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Modified surgical techniques of total alloplastic temporomandibular joint replacement: our institution's experience
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E-Poster Presentation
Objectives: To evaluated the feasibility and outcomes of open reduction and internal fixation of delayed intracapsular comminuted condylar fracture of mandible with preoperative computer-aided design. Methods: The study involved 6 males and 2 females. Diagnoses were made from clinical signs and CT scan. All patients have multiple injuries on the other parts of the body. The surgical plan was made by the senior surgeons according to the preoperative simulation on computer, that make sure the fracture segment with the attachment of lateral pterygoid muscle and the biggest one can be repositioned and fixed with screw. The mean (range) time between the injury and the operation was 6.5 (4–12) weeks and the mean follow-up duration was 7.1 months (range, 3–12 months). Findings and conclusions: The malocclusion was corrected and the passive mouth opening of each patient was never less than 3.5 cm. Postoperative clinical examination showed good occlusion and mouth opening of at least 3 cm in all patients after 3 months follow-up. All patients were satisfied with the outcomes. The strategy of open reduction and internal fixation of delayed intracapsular comminuted condylar fracture of mandible with preoperative computer-aided design is feasible and effective. http://dx.doi.org/10.1016/j.ijom.2015.08.406 Modified surgical techniques of total alloplastic temporomandibular joint replacement: our institution’s experience S.Y. Zhang ∗ , J.S. Zheng, P. Shen, Z.X. Jiao, W.F. Xu Shanghai Ninth People’s Hospital, Shanghai, China Purpose: To present three modified techniques of total alloplastic temporomandibular joint replacement (TMJ TJR) and evaluate the outcomes on the prosthesis stability and heterotopic bone formation. Patients and methods: 15 patients (19 joints), treated with the Biomet stock prosthesis from May 2006 to May 2013, were retrospectively analyzed. Surgical procedures were performed with the following three modifications: (1) Bone grafting of the glenoid fossa; (2) Salvage of TMJ discs; (3) harvesting retro-mandibular subcutaneous fats. The glenoid fossa depth was measured preoperatively by Surgicase 5.0 software. All patients were evaluated by radiographic examination and surgical observation. Results: The fossa was grafted with an autogenous bone in 15 joints (78.9%). In 4 joints (21.1%), only bone repair was performed. Radiographic evaluation revealed a good integration between the autogenous and host bones. All patients showed postoperative occlusal stability. In 5 joints (26.3%), the discs were salvaged. Both bleeding and operation time were reduced. Fat grafts were harvested in 17 joints (89.5%), in which there were no abnormalities in the periprosthetic bone structure. In 2 joints (10.5%), with no fat grafting, heterotopic bone formation was found. Conclusions: The modified techniques of TJR help improving prostheses stability, reducing heterotopic bone formation, and avoiding additional scars. http://dx.doi.org/10.1016/j.ijom.2015.08.407
Spontaneous bone regeneration following partial mandibulectomy: cases report and literature review Z. Zhang 1,2,∗ , J. Pan 2 , J. Hu 1 1 West China Hospital of Stomatology, Sichuan University, Chengdu, China 2 Beijing Stomatological Hospital, Capital Medical University, Beijing, China
Background: Spontaneous bone regeneration is an unexpected phenomenon that may take place in mandibular defects. This phenomenon gives an enlightening solution for mandibular defects reconstruction and endogenous bone tissue engineering. Although bone tissue engineering and bone substitutes have been hot research topics recently, the unique capacity of human body itself in bone regeneration should never be ignored. Objectives: To report our cases of spontaneous bone regeneration after partial mandibulectomy for tumours and discuss mechanism, influential factors and application prospect of this spontaneous ossification. Methods: From 2004 to 2012, 8 patients were managed with periosteum-preserving mandibulectomy surgery. The follow-up period ranged from 1 to 6 years (Figs 1 and 2, Table 1). Furthermore, a comprehensive literature search was made online through the PubMed. Findings: All patients showed evidence of spontaneous bone regeneration and synostoses, both clinically and radiographically. Furthermore, our final literature search shows that 33 reports of spontaneous regeneration of the mandible have been published in the English literature (Table 2). Conclusions: Spontaneous bone regeneration after periosteum-preserving mandibulectomy surgery is particularly beneficial and can be applied in clinics. The future study will focus on its detailed mechanism, which may promote this technique for better result of mandibular defects reconstruction. http://dx.doi.org/10.1016/j.ijom.2015.08.408 Medial sural artery perforator flap for reconstruction of oral and maxillofacial defect W.Q. Zhao ∗ , H.M. Wang, J.H. Liu, H.Y. Zhu, Z.Y. Li Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China Background: Several types of flap were reported to repair soft tissue defects of oral and maxillofacial region, but the application of medial sural artery perforator flap was not well studied. Objectives: To investigate the application of the medial sural artery perforator flap (MSAP) for reconstruction of oral and maxillofacial defects. Methods: From February 2013 to December 2014, MSAP was used for simultaneous reconstruction of soft tissue defect after oral cancer surgery in 26 patients. All patients received preoperative artery probing by Doppler Ultrasound Flowmetry, and the flap were designed according to the perforator situation. During operation, MSAP was prepared according the actual size of local soft tissue defect and preoperative perforator situation. Close observation of flap survival is dropped after surgery. All patients were followed-up within 3, 6, 12 and 24 months. The flap survival, functional improvement of intraoral surgical area, influence of appearance and function of lower leg were recorded in detail.
