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Mandibular reconstruction

Chengshuai Yang, Shunyao Shen, Jingyang Wu, Shilei Zhang
Mandibular reconstruction after partial or subtotal resection is considered a challenging procedure that is crucial for facial contour and function. Many reports regarding the reconstruction of mandibular defects have been published over the years. The fibula free flap has become a popular option for mandibular reconstruction since its introduction by Hidalgo in 1989. However, the locations of the reconstructed mandibular angle and the condyle of the fibular bone segments play a crucial role in facial symmetry and function...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
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
Raymund E Rebong, Kelton T Stewart, Achint Utreja, Ahmed A Ghoneima
OBJECTIVES: The aim of this study was to assess the dimensional accuracy of fused deposition modeling (FDM)-, Polyjet-, and stereolithography (SLA)-produced models by comparing them to traditional plaster casts. MATERIALS AND METHODS: A total of 12 maxillary and mandibular posttreatment orthodontic plaster casts were selected from the archives of the Orthodontic Department at the Indiana University School of Dentistry. Plaster models were scanned, saved as stereolithography files, and printed as physical models using three different three-dimensional (3D) printers: Makerbot Replicator (FDM), 3D Systems SLA 6000 (SLA), and Objet Eden500V (Polyjet)...
March 6, 2018: Angle Orthodontist
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
L Ganry, B Hersant, R Bosc, P Leyder, J Quilichini, J P Meningaud
No abstract text is available yet for this article.
February 27, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Benjamin T Ostrander, Howard D Wang, Alessandro Cusano, Paul N Manson, Arthur J Nam, Amir H Dorafshar
PURPOSE: Nonunion is an uncommon complication after mandibular fractures. The purpose of this investigation was to compare outcomes of patients with mandibular fracture nonunion who were treated with a 1- versus 2-stage approach and propose a pragmatic treatment algorithm for surgical management based on preoperative characteristics. MATERIALS AND METHODS: The authors conducted a retrospective study consisting of patients who presented to 2 level 1 trauma centers for the management of mandibular fracture nonunion over a 10-year period...
February 6, 2018: Journal of Oral and Maxillofacial Surgery
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
José de Souza Brandão Neto, Felipe Toyama Aires, Rogério Aparecido Dedivitis, Leandro Luongo Matos, Claudio Roberto Cernea
BACKGROUND: Suspicion of mandibular invasion directly influences perioperative strategy, requiring marginal or segmental mandibulectomy, or reconstruction in some cases. This has a considerable impact on outcome and quality of life. The aim of this study was to evaluate the accuracy of magnetic resonance and computed tomography in the prediction of mandibular invasion in patients with oral cavity cancer. METHOD: A systematic review was conducted, including diagnostic studies comparing magnetic resonance imaging with computed tomography in the prediction of bone invasion...
March 2018: Oral Oncology
Hidetomo Hirouchi, Kei Kitamura, Masahito Yamamoto, Kento Odaka, Satoru Matsunaga, Koji Sakiyama, Shinichi Abe
OBJECTIVE: Secondary cartilage develops from osteochondral progenitor cells. Hypertrophic chondrocytes in secondary cartilage increase within a very short time and then ossify rapidly. In the present study, we investigated the sequential development process of osteochondral progenitor cells, and the morphology and size of hypertrophic chondrocytes in secondary cartilage. DESIGN: ICR mice at embryonic days (E) 14.5-17.5 were used. The mandibular condyle and the medial pterygoid process of the sphenoid bone were observed as secondary cartilage, and the cranial base and the lateral pterygoid process of the sphenoid bone, which is primary cartilage, were observed as a control...
December 29, 2017: Archives of Oral Biology
Mahvash Hasani, Shoaleh Shahidi, Shahrzad Alsadat Shamszade
Statement of the Problem: It is crucial for clinicians to be certain about the location of mandibular canal and determine any anatomical variants relevant to it. The temporal crest canal (TCC) is a rare anatomical variant of mandibular canal that lack of awareness about its presence can complicate surgical procedures. Purpose: This study investigated the anatomical characteristics and prevalence of the TCC using CBCT. Materials and Method: This descriptive cross-section study evaluated 327 CBCTs (654 sides) from all the patients with various problems...
