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New technique for implant insertion and reconstruction of fix bridge in atrophic mandibular bone
e142
Oral Presentation
and cN3 in 6 patients. 8 patients were postoperatively treated by surgery and radiotherapy, and 15 patients had post-operative chemoradiotherapy. Radiotherapy fields included all levels of the ipsilateral neck and mucosal surfaces. The median time for surgery to completion of radiotherapy was 89 days (range 46–113 days). All the patients had comprehensive neck dissection (including levels I–V) Following histopathological analysis of surgical specimens, the pN stage was N1 in 5 cases, N2 in 12 and N3 for the remaining 6 patients. 9/23 (39%) patients had evidence of extracapsular extension on histological analysis. The mean follow-up was 49 months (range 2–72 months). There were 10 deaths. No patient developed evidence of local recurrence within the upper aerodigestive tract during follow-up. Three patients developed regional recurrence, two of which were ipsilateral, all of them ultimately died of disease. Three patients developed metastatic disease. Four patients died from primary lung cancer. The 5 year overall survival, and regional recurrence free survival were 56.5 and 86% respectively. From a total of 666 excised nodes, 211 (32%) were found to contain metastatic SCC. Nodes from multiples levels were found to be involved in 16 cases (70%). In the remaining 7 cases (30%), involvement was limited to a single level. Of the 23 patients who had all levels of the neck treated surgically, level I was clinically involved in three cases (13%), level II in 16 (69.5%), level III in 9 (39%), level IV in 6 (26%) and level V in one case (4%). Postoperative histopathological assessment identified disease in level I in three cases (13%), level II in 20 cases (87%), level III in 11 (49%), level IV in 7 (30%) and level V in 6 cases (26%). Comparison of clinical versus pathological staging in the patients with comprehensive neck dissection revealed that 22% of nodal basins preoperatively considered free of disease were late shown to harbor microscopic pathological evidence of occult metastasis. Conclusions: Our results suggest that in patients with carcinoma of unknown primary, the probability of occult disease may be high enough to consider level V when performing neck dissection.
New technique for implant insertion and reconstruction of fix bridge in atrophic mandibular bone H. Shahoon 1,∗ , Z. Yari 2 1 2
Faculty of Dentistry, Shahed University, Tehran, Iran Iranian Periodotology Society, Tehran, Iran
Background: Low height of bone above inferior alveolar canal (IAC) were confiner from implant supported prosthesis. The aim of current study were to introduced novel approach for placement of implants without need for bone augmentation and nerve repositioning from use of splinted mini implants with telescopic crowns and placed in buccal aspect of inferior alveolar canal. Methods: Twenty patients with bone height less than 6 mm above the inferior alveolar canal (IAC) were selected. In the every sextant, two one piece mini implants placed with 3 mm distance on behalf of posterior retainer and regular implant placed for anterior retainer. After 4 month healing period, posterior implants splinted with telescopic crown and get parallel with anterior abutments. Results: The mean follow up period for 60 mini-implants were 18 months. There were no surgical and early failure or prosthetic complication. The mean value of marginal bone loss around 60 mini implants were 1.9 mm and 2.3 mm for anterior implants, respectively. Conclusion: Mandibular atrophic bone with adequate width could be treated with splinted mini implants, regarding that implant placement in lateral aspect of IAC were technique sensitive. http://dx.doi.org/10.1016/j.ijom.2015.08.798 Highway to runway M. Shaik St. Joseph Dental College, Eluru, India
Uncommon cases present in oral & maxillofacial region: modification of surgical procedure accompanied by post operation reports
Currently much attention has been focused on Panfacial trauma which affects the upper, middle and lower third of the facial skeleton. The management of Panfacial fractures is complex because of the lack of the reliable land marks. Literature has shown many approaches for the management of the Panfacial fractures. The aim of this paper is to analyze the principles and treatment modalities of Panfacial trauma.
H. Shahoon 1,∗ , S. Farhadi 2
http://dx.doi.org/10.1016/j.ijom.2015.08.799
http://dx.doi.org/10.1016/j.ijom.2015.08.796
1 2
Faculty of Dentistry, Shahed University, Tehran, Iran Islamic Azad University, Tehran, Iran
Aim and background: This study was aimed to describe some uncommon oral & maxillofacial case, frequently were approached with modifications in surgical procedures. Material and methods: 9 uncommon cases of oral & maxillofacial region were introduced in this study. Every case was presented with the unusual points in order to huge tumor size, uncommon location or modification in surgical approaches. Pre and post operation reports were available to clarify the diagnostic and surgical procedures. Conclusion: Report of uncommon cases always would be notable for surgeons and pathologists resulting in better management of similar cases. Also, presentation of the modifications in surgical approach of unusual oral & maxillofacial cases with unusual size or locations would be helpful in similar situations. http://dx.doi.org/10.1016/j.ijom.2015.08.797
A 5-year retrospective study of free anterolateral thigh flap application in 406 head and neck tumor cases Z.J. Shang ∗ , Z. Xu, J. Jia, K. Liu, Z. Shao, H.X. Zou Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China This study aimed to discuss the clinical features, reliability, and various applications of free anterolateral thigh flaps and introduce a 5-year retrospective review of this flap application in head and neck tumor patients. A retrospective study was performed of 406 patients who underwent immediate reconstruction of head and neck tumor-induced defects with ALT flaps from April 2009 to April 2014. The study consisted of 305 males and 101 females aged 18–79 years old. The shape and size of flaps were designed individually to meet various demands of reconstruction in the head and neck regions. The overall successful reconstruction rate