E-Poster Presentation
Objectives: To evaluated the feasibility and outcomes of open reduction and internal fixation of delayed intracapsular comminuted condylar fracture of mandible with preoperative computer-aided design. Methods: The study involved 6 males and 2 females. Diagnoses were made from clinical signs and CT scan. All patients have multiple injuries on the other parts of the body. The surgical plan was made by the senior surgeons according to the preoperative simulation on computer, that make sure the fracture segment with the attachment of lateral pterygoid muscle and the biggest one can be repositioned and fixed with screw. The mean (range) time between the injury and the operation was 6.5 (4–12) weeks and the mean follow-up duration was 7.1 months (range, 3–12 months). Findings and conclusions: The malocclusion was corrected and the passive mouth opening of each patient was never less than 3.5 cm. Postoperative clinical examination showed good occlusion and mouth opening of at least 3 cm in all patients after 3 months follow-up. All patients were satisfied with the outcomes. The strategy of open reduction and internal fixation of delayed intracapsular comminuted condylar fracture of mandible with preoperative computer-aided design is feasible and effective. http://dx.doi.org/10.1016/j.ijom.2015.08.406 Modified surgical techniques of total alloplastic temporomandibular joint replacement: our institution’s experience S.Y. Zhang ∗ , J.S. Zheng, P. Shen, Z.X. Jiao, W.F. Xu Shanghai Ninth People’s Hospital, Shanghai, China Purpose: To present three modified techniques of total alloplastic temporomandibular joint replacement (TMJ TJR) and evaluate the outcomes on the prosthesis stability and heterotopic bone formation. Patients and methods: 15 patients (19 joints), treated with the Biomet stock prosthesis from May 2006 to May 2013, were retrospectively analyzed. Surgical procedures were performed with the following three modifications: (1) Bone grafting of the glenoid fossa; (2) Salvage of TMJ discs; (3) harvesting retro-mandibular subcutaneous fats. The glenoid fossa depth was measured preoperatively by Surgicase 5.0 software. All patients were evaluated by radiographic examination and surgical observation. Results: The fossa was grafted with an autogenous bone in 15 joints (78.9%). In 4 joints (21.1%), only bone repair was performed. Radiographic evaluation revealed a good integration between the autogenous and host bones. All patients showed postoperative occlusal stability. In 5 joints (26.3%), the discs were salvaged. Both bleeding and operation time were reduced. Fat grafts were harvested in 17 joints (89.5%), in which there were no abnormalities in the periprosthetic bone structure. In 2 joints (10.5%), with no fat grafting, heterotopic bone formation was found. Conclusions: The modified techniques of TJR help improving prostheses stability, reducing heterotopic bone formation, and avoiding additional scars. http://dx.doi.org/10.1016/j.ijom.2015.08.407
Spontaneous bone regeneration following partial mandibulectomy: cases report and literature review Z. Zhang 1,2,∗ , J. Pan 2 , J. Hu 1 1 West China Hospital of Stomatology, Sichuan University, Chengdu, China 2 Beijing Stomatological Hospital, Capital Medical University, Beijing, China
Background: Spontaneous bone regeneration is an unexpected phenomenon that may take place in mandibular defects. This phenomenon gives an enlightening solution for mandibular defects reconstruction and endogenous bone tissue engineering. Although bone tissue engineering and bone substitutes have been hot research topics recently, the unique capacity of human body itself in bone regeneration should never be ignored. Objectives: To report our cases of spontaneous bone regeneration after partial mandibulectomy for tumours and discuss mechanism, influential factors and application prospect of this spontaneous ossification. Methods: From 2004 to 2012, 8 patients were managed with periosteum-preserving mandibulectomy surgery. The follow-up period ranged from 1 to 6 years (Figs 1 and 2, Table 1). Furthermore, a comprehensive literature search was made online through the PubMed. Findings: All patients showed evidence of spontaneous bone regeneration and synostoses, both clinically and radiographically. Furthermore, our final literature search shows that 33 reports of spontaneous regeneration of the mandible have been published in the English literature (Table 2). Conclusions: Spontaneous bone regeneration after periosteum-preserving mandibulectomy surgery is particularly beneficial and can be applied in clinics. The future study will focus on its detailed mechanism, which may promote this technique for better result of mandibular defects reconstruction. http://dx.doi.org/10.1016/j.ijom.2015.08.408 Medial sural artery perforator flap for reconstruction of oral and maxillofacial defect W.Q. Zhao ∗ , H.M. Wang, J.H. Liu, H.Y. Zhu, Z.Y. Li Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China Background: Several types of flap were reported to repair soft tissue defects of oral and maxillofacial region, but the application of medial sural artery perforator flap was not well studied. Objectives: To investigate the application of the medial sural artery perforator flap (MSAP) for reconstruction of oral and maxillofacial defects. Methods: From February 2013 to December 2014, MSAP was used for simultaneous reconstruction of soft tissue defect after oral cancer surgery in 26 patients. All patients received preoperative artery probing by Doppler Ultrasound Flowmetry, and the flap were designed according to the perforator situation. During operation, MSAP was prepared according the actual size of local soft tissue defect and preoperative perforator situation. Close observation of flap survival is dropped after surgery. All patients were followed-up within 3, 6, 12 and 24 months. The flap survival, functional improvement of intraoral surgical area, influence of appearance and function of lower leg were recorded in detail.