printer (Tronxy P802MA, Shenzhen, Tronxy Technology Co), with Open source software...
January 2018: Plastic and Reconstructive Surgery. Global Open
Mehmet Akif Cakmak, Hakan Cinal, Ensar Zafer Barin, Muhammed Sedat Sakat, Harun Karaduman, Onder Tan
Free flaps based on static slings principles cannot provide esthetic and functional outcomes at a desired level in total or close to total lip loss. Therefore, dynamic methods have become a current issue in recent years and especially the idea of functional gracilis free muscle flap has been suggested. In this study, we present a case of a successful total lower lip repair with this flap.In a 78-year-old female patient who was diagnosed with squamous cell carcinoma involving the entire lower lip, bilateral modified radical neck dissection and full-thickness total resection with 1 cm surgical margin so as to include both commissures of the tumor were performed and then a free gracilis muscle flap was transferred from the same side...
February 14, 2018: Journal of Craniofacial Surgery
Marcus Seiler, Peer W Kaemmerer, Michael Peetz, Amely Gundula Hartmann
The aim of this initial case report was to provide a new protocol for the clinical application of a patient-specific titanium lattice structure (Yxoss CBR®, ReOSS, Filderstadt, Germany) for customized bone regeneration. To obtain a 3-dimensional reconstruction of a posterior mandible segment in a 61-year-old woman, a patient-specific titanium customized lattice structure was used. As graft material autogenous bone tissue mixed with xenogenic alloplastic material (Bio Oss®, Geistlich Pharma, Wolhusen, Switzerland) was obtained for reconstruction...
February 19, 2018: Journal of Oral Implantology
Johannes T M van Gemert, Jan H Abbink, Robert J J van Es, Antoine J W P Rosenberg, Ron Koole, Ellen M Van Cann
BACKGROUND AND OBJECTIVES: Evaluation of mandibular reconstructions with free fibula flaps. Identification of factors associated with major recipient site complications, that is, necessitating surgical intervention under general anaesthesia. METHODS: Seventy-nine reconstructions were included. The following factors were analyzed: fixation type, number of osteotomies, site of defect (bilateral/unilateral), surgeon, sex, ASA classification, continuous smoking, pathological N-stage, age, defect size, flap ischemic time, and postoperative radiotherapy...
February 15, 2018: Journal of Surgical Oncology
Frances L Forrest, Thomas W Plummer, Ryan L Raaum
The current study describes a new method of mandibular ecological morphology (ecomorphology). Three-dimensional geometric morphometrics (3D GM) was used to quantify mandibular shape variation between extant bovids with different feeding preferences. Landmark data were subjected to generalized Procrustes analysis (GPA), principal components analysis (PCA), and discriminant function analysis (DFA). The PCA resulted in a continuum from grazers to browsers along PC1 and DFA classified 88% or more of the modern specimens to the correct feeding category...
January 2018: Journal of Human Evolution
João Ricardo Almeida Grossi, Tatiana Miranda Deliberador, Tielly Saad, Rafaela Scariot, Joao Cesar Zielak, Allan Fernando Giovanini
Ameloblastoma is an aggressive odontogenic tumor which typically occurs between third and fourth decade of life that often needs resective approach. Immediate reconstruction may show better results. The treatment of multicystic ameloblastoma in the mandible being a rare case that occurred in the late second decade of life, which was surgically removed along with the affected teeth with safety margins, and the region was immediately reconstructed using a vascularized graft, removed from the fibula. Its integration, in combination with osseointegrated dental implants and fixed implant-supported prostheses, restored chewing function and esthetics...
January 2018: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Christopher D Lopez, J Rodrigo Diaz-Siso, Lukasz Witek, Jonathan M Bekisz, Bruce N Cronstein, Andrea Torroni, Roberto L Flores, Eduardo D Rodriguez, Paulo G Coelho
BACKGROUND: Vascularized bone tissue transfer, commonly used to reconstruct large mandibular defects, is challenged by long operative times, extended hospital stay, donor-site morbidity, and resulting health care. 3D-printed osseoconductive tissue-engineered scaffolds may provide an alternative solution for reconstruction of significant mandibular defects. This pilot study presents a novel 3D-printed bioactive ceramic scaffold with osseoconductive properties to treat segmental mandibular defects in a rabbit model...
March 2018: Journal of Surgical Research
Antonio Cortese, Mario Caggiano, Giuseppe Pantaleo, Massimo Amato, Pier P Claudio
BACKGROUND: Mandibular reconstruction after ablative surgery is challenging not only for the amount of bone tissue needed following bone loss after benign or malignant tumor surgical removal, but mainly to reconstruct bone shape and structure necessary for subsequent implant insertion to preserve the function (speech, swallowing and chewing) and aesthetic of the lower face. Several different techniques for maxillary bone defects reconstruction have been described. The aim of our work is to describe a new technique for mandibular reconstruction that uses an intramural distractor, which is placed in one surgical step and without the need for a skin incision...
February 9, 2018: Minerva Stomatologica
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