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P.338 Two-step reconstruction of the mandible body after wide tumour resections
218 Journal of Cranio-Maxillofacial Surgery 34(2006) Suppl. S1 P.336 Hereditary transmitted complex oro-facial-digital syndrome – Case report E. Paraschivescu, H. Sailer, M. Noditi, F. Urtila. “Victor Babes” University of Medicine and Pharmacy Timisoara, Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Romania The presence of such syndromes with hereditary transmission is not too frequently encountered. The authors would like to present such a rare syndrome, characterized by ectrodactyly, ectodermal dysplasia and cleft lip and palate. In the literature this syndrome is known as Rudiger– Freiere–Maia. At both mother and child the same clinical manifestations are found, suggesting the genetic component of this case. The first genetic examination reveals the autosomal dominant expression. The genetic linkage is a minor form. The results of the genetic analysis SSNP are presented in this paper. This case is interesting as it has by both the complexity and rarity, and the ascendant–descendant genetic implications as well. Keywords: complex syndrome; ectrodactyly; ectodermal dysplasia; cleft lip and palate P.337 Reconstruction of the mandible and the lower face following large tumour resection E. Paraschivescu, Z. Crainiceanu, E. Ianes, F. Urtila. “Victor Babes” University of Medicine and Pharmacy Timisoara, Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Romania Malignant tumours could involve, primarily or secondarily, the mandible and the soft tissues in the vicinity. In such situations, the only solution we see is the extensive resection, far into the healthy tissues, followed by complementary treatments, such as radio- and chemotherapy. Considering that these operations severely alter the aesthetic and functions (speech, deglutition, mastication), our next goal is to reconstruct the resulting defects. Most of the time, the local tissues left are neither enough nor reliable to allow the reconstruction and therefore we resorted to microsurgery, using osteo-mio-cutaneous or mio-cutaneous flaps which were subsequently doubled by bony structures, harvested from the fibula or iliac crest. Thus, in all the 12 cases we solved, the anatomy was partially restored and the functions improved considerably. In some of these cases the social reintegration was possible. P.338 Two-step reconstruction of the mandible body after wide tumour resections S. Talpos, F. Urtila. “Victor Babes” University of Medicine and Pharmacy Timisoara, Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, Romania Many types of mouth floor cancer involve different parts of the mandible body. Monoblock tumour resection is superimposed in these cases and bilateral neck dissection has to be performed at the same time. This surgery causes serious mutilation of the face and also causes other functional alterations such as respiratory distress due to tongue ptosis as a consequence of the mandibular arch absence. In order to decrease these esthetic effects caused by the soft tissue ptosis in the lower face, we have thought to consider a mandible reconstruction in two surgical steps. The first step
Abstracts, EACFMS XVIII Congress consists in tumour resection at the same time maintaining the continuity of the anterior mandibular arch using a special screw fixed titanium bar. After that, the titanium bar is covered with soft tissues comprising suprahyoid and genioglos muscles which represent important tissues in the tongue protraction. The second step of the operation consists in a graft extraction from anterior iliac crest 45 days after the first intervention and its fixation on the lingual part of the titanium bar. The advantages of this procedure are both psychological, minimizing the aesthetic changes, and respiratory functional, avoiding the necessity of tracheotomy. P.339 Dental pulp-derived neurospheres for peripheral nerve reconstruction R. Sasaki1 , S. Aoki2 , M. Yamato3 , H. Uchiyama1 , K. Wada2 , T. Okano3 , H. Ogiuchi1 . 1 Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, Graduate School of Medicine, Japan; 2 Department of Degenerative Neurological Diseases, National Institute of Neuroscience, NCNP, Japan; 3 Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Japan Introduction and Objectives: Nerve autografting is the most common surgical procedure currently used to repair nerve defects caused by traffic accidents and malignant tumour resections. A number of recent studies have shown the effectiveness of tubulation as an alternative therapy to nerve autografting for peripheral nerve gaps. However, for large peripheral nerve defects, tubulation alone is limited to nerve regeneration. It has been reported that tubulation using brain-derived neural progenitor cells promotes nerve regeneration. However, use of neural stem cells or neural progenitor cells has ethical considerations and potentially serious clinical complications. Therefore, we explored the use of dental pulp as a new cell source for such artificial nerves. We