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Mandibular reconstruction

Jung-Won Cho, Jung-Hyun Park, Jin-Woo Kim, Sun-Jong Kim
BACKGROUND: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. CASE REPORT: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Jiabing Fan, Mian Guo, Choong Sung Im, Joan Pi-Anfruns, Zhong-Kai Cui, Soyon Kim, Benjamin Wu, Tara Aghaloo, Min Lee
Growth factor-based therapeutics using bone morphogenetic protein 2 (BMP-2) present a promising strategy to reconstruct craniofacial bone defects such as mandible. However, clinical applications require supraphysiological BMP doses that often increase inappropriate adipogenesis, resulting in well-documented cyst-like bone formation. Here we reported a novel complementary strategy to enhance osteogenesis and mandibular bone repair by employing small molecule phenamil that has been shown to be a strong activator of BMP signaling...
October 22, 2016: Tissue Engineering. Part A
Hossein E Jazayeri, Mohammadreza Tahriri, Mehdi Razavi, Kimia Khoshroo, Farahnaz Fahimipour, Erfan Dashtimoghadam, Luis Almeida, Lobat Tayebi
Tissue regeneration is rapidly evolving to treat anomalies in the entire human body. The production of biodegradable, customizable scaffolds to achieve this clinical aim is dependent on the interdisciplinary collaboration among clinicians, bioengineers and materials scientists. While bone grafts and varying reconstructive procedures have been traditionally used for maxillofacial defects, the goal of this review is to provide insight on all materials involved in the progressing utilization of the tissue engineering approach to yield successful treatment outcomes for both hard and soft tissues...
January 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
Eva Meia Rüegg, Paul Gniadek, Ali Modarressi, Denise Baratti-Mayer, Brigitte Pittet-Cuénod
INTRODUCTION: Reconstruction of facial bone defects in children is challenging. The use of well-vascularized bone is mandatory to obtain stable lasting results. This study reports our experience of facial bone reconstruction using prefabricated vascularized calvarium flaps. METHODS: Retrospective case series of 50 patients who underwent 52 maxillary, malar, and mandibular reconstructions between 1988 and 2014 using prefabricated vascularized calvarium flaps. Forty-nine patients suffered from noma sequels; one patient had craniofacial cleft Tessier 3-11...
September 10, 2016: Journal of Cranio-maxillo-facial Surgery
Andreas Gravvanis, Despoina Kakagia, Nick Katsikeris, Dimosthenis Tsoutsos
BACKGROUND: This report aims to first present Integra as an adjunct to complex mandibular reconstruction for intraoral lining resurfacing, and to review the literature on the use of dermal matrices for mucosal resurfacing of the floor of the mouth. CLINICAL REPORT: A 62-year-old female patient with previous ablation surgery for squamous cell carcinoma of the floor of the mouth, presented with extrusion of the mandibular plate through the chin skin and serious tongue tethering...
October 2016: Journal of Craniofacial Surgery
Hyung-In Yoon
OBJECTIVE: This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. DESIGN: A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects...
October 2016: Journal of Craniofacial Surgery
Yohei Sotsuka, Toshihiro Fujiwara, Kenichiro Kawai, Soh Nishimoto, Masao Kakibuchi
Recent reports have shown successful transfer of vascularized fibular flap in bisphosphonate-induced mandibular osteonecrosis. We present a case of a 50-year-old patient who presented with bisphosphonate-related osteonecrosis of bilateral maxilla, which is reconstructed using a fibular flap.
September 2016: Plastic and Reconstructive Surgery. Global Open
Narges Shayesteh Moghaddam, Ahmadreza Jahadakbar, Amirhesam Amerinatanzi, Mohammad Elahinia, Michael Miller, David Dean
: The aim of this study is to investigate the behavior of the healthy mandible under maximum molar bite force to demonstrate the problems associated with the current standard of care procedures for mandibular segmental defect reconstruction (ie, use of Ti-6Al-4V hardware and either a single- or double-barrel fibular graft). With current Ti-6Al-4V mandibular reconstruction hardware, there is a significant stiffness mismatch among the hardware, graft, and the remaining host anatomy. How the distribution of mechanical forces through the mandible is altered after a segmental bone loss and reconstruction is incompletely understood...
September 2016: Plastic and Reconstructive Surgery. Global Open
Christopher M Runyan, Vishal Sharma, David A Staffenberg, Jamie P Levine, Lawrence E Brecht, Leonard H Wexler, David L Hirsch
BACKGROUND: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. METHODS: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality...
October 14, 2016: Journal of Craniofacial Surgery
Erick Silva, Emanuela Prado Ferraz, Evandro Carneiro Martins Neto, Liat Chaushu, Gavriel Chaushu, Samuel Porfirio Xavier
The aim of this prospective controlled study present study is to evaluate volumetric changes of newly created bone following reconstruction of the atrophic posterior mandible using FFB. Twenty consecutive patients presenting for reconstruction of posterior mandibular alveolar bone ridge width ≤ 6.0 mm and/or height≤ 6.0 who met all inclusion and exlusion criteria were included. FFB blocks were used. The main outcome variable investigated was bone volume dynamics. Vertical, horizontal and three-dimensional bone gain data was measured from computerized tomography scans...
October 18, 2016: Journal of Oral Implantology
Senthil Murugan, Reena Rachel John, V B Krihnakumar Raja, Ajay Mohan, Lokesh Bhanumurthy
INTRODUCTION: Successful outcome of any vascularised free flap basically depends upon the successful restoration of circulation in the flap after anastomosis. As the flap ischemic time is the significant factor which determines the outcome of any free flaps, due consideration is given to reduce the time for anastomosis for reperfusion. The present study compares and evaluates whether the usage of microvascular couplers with the conventional suturing reduce the ischemic time of the free flaps...
