Hydroxyapatite implants – an alternative to AUTOGRAFTS?

1106

Poster

large bone and soft tissue defects that affect orofacial appearance and function. The use of autogenous bone graft is highly recommended but immobilization of both the graft and mandible by intraosseous wiring and maxillomandibular fixation is feasible only when enough teeth are present. Thus, the reconstruction of such defects in a resource limited environment poses immense challenge to the attending surgeon. We document our experience with four cases managed at the Maxillofacial Unit, Obafemi Awolowo University Teaching hospital, Ile-Ife, Nigeria. Conclusion: In a resource limited environment where financial constraints limit access and availability of appropriate antimicrobial agents and rigid internal fixation, the major challenges encountered in mandibular reconstruction following surgical ablation of giant tumours are anaesthetic difficulty, immobilization and provision of adequate cover (extraorally) and lining (intraorally) for the graft and risk of infection. doi:10.1016/j.ijom.2007.09.124

P124 A clinical study of sensory disturbance following the nerve repair operation during mandibulectomy Y. Takasaki*, M. Hamase, M. Kuwayama, M. Takano, T. Shibahara, T. Kakizawa Oral & Maxillo-Facial Surgery, Suidoubashi Hospital, Tokyo Dental College, Japan Objective: The purpose of this study is to examine the difference of recovery process of management for inferior alveolar nerve during mandibulectomy. Methods: Subjects were patients who underwent neurorrhaphy (n = 8) or nerve grafting (n = 8). Patients in whom the neurovascular bundle was exposed were analysed as controls (n = 7). Subjects were examined at 1, 3 and 6 months after surgery using Semmes-Weinstein monofilaments. Results: About the chronological change for each group, significant differences were observed (Friedman: P < 0.05). For comparison of three groups at each test period, significant differences were observed (Kruskal– Wallis: P < 0.05). Conclusion: The results confirmed differences in recovery among three groups. doi:10.1016/j.ijom.2007.09.125

P125 An unusual anatomical variant of the vascular anatomy in the Anterolateral Thigh Flap C. J. Johnston*, N. Bhujel, S. Parmar, T. Martin Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital, University Hospital Birmingham, Edgbaston, Birmingham B15 2TH, United Kingdom The Anterolateral Thigh Flap is a fasciocutaneous flap based on the descending branch of the lateral circumflex femoral artery. The vascular pedicle and its perforators have a varied anatomical course which has led to difficulties in flap harvest. Although many papers have described the anatomical variation in the origin and path of this vessel, they all show one artery and two accompanying venae comitantes. We report the first case of duplication of the descending branch of the lateral circumflex femoral artery. We also discuss whether this variation requires two arterial anastomoses or not? doi:10.1016/j.ijom.2007.09.126

P126 ‘Maxilla reconstruction using deep circumflex iliac artery based free iliac crest graft’ G.H. Shaha, N.A. Malikb a Nair Hospital, Mumbai, India b Nair hospital and Dental College, Mumbai, India Maxillary reconstruction is a challenging endeavour in functioning & aesthetic restoration. The maxillae occupy a prominent portion of the face, hence reconstructing a maxillectomy defect is challenging not only in terms of functional aspects of mastication and deglutition but also in terms of aesthetics as for support & projection of midface. Conventionally, these defects were restored using an obturator withal its inherent drawbacks. Then, various pedicled and free tissue transfer flaps have been described for reconstructing a maxillectomy defect but no single flap method has been preferred. The Deep Circumflex Iliac Artery free flap with internal oblique muscle has been regarded as a flap which provides reliable support for cheek and orbit, and also has a good bone stock for placing implants, and is getting now world wide acceptance. This poster intends to present cases of maxillectomy defects restored using the Deep Circumflex Iliac Artery flap, its harvesting technique, the

surgical procedure and pitfalls in comparison to other techniques. doi:10.1016/j.ijom.2007.09.127

P127 Use of reconstruction plate with condyle immediately after resection of mandible – a case report K. Chatterjee*, R.N. Poddar Department of Oral & Maxillofacial Surgery. Dr. R. Ahmed Dental College & Hospital, Kolkata 14, India The aim of this poster is to describe one method of immediate reconstruction of mandible using reconstructive plate with condyle after partial resection of mandible from body to condyle in a middle aged female diagnosed as ameloblastoma. Patient has satisfactory aesthetic and function for 3 years post-operatively. doi:10.1016/j.ijom.2007.09.128

P128 Hydroxyapatite implants – an alternative to AUTOGRAFTS? M. Padmanabh*, K. P. Arun Coorg Institute of Dental Sciences, Maggula, Virajpet 517218, Madikeri Dist., Karnataka, India The reconstruction of mandible is a continuing clinical challenge. The current ‘gold standard’ auto graft bone or its alternative the cadaver bone, both have their own minor or major disadvantages. In my poster, I have made an humble effort to showcase the project work on ‘alternative approach to bone replacement’ which is a unique, multi-disciplinary effort involving the University of Illinois College of Engineering, the Beckham Institute for Advanced Science and Technology, Sandia National Laboratories and Carle Foundation Hospital. The above project involves the designing of a hydroxyapatite implant that provides to the surgeon a customized synthetic bone scaffold that rival the healing and remodeling results now achieved with auto grafting and also obviates the risk and discomfort of bone harvest surgery. doi:10.1016/j.ijom.2007.09.129

P129 Reconstruction of mandibular defect with double barrel fibular