- Email: [email protected]
Upper maxillary reconstruction of oncological defects a clinical series of 31 patients
1250
21st ICOMS 2013—Abstracts: Oral Papers
Conclusions: Compared to conventional planning, prefabrication ensures an optimal position of the flap that enables prosthetically ideal implant placement. The future gingiva is prefabricated and incorporated into the flap, thus sparing the patient from secondary multistage soft tissue procedures prior to prosthetic rehabilitation. In addition, operating room time, ischemia time and handling trauma to the graft are reduced. http://dx.doi.org/10.1016/j.ijom.2013.07.269 T12.OR014 Reconstruction of mandibular defect by transport distraction osteogenesis: case report A. Maciel ∗ , A. Cerqueira, L. Cincura, W. Cavalcante Saint Antony Hospital, United States Several lesions occurring at the mandible require as the treatment of choice to minimize recurrence, an extensive resection with security margin. The rehabilitation of those patients promotes a great challenge for the surgeon, especially when the symphyseal area is involved. Traditionally, bone graft, harvested from a secondary donor site, with the use of microvascular reconstruction techniques or osseous free flaps are the procedures used to promote the reconstruction of the mandible, however, the weaknesses of bone graft still exist, and complications associated with the donor site are frequent. The distraction osteogenesis is a biological process of generating new bone by gradual traction of the divided bone segments. The technique of distraction osteogenesis was applied first in orthopaedic surgery for long-bone lengthening and was subsequently utilized in the treatment of cranio-facial microsomia and bone defect. The most significant advantage is that this technique can obviate any bone grafts and hence avoids donor site morbidity, also it allows the growth of soft tissue, minimizing dehiscence and bone exposure. This paper has the aim of presenting a case report of mandible reconstruction through the use of transport distraction osteogenesis and rehabilitation with osseointegrated implants and prosthetics in order to reconstruct a bone defect ranging from symphysis to temporomandibular joint in a patient who underwent mandibular resection due to odontogenic lesion, allowing the recovery of both function and aesthetics.
Results: Used flaps were: (1) temporalis muscle flap (38%); (2) microvascular fibular free flap (26%); (3) microvascular radial forearm free flap (12%); (4) buccinators myomucosal flap (15%); (5) Bichat’s buccal fat pad or direct closure (8%). According to Brown & Shaw classification, the most common defect after resective surgery was type IIb. In most cases, the relationship between type of defect and used flap was: (1) microvascular fibular free flap: type II defects; (2) temporalis muscle flap: type Ib; (3) microvascular radial forearm free flap: types Ib and IIb; (4) buccinators myomucosal flap and direct closure: type I defects Conclusions: Microvascular fibular free flap would be specially recommended for type II defects (b, c and d), temporalis muscle flap for type Ib and buccinators myomucosal flap for type I defects (a, b and c).Key words: oncological defects; maxillary reconstruction http://dx.doi.org/10.1016/j.ijom.2013.07.271 T12.OR016 Costochondral reconstruction of the mandibular condyle after hemimandibulectomy due to ameloblastoma I. Mulyawan 1,2,∗ , N.D. Ismawati 2 1
Faculty of Dentistry, Airlangga University, Surabaya, Indonesia Dr. Soetomo General and Teaching Hospital, Surabaya, Indonesia
2
T12.OR015
Costochondral grafts have gained increasing popularity among oral surgeons in reconstructing the mandibular condyle in cases, such as ameloblastoma. Seven patients with mandible ameloblastoma were treated with resection and immediate reconstruction by mean of autogenous non-vascularized costochondral at the Department of Oral and Maxillofacial Surgery, Stomatology Instalation, Dr. Soetomo General and Teaching Hospital. Analysis of the results was gained as a result of a retrospective study of patients when they attended appointments for 1 year post op follow up. Clinical and radiological evaluations obtained during the follow up showed significant anatomical and functional rehabilitation of the mandible as a result of the costochondral graft. The conclusion of this study is that free costochondral grafting is a successful technique for reconstruction of portions of the mandible and its temporal articulation The purpose of this study is to evaluate costochondral graft reconstruction of the mandibular condyle after hemimandibulectomy.Key words: costochondral grafts; mandible reconstruction
Upper maxillary reconstruction of oncological defects a clinical series of 31 patients
http://dx.doi.org/10.1016/j.ijom.2013.07.272
http://dx.doi.org/10.1016/j.ijom.2013.07.270
M. Moreno Sánchez ∗ , R. González García, L. Ruiz Laza, D. Manzano Solo de Zaldívar, J. Mateo Arias, C. Moreno García, O. Maestre Rodríguez, L. Villanueva Alcojol, D. González Ballester, F. Monje Gil Infanta Cristina Hospital, Spain Background: Upper maxillary reconstruction of oncological defects remains a challenge for both aesthetic and functional reasons. Objective: Assess the results after using different reconstructive techniques. Methods: A retrospective study of 31 patients who underwent surgery due to upper maxilla cancer was carried out. The maxillary defects were reconstructed with different flaps and were defined according to Brown & Shaw classification.