used a neurosphere assay to investigate whether adult rat dental pulp cells can form neurospheres and differentiate into neuronal cells. Materials and Methods: Adult rat incisors were extracted, and the dental pulp was collected from the excised teeth. Cell suspensions from dissociated dental pulp were plated on superhydrophilic plates in serum-free culture medium supplemented with EGF and bFGF. Results: Adult rat dental pulp cells formed neurospheres in serum-free culture. We found that dental pulp-derived spheres contain nestin-positive progenitor cells, Tuj1-positive neuronal cells and S100-positive glial cells. Plating the dental pulp-derived spheres on an adhesive substrate induced differentiation into Tuj1- and MAP2-positive neuronal cells. Conclusions: Dental pulp may be a viable source of easily obtainable cells for potential use in peripheral nerve reconstruction. P.340 In situ performance and gap-ossification in the double-barrel technique for vascularized free fibular flap reconstruction of the mandible R. Gonz´alez-Garc´ıa, F.J. Rodr´ıguez-Campo, M.F. Mu˜noz-Guerra, V. Escorial-Hern´andez, P.L. Martos, M. Mancha de la Plata, L. Naval-G´ıas. Department of Oral and Maxillofacial Surgery, University Hospital La Princesa, Madrid, Spain Introduction and Objectives: The vascularized free fibular flap (VFFF) has been extensively used for mandibular reconstruction. ‘In situ’ performance of the VFFF and the double-barrel technique may add some advantages to the flap. Material and Methods: By means of ‘in situ’ VFFF the replication of the mandible by osteotomies is performed while the fibula
Abstracts, EACFMS XVIII Congress consists in tumour resection at the same time maintaining the continuity of the anterior mandibular arch using a special screw fixed titanium bar. After that, the titanium bar is covered with soft tissues comprising suprahyoid and genioglos muscles which represent important tissues in the tongue protraction. The second step of the operation consists in a graft extraction from anterior iliac crest 45 days after the first intervention and its fixation on the lingual part of the titanium bar. The advantages of this procedure are both psychological, minimizing the aesthetic changes, and respiratory functional, avoiding the necessity of tracheotomy. P.339 Dental pulp-derived neurospheres for peripheral nerve reconstruction R. Sasaki1 , S. Aoki2 , M. Yamato3 , H. Uchiyama1 , K. Wada2 , T. Okano3 , H. Ogiuchi1 . 1 Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, Graduate School of Medicine, Japan; 2 Department of Degenerative Neurological Diseases, National Institute of Neuroscience, NCNP, Japan; 3 Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Japan Introduction and Objectives: Nerve autografting is the most common surgical procedure currently used to repair nerve defects caused by traffic accidents and malignant tumour resections. A number of recent studies have shown the effectiveness of tubulation as an alternative therapy to nerve autografting for peripheral nerve gaps. However, for large peripheral nerve defects, tubulation alone is limited to nerve regeneration. It has been reported that tubulation using brain-derived neural progenitor cells promotes nerve regeneration. However, use of neural stem cells or neural progenitor cells has ethical considerations and potentially serious clinical complications. Therefore, we explored the use of dental pulp as a new cell source for such artificial nerves. We used a neurosphere assay to investigate whether adult rat dental pulp cells can form neurospheres and differentiate into neuronal cells. Materials and Methods: Adult rat incisors were extracted, and the dental pulp was collected from the excised teeth. Cell suspensions from dissociated dental pulp were plated on superhydrophilic plates in serum-free culture medium supplemented with EGF and bFGF. Results: Adult rat dental pulp cells formed neurospheres in serum-free culture. We found that dental pulp-derived spheres contain nestin-positive progenitor cells, Tuj1-positive neuronal cells and S100-positive glial cells. Plating the dental pulp-derived spheres on an adhesive substrate induced differentiation into Tuj1- and MAP2-positive neuronal cells. Conclusions: Dental pulp may be a viable source of easily obtainable cells for potential use in peripheral nerve reconstruction. P.340 In situ performance and gap-ossification in the double-barrel technique for vascularized free fibular flap reconstruction of the mandible R. Gonz´alez-Garc´ıa, F.J. Rodr´ıguez-Campo, M.F. Mu˜noz-Guerra, V. Escorial-Hern´andez, P.L. Martos, M. Mancha de la Plata, L. Naval-G´ıas. Department of Oral and Maxillofacial Surgery, University Hospital La Princesa, Madrid, Spain Introduction and Objectives: The vascularized free fibular flap (VFFF) has been extensively used for mandibular reconstruction. ‘In situ’ performance of the VFFF and the double-barrel technique may add some advantages to the flap. Material and Methods: By means of ‘in situ’ VFFF the replication of the mandible by osteotomies is performed while the fibula