March 2018: Journal of Dentistry
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
Hamid Neshandar Asli, Zahra Dalili Kajan, Fatemeh Gholizade
STATEMENT OF PROBLEM: Cement-retained implant-supported restorations have advantages over screw-retained restorations but are difficult to retrieve. Identifying the approximate location of the screw access hole (SAH) may reduce damage to the prosthesis. PURPOSE: The purpose of this in vitro study was to evaluate the ability of cone beam computed tomography (CBCT) imaging to determine the location and direction of SAHs in cement-retained implant prostheses. MATERIAL AND METHODS: Five clear acrylic resin casts were made based on a mandibular model...
February 21, 2018: Journal of Prosthetic Dentistry
Max J H Witjes, Rutger H Schepers, Joep Kraeima
PURPOSE OF REVIEW: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. RECENT FINDINGS: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning...
February 20, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Mohamed Farid Shehab, Nabila Mohammed Abdel Hamid, Nevien Abdullatif Askar, Ahmed Mokhtar Elmardenly
BACKGROUND: Immediate mandibular reconstruction was performed using a patient-specific titanium mesh tray fabricated by electron beam melting (EBM) /rapid prototyping techniques. METHODS: Patient-specific titanium trays were virtually designed and fabricated using EBM technology/rapid prototyping for patients requiring mandibular resection and immediate reconstruction using an iliac crest bone graft. Dental implants were placed in the grafted sites and the patients received prosthetic rehabilitation with a follow-up of one year...
February 21, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Gero Stefan Michael Kinzinger, Jan Hourfar, Cornelia Kober, Jörg Alexander Lisson
OBJECTIVE: During therapy of distoclusion entailing a rigid, fixed orthodontic appliance, the mandibular fossa and condyle are ideally remodeled, while dentoalveolar effects occur through adaptive mechanisms. Adaptive processes, especially in the fossa region, have not been adequately investigated. Our magnetic resonance imaging (MRI) investigation aimed to assess the effects of therapy with a functional mandibular advancer (FMA) on mandibular fossa morphology. PATIENTS AND METHODS: We monitored via MRI the therapeutic course of 25 patients at three time points...
February 20, 2018: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
Sean S Li, Libby R Copeland-Halperin, Alexander J Kaminsky, Jihui Li, Fahad K Lodhi, Reza Miraliakbari
BACKGROUND:  Computer-aided surgical simulation (CASS) has redefined surgery, improved precision and reduced the reliance on intraoperative trial-and-error manipulations. CASS is provided by third-party services; however, it may be cost-effective for some hospitals to develop in-house programs. This study provides the first cost analysis comparison among traditional (no CASS), commercial CASS, and in-house CASS for head and neck reconstruction. METHODS:  The costs of three-dimensional (3D) pre-operative planning for mandibular and maxillary reconstructions were obtained from an in-house CASS program at our large tertiary care hospital in Northern Virginia, as well as a commercial provider (Synthes, Paoli, PA)...
February 20, 2018: Journal of Reconstructive Microsurgery
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
Cecilia García-Campos, María Martinón-Torres, Laura Martín-Francés, Marina Martínez de Pinillos, Mario Modesto-Mata, Bernardo Perea-Pérez, Clément Zanolli, Elena Labajo González, José Antonio Sánchez Sánchez, Elena Ruiz Mediavilla, Claudio Tuniz, José María Bermúdez de Castro
OBJECTIVES: Accurate sex estimation is an essential step for the reconstruction of the biological profile of human remains. Earlier studies have shown that elements of the human permanent dentition are sexually dimorphic. The aims of this study are to determine the degree of sexual dimorphism in the dental tissue volumes and surface areas of mandibular canines and to explore its potential for reliable sex determination. METHOD: The teeth included in this study (n = 69) were selected from anthropological collections from Spain, South Africa and Sudan...
February 20, 2018: American Journal of Physical Anthropology
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
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