Oral Presentation
and cN3 in 6 patients. 8 patients were postoperatively treated by surgery and radiotherapy, and 15 patients had post-operative chemoradiotherapy. Radiotherapy fields included all levels of the ipsilateral neck and mucosal surfaces. The median time for surgery to completion of radiotherapy was 89 days (range 46–113 days). All the patients had comprehensive neck dissection (including levels I–V) Following histopathological analysis of surgical specimens, the pN stage was N1 in 5 cases, N2 in 12 and N3 for the remaining 6 patients. 9/23 (39%) patients had evidence of extracapsular extension on histological analysis. The mean follow-up was 49 months (range 2–72 months). There were 10 deaths. No patient developed evidence of local recurrence within the upper aerodigestive tract during follow-up. Three patients developed regional recurrence, two of which were ipsilateral, all of them ultimately died of disease. Three patients developed metastatic disease. Four patients died from primary lung cancer. The 5 year overall survival, and regional recurrence free survival were 56.5 and 86% respectively. From a total of 666 excised nodes, 211 (32%) were found to contain metastatic SCC. Nodes from multiples levels were found to be involved in 16 cases (70%). In the remaining 7 cases (30%), involvement was limited to a single level. Of the 23 patients who had all levels of the neck treated surgically, level I was clinically involved in three cases (13%), level II in 16 (69.5%), level III in 9 (39%), level IV in 6 (26%) and level V in one case (4%). Postoperative histopathological assessment identified disease in level I in three cases (13%), level II in 20 cases (87%), level III in 11 (49%), level IV in 7 (30%) and level V in 6 cases (26%). Comparison of clinical versus pathological staging in the patients with comprehensive neck dissection revealed that 22% of nodal basins preoperatively considered free of disease were late shown to harbor microscopic pathological evidence of occult metastasis. Conclusions: Our results suggest that in patients with carcinoma of unknown primary, the probability of occult disease may be high enough to consider level V when performing neck dissection.
New technique for implant insertion and reconstruction of fix bridge in atrophic mandibular bone H. Shahoon 1,∗ , Z. Yari 2 1 2
Faculty of Dentistry, Shahed University, Tehran, Iran Iranian Periodotology Society, Tehran, Iran
Background: Low height of bone above inferior alveolar canal (IAC) were confiner from implant supported prosthesis. The aim of current study were to introduced novel approach for placement of implants without need for bone augmentation and nerve repositioning from use of splinted mini implants with telescopic crowns and placed in buccal aspect of inferior alveolar canal. Methods: Twenty patients with bone height less than 6 mm above the inferior alveolar canal (IAC) were selected. In the every sextant, two one piece mini implants placed with 3 mm distance on behalf of posterior retainer and regular implant placed for anterior retainer. After 4 month healing period, posterior implants splinted with telescopic crown and get parallel with anterior abutments. Results: The mean follow up period for 60 mini-implants were 18 months. There were no surgical and early failure or prosthetic complication. The mean value of marginal bone loss around 60 mini implants were 1.9 mm and 2.3 mm for anterior implants, respectively. Conclusion: Mandibular atrophic bone with adequate width could be treated with splinted mini implants, regarding that implant placement in lateral aspect of IAC were technique sensitive. http://dx.doi.org/10.1016/j.ijom.2015.08.798 Highway to runway M. Shaik St. Joseph Dental College, Eluru, India
Uncommon cases present in oral & maxillofacial region: modification of surgical procedure accompanied by post operation reports
Currently much attention has been focused on Panfacial trauma which affects the upper, middle and lower third of the facial skeleton. The management of Panfacial fractures is complex because of the lack of the reliable land marks. Literature has shown many approaches for the management of the Panfacial fractures. The aim of this paper is to analyze the principles and treatment modalities of Panfacial trauma.
H. Shahoon 1,∗ , S. Farhadi 2
http://dx.doi.org/10.1016/j.ijom.2015.08.799
http://dx.doi.org/10.1016/j.ijom.2015.08.796
1 2
Faculty of Dentistry, Shahed University, Tehran, Iran Islamic Azad University, Tehran, Iran
Aim and background: This study was aimed to describe some uncommon oral & maxillofacial case, frequently were approached with modifications in surgical procedures. Material and methods: 9 uncommon cases of oral & maxillofacial region were introduced in this study. Every case was presented with the unusual points in order to huge tumor size, uncommon location or modification in surgical approaches. Pre and post operation reports were available to clarify the diagnostic and surgical procedures. Conclusion: Report of uncommon cases always would be notable for surgeons and pathologists resulting in better management of similar cases. Also, presentation of the modifications in surgical approach of unusual oral & maxillofacial cases with unusual size or locations would be helpful in similar situations. http://dx.doi.org/10.1016/j.ijom.2015.08.797
A 5-year retrospective study of free anterolateral thigh flap application in 406 head and neck tumor cases Z.J. Shang ∗ , Z. Xu, J. Jia, K. Liu, Z. Shao, H.X. Zou Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China This study aimed to discuss the clinical features, reliability, and various applications of free anterolateral thigh flaps and introduce a 5-year retrospective review of this flap application in head and neck tumor patients. A retrospective study was performed of 406 patients who underwent immediate reconstruction of head and neck tumor-induced defects with ALT flaps from April 2009 to April 2014. The study consisted of 305 males and 101 females aged 18–79 years old. The shape and size of flaps were designed individually to meet various demands of reconstruction in the head and neck regions. The overall successful reconstruction rate