September 2016: Journal of Maxillofacial and Oral Surgery
Vinay V Kumar, P C Jacob, Vikram Kekatpure, Naveen Hedne, Felix P Koch, Moni A Kuriakose
AIM: The aim of this clinical paper is to introduce a technique to plan for functional maxillofacial reconstructions. MATERIALS AND METHODS: Preoperative dental casts were made of the patient and mock surgery performed on the casts. A fibula analogue was then placed in an ideal functional reconstruction position. New dentures were fabricated on the fibula analogue and drill holes for the placement of implants were placed through the denture. This denture formed as a guide to position the fibula transplant during surgery...
September 2016: Journal of Maxillofacial and Oral Surgery
Soung Min Kim, Emmanuel K Amponsah, Hui Young Kim, Ik Jae Kwon, Hoon Myoung, Jong Ho Lee
: Ameloblastoma is the most common benign odontogenic tumor of the jaw, and expansional growth of a huge untreated ameloblastoma can result in disturbances in facial aesthetics and function, such as difficulty with mouth opening, swallowing, chewing, breathing, neurologic deficits, and pathologic fractures. Radical wide resection with safety margins and subsequent reconstruction is generally recommended. A fibular free flap (FFF) is commonly used to reconstruct the mandible in order to adequately restore both aesthetic appearance and function...
September 2016: Ghana Medical Journal
Sharad Gupta, Akshay Bhargava, Praful Mehra
Rehabilitation of mandibular resection poses functional, esthetic, and psychological challenges. The deviation and rotation of the mandible toward the resected side leaves the patient with almost no option of chewing. This is aggravated if the patient is edentulous. The case report discussed in this article was an edentulous patient taken up with the primary goal to limit deviation toward resected side and provide a stable and retentive prosthesis to the patient. Two implants were placed anteriorly, splinted with bar and clip supported superstructure...
October 2016: Journal of Indian Prosthodontic Society
Sowmya Velekkatt Surendran, Sharmila Hussain, S Bhoominthan, Sanjna Nayar, Ragavendra Jayesh
STATEMENT OF PROBLEM: When reconstructing the occlusal curvatures dentists often use a 4-inch radii arc as a rough standard based on Monson spherical theory. The use of an identical radius for the curve of Spee for all patients may not be appropriate because each patient is individually different. The validity of application of this theory in the Indian population and the present study has been undertaken. AIMS AND OBJECTIVES: This study is an attempt to evaluate the curve of Spee and curve of Wilson in young Indian population using three dimensional analysis...
October 2016: Journal of Indian Prosthodontic Society
Loreto Castellon, Daniel Jerez, Jaime Mayorga, Carlos Fuenzalida
Mandibular tumors are rare in children. Most mandibular tumors in children are benign and locally aggressive, and some might require resection to prevent recurrence. Mandibular reconstruction after tumor resection in children has been less documented in published studies than mandibular reconstruction in adults. In children, age, the growth potential of the mandible, and the donor site are important factors that must be considered. The costochondral graft is an option for reconstruction of the resected portion of the mandible in children, especially when the resection involves the condyle, owing to its biologic and anatomic similarity to the temporomandibular joint and its regenerative and growth potential...
September 17, 2016: Journal of Oral and Maxillofacial Surgery
M Pedrazzoli, L Autelitano, F Biglioli
Mandibular fracture is usually the clinical end of bisphosphonate-related osteonecrosis of the jaw. This is a painful complication and patients cannot feed as usual, with a worsening of their quality of life. The goal of treatment in bisphosphonate related osteonecrosis of jaw (BRONJ) patients is to slow progression of bone necrosis. We present a novel technique for treatment of severe mandibular BRONJ in stage 3 patients that present with a high risk to develop fracture, since they have a residual unaffected mandibular bone height less than 6 mm...
August 2016: Acta Otorhinolaryngologica Italica
Jeffrey Y Tsai, Barry C Boyd, Ted C Ondracek, Etern S Park
We present a case of a parapharyngeal schwannoma of the mandibular nerve with intraosseous extension into the mandible. The initial symptoms included decreased auditory acuity, with subsequent magnetic resonance imaging findings suggestive of Eustachian tube obstruction. This represents a rare symptom of schwannomas of the mandibular nerve. Owing to the degree of bony expansion and cortical thinning of the adjacent mandibular ramus, concern existed for a pathologic fracture. Treatment involved complete excision of the lesion using hemimandibulectomy with second stage reconstruction...
September 15, 2016: Journal of Oral and Maxillofacial Surgery
Eyituoyo Okoturo
INTRODUCTION: Mandibular defect reconstruction is extremely important to achieving an improved quality of life of patients as this bony defect influences facial harmony and aesthetics. Reconstruction of mandibular defects at our centre comprises use of reconstruction plate, non-vascularised anterior iliac crest graft and vascularised fibula flap. Despite the large mandibular defect recorded in our developing environment, non-vascularised iliac crest graft continues to play a role in its exclusive use for lateral mandibular defects...
October 10, 2016: Oral and Maxillofacial Surgery
Tommy Wilkman, Satu Apajalahti, Erika Wilkman, Jyrki Törnwall, Patrik Lassus
PURPOSE: The aim of the present study was to compare the resorption of the bone in the free scapular, free iliac crest, and free fibular microvascular flaps in mandibular reconstruction over time. PATIENTS AND METHODS: In the present retrospective study, we analyzed 186 consecutive patients with scapular, fibular, or deep circumflex iliac artery (DCIA) osseous free microvascular flaps in mandibular reconstruction. We followed up the patients clinically and using multislice computed tomography (MSCT) with volume analyses of the bone...
September 15, 2016: Journal of Oral and Maxillofacial Surgery
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