Mandibular reconstruction using a titanium mesh sheet processed by laser welding after segmental mandibulectomy for implant placement

Author(s):  
Yoshio Yamashita ◽  
Yoshimasa Yamaguchi ◽  
Nobuhiro Noguchi ◽  
Masaaki Goto
Author(s):  
Shigeo Ishikawa ◽  
Kazyuki Yusa ◽  
Kaoru Edamatsu ◽  
Shohei Ueda ◽  
Ayako Sugano ◽  
...  

A particulate cancellous bone and marrow (PCBM) graft combined with titanium (Ti-) mesh tray has become one of the most popular mandibular reconstruction methods. The technique has been applied to the mandibular discontinuity defects after segmental mandibulectomy. To the best of our knowledge, there are no reports on using the technique after hemimandibulectomy, during which a wide mandibular resection, including the condyle, is performed. Here we report firstly a case of mandibular reconstruction after hemimandibulectomy, using a plate and soft-tissue free flap, followed by a Ti-mesh and PCBM harvested from the bilateral posterior ilia, which was successful. This case report first revealed how bone resorption occurred clinically in mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. We also revealed the high predictability of the mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. Our report also provides a guiding principle to overcome the limitation of mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. However, our manuscript has limited evidence being a case report.


2010 ◽  
Vol 36 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Guillaume Odin ◽  
Thierry Balaguer ◽  
Charles Savoldelli ◽  
Gérard Scortecci

Abstract The authors describe a case of squamous cell carcinoma of the oral cavity managed by ablative surgery, mandibular reconstruction with a fibula free flap, and implant placement during the same session. Immediate functional implant loading, respecting the principles of basal implantology, was performed 48 hours later using a highly rigid, screw-secured fixed prosthesis that served as an external fixator for the implants and grafted bone. Implant loading before external beam radiotherapy improves flap stability, bone consolidation, and quality of life. Functional and esthetic outcomes were evaluated 2 years after radiotherapy was completed.


Materials ◽  
2020 ◽  
Vol 13 (10) ◽  
pp. 2389 ◽  
Author(s):  
Carlo Maiorana ◽  
Mattia Manfredini ◽  
Mario Beretta ◽  
Fabrizio Signorino ◽  
Andrea Bovio ◽  
...  

Background: bone augmentation by means of manually shaped titanium mesh is an established procedure to regenerate atrophic alveolar ridges and recreate a proper contour of the peri-implant bone anatomy. Conversely, current literature on the use of preformed titanium meshes instead of traditional grids remains lacking. Therefore, the aim of the present prospective study was to evaluate the use of preformed titanium mesh to support bone regeneration simultaneously to implant placement at dehiscence-type defects from clinical, radiological, and patient-related outcomes. Methods: 8 implants showing buccal dehiscence defects were treated with preformed titanium mesh directly fixed to flat abutments screwed to the implant. Intrasurgical clinical measurements and radiographic evaluations by means of cone-beam computed tomography scans were performed to assess the horizontal bone gain after 8 months from the augmentation surgery. Biological and patient-centered outcomes were also evaluated.; Results: clinically, a mean horizontal bone gain of 4.95 ± 0.96 mm, and a mean horizontal thickness of the buccal plate of 3.25 ± 0.46 mm were found. A mean horizontal bone gain of 5.06 ± 0.88 mm associated with a mean horizontal thickness of the buccal plate of 3.45 ± 0.68 mm were observed radiographically. From a macroscopic aspect, the remodeled graft appeared well integrated with the host bone. Well vascularized newly formed bone-like tissue was observed in intimate contact with the implants. Conclusions: preformed titanium mesh may be effective in supporting simultaneous horizontal bone regeneration at dehiscence-type peri-implant defects. Titanium mesh exposure still remain an issue in this type of surgery.


Materials ◽  
2020 ◽  
Vol 13 (17) ◽  
pp. 3874 ◽  
Author(s):  
Marco Tallarico ◽  
Chang-Joo Park ◽  
Aurea Immacolata Lumbau ◽  
Marco Annucci ◽  
Edoardo Baldoni ◽  
...  

Alveolar-ridge augmentation, anterior aesthetics, and digital technologies are probably the most popular topics in the dental-implant field. The aim of this report is to present a clinical case of severe atrophy of the anterior maxilla in a younger female patient, treated with a titanium membrane customized with computer-aided design/computer-aided manufacturing (CAD/CAM), simultaneous guided implant placement, and a fully digital workflow. A young female patient with a history of maxillary trauma was treated and followed-up for 1 year after implant placement. A narrow implant was inserted in a prosthetically driven position with the aid of computer-guided surgery. In the same surgical section, a customized implantable titanium mesh was applied. The scaffold was designed according to the contralateral maxillary outline in order to recreate a favorable maxillary bone volume. Finally, highly aesthetic, CAD/CAM, metal-free restorations were delivered using novel digital technologies.