T12.OR017 Pedicled submandibular gland flap for reconstruction of oropharyngeal defects L. Pingarrón Martín 1,∗ , S. Zhou 2 , W. Yang 1,2 , C. Zhang 1,2 1 Fundación Jiménez Díaz Avda, Reyes Católicos, 2 – 28040 Madrid, Spain 2 9th People’s Hospital School of Medicine, Shanghai Jiao Tong University 639 Zhizaoju Road, Shanghai 200011, China
Background and objectives: The pedicled submandibular gland flap is an arterialized local flap in the head and neck region with an axial blood supply provided by the facial artery. As far as the authors know, the SGF has been used as modality of preventive care for xerostomia in patients undergoing radiation therapy of the
21st ICOMS 2013—Abstracts: Oral Papers
Conclusions: Compared to conventional planning, prefabrication ensures an optimal position of the flap that enables prosthetically ideal implant placement. The future gingiva is prefabricated and incorporated into the flap, thus sparing the patient from secondary multistage soft tissue procedures prior to prosthetic rehabilitation. In addition, operating room time, ischemia time and handling trauma to the graft are reduced. http://dx.doi.org/10.1016/j.ijom.2013.07.269 T12.OR014 Reconstruction of mandibular defect by transport distraction osteogenesis: case report A. Maciel ∗ , A. Cerqueira, L. Cincura, W. Cavalcante Saint Antony Hospital, United States Several lesions occurring at the mandible require as the treatment of choice to minimize recurrence, an extensive resection with security margin. The rehabilitation of those patients promotes a great challenge for the surgeon, especially when the symphyseal area is involved. Traditionally, bone graft, harvested from a secondary donor site, with the use of microvascular reconstruction techniques or osseous free flaps are the procedures used to promote the reconstruction of the mandible, however, the weaknesses of bone graft still exist, and complications associated with the donor site are frequent. The distraction osteogenesis is a biological process of generating new bone by gradual traction of the divided bone segments. The technique of distraction osteogenesis was applied first in orthopaedic surgery for long-bone lengthening and was subsequently utilized in the treatment of cranio-facial microsomia and bone defect. The most significant advantage is that this technique can obviate any bone grafts and hence avoids donor site morbidity, also it allows the growth of soft tissue, minimizing dehiscence and bone exposure. This paper has the aim of presenting a case report of mandible reconstruction through the use of transport distraction osteogenesis and rehabilitation with osseointegrated implants and prosthetics in order to reconstruct a bone defect ranging from symphysis to temporomandibular joint in a patient who underwent mandibular resection due to odontogenic lesion, allowing the recovery of both function and aesthetics.
Results: Used flaps were: (1) temporalis muscle flap (38%); (2) microvascular fibular free flap (26%); (3) microvascular radial forearm free flap (12%); (4) buccinators myomucosal flap (15%); (5) Bichat’s buccal fat pad or direct closure (8%). According to Brown & Shaw classification, the most common defect after resective surgery was type IIb. In most cases, the relationship between type of defect and used flap was: (1) microvascular fibular free flap: type II defects; (2) temporalis muscle flap: type Ib; (3) microvascular radial forearm free flap: types Ib and IIb; (4) buccinators myomucosal flap and direct closure: type I defects Conclusions: Microvascular fibular free flap would be specially recommended for type II defects (b, c and d), temporalis muscle flap for type Ib and buccinators myomucosal flap for type I defects (a, b and c).Key words: oncological defects; maxillary reconstruction http://dx.doi.org/10.1016/j.ijom.2013.07.271 T12.OR016 Costochondral reconstruction of the mandibular condyle after hemimandibulectomy due to ameloblastoma I. Mulyawan 1,2,∗ , N.D. Ismawati 2 1
Faculty of Dentistry, Airlangga University, Surabaya, Indonesia Dr. Soetomo General and Teaching Hospital, Surabaya, Indonesia
2
T12.OR015
Costochondral grafts have gained increasing popularity among oral surgeons in reconstructing the mandibular condyle in cases, such as ameloblastoma. Seven patients with mandible ameloblastoma were treated with resection and immediate reconstruction by mean of autogenous non-vascularized costochondral at the Department of Oral and Maxillofacial Surgery, Stomatology Instalation, Dr. Soetomo General and Teaching Hospital. Analysis of the results was gained as a result of a retrospective study of patients when they attended appointments for 1 year post op follow up. Clinical and radiological evaluations obtained during the follow up showed significant anatomical and functional rehabilitation of the mandible as a result of the costochondral graft. The conclusion of this study is that free costochondral grafting is a successful technique for reconstruction of portions of the mandible and its temporal articulation The purpose of this study is to evaluate costochondral graft reconstruction of the mandibular condyle after hemimandibulectomy.Key words: costochondral grafts; mandible reconstruction
Upper maxillary reconstruction of oncological defects a clinical series of 31 patients
http://dx.doi.org/10.1016/j.ijom.2013.07.272
http://dx.doi.org/10.1016/j.ijom.2013.07.270
M. Moreno Sánchez ∗ , R. González García, L. Ruiz Laza, D. Manzano Solo de Zaldívar, J. Mateo Arias, C. Moreno García, O. Maestre Rodríguez, L. Villanueva Alcojol, D. González Ballester, F. Monje Gil Infanta Cristina Hospital, Spain Background: Upper maxillary reconstruction of oncological defects remains a challenge for both aesthetic and functional reasons. Objective: Assess the results after using different reconstructive techniques. Methods: A retrospective study of 31 patients who underwent surgery due to upper maxilla cancer was carried out. The maxillary defects were reconstructed with different flaps and were defined according to Brown & Shaw classification.
T12.OR017 Pedicled submandibular gland flap for reconstruction of oropharyngeal defects L. Pingarrón Martín 1,∗ , S. Zhou 2 , W. Yang 1,2 , C. Zhang 1,2 1 Fundación Jiménez Díaz Avda, Reyes Católicos, 2 – 28040 Madrid, Spain 2 9th People’s Hospital School of Medicine, Shanghai Jiao Tong University 639 Zhizaoju Road, Shanghai 200011, China
Background and objectives: The pedicled submandibular gland flap is an arterialized local flap in the head and neck region with an axial blood supply provided by the facial artery. As far as the authors know, the SGF has been used as modality of preventive care for xerostomia in patients undergoing radiation therapy of the