2012 ◽  
Vol 5 (3) ◽  
pp. 123-126 ◽  
Author(s):  
Yan Lin Yap ◽  
Jane Lim ◽  
Wei Chen Ong ◽  
Matthew Yeo ◽  
Hanjing Lee ◽  
...  

The fibular free flap is the gold standard for mandibular reconstruction. Accurate 3-dimensional contouring and precise alignment of the fibula is critical for reestablishing native occlusion and facial symmetry. Following segmental mandibulectomy, the remaining mandibular fragments become freely mobile. Various stabilization methods including external fixation, intermaxillary fixation, and preplating with reconstruction plate have been used. We describe a modification to the preplating technique. After wide resection of buccal squamous cell carcinoma, our patient had an 11-cm mandibular defect from the angle of the left mandible to the right midparasymphyseal region. A single 2.0-mm Unilock® (Synthes, Singapore) plate was used to span the defect. This was placed on the vestibular aspect of the superior border of the mandibular remnants before resection. Segmental mandibulectomy was then performed with the plate removed. The spanning plate was then reattached to provide rigid fixation. The fibular bone was contoured with a single osteotomy and reattached. The conventional technique involves molding of the plate at the inferior border of the mandible. This is time-consuming and not possible in patients with distorted mandibular contour. It is also difficult to fit the osteotomized fibula to the contoured plate. In comparison, the superiorly positioned spanning plate achieve rigid fixation of the mandible while leaving the defect completely free and unhampered by hardware, allowing space for planning osteotomies and easier fixation of the neomandible. Using this modified technique, we are able to recreate the original mandibular profile with ease.


2017 ◽  
Vol 2 (3) ◽  
pp. 197
Author(s):  
Anton Anton ◽  
Poerwati S. Rahajoe ◽  
Bambang Dwirahardjo

Objective: Reporting the application of SBA procedure with titanium mesh as an alternative solution for immediate implant placement in socket with dentoalveolar trauma-induced buccal bone defect.Methods: An 18-year-old female patient visited our department, with a history dentoalveolar trauma and a loss of  tooth 21. Clinical examination during the implant placement procedure exposed  a socket with buccal bone defect. SBA with autogenous chin bone graft combined with DFDBA allograft and stabilized with titanium mesh (Ti-Mesh) for buccal defect on which flap reposition was done with tension free primary closure.Results: Ti-Mesh was removed after 3 months which no sign of inflamation appeared, implant was in a stable condition and new bone formation was observed. Subsequently, healing abutment was placed. A one-year observation suggested a good clinical retention with no luxation observed, along with decent functional and esthetic results. CBCT evaluation showed buccal bone thickness preserved.Conclusion: Sandwich bone augmentation with stabilized titanium mesh provides a satisfying result in treating horizontal buccal bone defect.


Materials ◽  
2021 ◽  
Vol 14 (21) ◽  
pp. 6556
Author(s):  
Isao Hoshi ◽  
Tadashi Kawai ◽  
Shingo Kurosu ◽  
Tadaharu Minamino ◽  
Kei Onodera ◽  
...  

Mandibular reconstruction using a titanium mesh tray and autologous bone is a common procedure in oral and maxillofacial surgery. However, there can be material problems—such as broken titanium mesh trays—which may undermine long-term functionality. This study was designed to investigate the optimal conditions for a titanium mesh tray with an ideal mandibular shape and sufficient strength, using computer-aided design, computer-aided manufacturing technology, and electron beam additive manufacturing. Specimens were prepared using Ti-6Al-4V extra low interstitial titanium alloy powder and an electron beam melting (EBM) system. The mechanical strength of the plate-shaped specimens was examined for differences in the stretch direction with respect to the stacking direction and the presence or absence of surface treatment. While evaluating the mechanical strength of the tray-shaped specimens, the topology was optimized and specimens with a honeycomb structure were also verified. Excellent mechanical strength was observed under the condition that the specimen was stretched vertically in the stacking direction and the surface was treated. The results of the tray-shaped specimens indicated that the thickness was 1.2 mm, the weight reduction rate was 20%, and the addition of a honeycomb structure could withstand an assumed bite force of 2000 N. This study suggests that the EBM system could be a useful technique for preparing custom-made titanium mesh trays of sufficient strength for mandibular reconstruction by arranging various manufacturing conditions.


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