Introduction of a Synthetic Barrier Role in Isolating Reconstruction Plate From Soft Tissue in Mandibular Reconstruction for Reducing Plate Exposure: Technical Note and Initial Experience

2010 ◽  
Vol 68 (9) ◽  
pp. e30
Author(s):  
A. Garajei
Keyword(s):  
Soft Tissue ◽  
Technical Note ◽  
Mandibular Reconstruction ◽  
Initial Experience ◽  
Reconstruction Plate

scholarly journals Simplified Transoral Load-Bearing Osteosynthesis with Preformed Mandible Reconstruction Plates

2013 ◽  
Vol 6 (3) ◽  
pp. 211-214 ◽  
Author(s):  
Sebastian Schiel ◽  
Sven Otto ◽  
Christoph Pautke ◽  
Carl-Peter Cornelius ◽  
Florian A. Probst
Keyword(s):  
Posterior Margin ◽  
Technical Note ◽  
Mandibular Reconstruction ◽  
Body Region ◽  
Reconstruction Plate ◽  
Mandible Reconstruction ◽  
Load Bearing ◽  
External Incisions ◽  
Room Time ◽  
Operating Room Time

Transcutaneous submandibular approaches are the preferred technique for the application of load-bearing mandibular osteosynthesis plates. However, an extraoral approach is associated with several shortcomings, like the risk of harming the facial nerve and scarring. This technical note presents a specialized mandibular reconstruction plate (MatrixMANDIBLE Preformed Reconstruction Plate [Synthes Maxillofacial, Paoli, PA]), simplifying the transoral application by its design with a preformed curvature along the lateral surface of the mandible. The application of wide-spanning plates reaching from the posterior margin of the ramus even into the contralateral body region is facilitated. Transoral application of preformed mandibular reconstruction plates seems to be a promising option to bypass external incisions and to reduce operating room time.

Soft tissue coverage of mandibular reconstruction plates

Head & Neck ◽  
1994 ◽  
Vol 16 (2) ◽  
pp. 112-115 ◽  
Author(s):  
Peter G. Cordeiro ◽  
David A. Hidalgo
Keyword(s):  
Soft Tissue ◽  
Mandibular Reconstruction ◽  
Soft Tissue Coverage

scholarly journals Salvage Secondary Reconstruction of the Mandible with Vascularized Fibula Flap

2019 ◽  
Vol 12 (4) ◽  
pp. 274-283
Author(s):  
Dinesh Kadam
Keyword(s):  
Soft Tissue ◽  
Tissue Loss ◽  
Successful Outcome ◽  
Primary Reconstruction ◽  
Reconstruction Plate ◽  
Secondary Reconstruction ◽  
Fibula Flap ◽  
Skeletal Defects ◽  
Vascularized Fibula ◽  
Free Fibula

Primary restoration of the mandibular continuity remains the standard of care for defects, and yet several constraints preclude this objective. Interim reconstructions with plate and nonvascular bone grafts have high failure rates. The secondary reconstruction, when becomes inevitable, remains a formidable task. This retrospective study evaluates various issues to address secondary reconstruction. Twenty-one patients following mandibulectomy presented with various complications between 2012 and 2016 were included in the study. The profile of primary reconstruction includes reconstruction plate ( n = 9), reconstruction plate with rib graft ( n = 3), soft tissue only reconstruction ( n = 4), free fibula ( n = 2), inadequate growth of reconstructed free fibula during adolescence ( n = 1), nonvascular bone graft alone ( n = 1), and no reconstruction ( n = 1). All had problems or complications related to unsatisfactory primary reconstruction such as plate fracture, recurrent infection, plate exposure, deformity, malocclusion, and failed fibula reconstruction. All were reconstructed with osteocutaneous free fibula flap with repair of soft-tissue loss. All flaps survived and had satisfactory outcome functionally and aesthetically. Dental rehabilitation was done in four patients. One flap was reexplored for thrombosis and salvaged. The challenges in secondary reconstruction include difficulty in recreating true defects, extensive fibrosis and loss of planes, unanticipated soft-tissue and skeletal defects, reestablishing the contour and occlusion, insufficient bone strength, dearth of suitable recipient vessels, nonpliable skin, tissue contraction to accommodate new mandible, need of additional flap for defect closure, and postirradiation effects. Notwithstanding them, the reasonable successful outcome can be attainable.

scholarly journals Sequela de cirurgia para reconstrução mandibular após ressecção de ameloblastoma

2019 ◽  
Vol 8 (8) ◽  
Author(s):  
Allancardi dos Santos Siqueira ◽  
Luiz Henrique Soares Torres ◽  
Jiordanne Araújo Diniz ◽  
Éwerton Daniel Rocha Rodrigues ◽  
Caio Pimenteira Uchôa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Platelet Rich Plasma ◽  
Treatment Algorithm ◽  
Free Flaps ◽  
Mandibular Reconstruction ◽  
Benign Tumors ◽  
New Classification ◽  
Oromandibular Reconstruction ◽  
Head Neck

Os defeitos mandibulares devido à ressecção de lesão óssea interferem a harmonia e estética facial comprometendo a qualidade de vida dos pacientes. Grandes defeitos exigem planejamento minucioso, principalmente quando lançamos mão de enxertos e placas de reconstrução, evitando assim resultados insatisfatórios ou até mesmo sequelas. Apesar de algumas classificações dos defeitos mandibulares vêm sendo discutidas ao longo dos anos, ainda não há um protocolo definido para reconstrução mandibular. O uso de prototipagem na Cirurgia Bucomaxilofacial tem se tornado cada vez mais frequente; a precisão da reconstrução, diminuição do tempo de cirurgia reflete em recuperação mais rápida do paciente. Mesmo com a ferramenta da prototipagem, grandes lesões e perdas ósseas permanecem como grande desafio ao cirurgião.  O objetivo deste trabalho é relatar um caso clínico de reconstrução mandibular no qual houve a necessidade de ser tratado com remoção de placa de reconstrução e nova reabilitação cirúrgica do paciente.Descritores: Mandíbula; Reconstrução Mandibular; Modelos Biológicos.ReferênciasSantos LCS, Seixas AM, Barbosa B, Cincura RNS. Adaptação de placas reconstrutivas: uma nova técnica. Rev Cir Traumatol Buco-Maxilo-Fac. 2011;11(2):9-14.Lin PY, Lin KC, Jeng SF. Oromandibular reconstruction: the history, operative options and strategies, and our experience. ISRN Surg. 2011;2011:824251.Martins Jr. JC, Keim FS. Uso de prototipagem no planejamento de reconstrução microcirúrgica da mandíbula. Rev Bras Cir Craniomaxilofac. 2011;14(4):225-28.Montoro JR, Tavares MG, Melo DH, Franco Rde L, Mello-Filho FV, Xavier SP, Trivellato AE, Lucas AS. Mandibular ameloblastoma treated by bone resection and imediate reconstruction. Braz J Otorhinolaryngol. 2008;74(1):155-57.Nóia CF, Ortega-Lopes R, Chaves Netto HDM, Nascimento FFAO, Sá BCM. Desafios na reconstrução mandibular devido a lesões extensas ou traumatismos. Rev Assoc Paul Cir Dent. 2015;69(2):158-63.Cohen A, Laviv A, Berman P, Nashef R, Abu-Tair J. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):661-6.Rana M, Warraich R, Kokemüller H,  Lemound J,  Essig H, Tavassol F et al. Reconstruction of mandibular defects - clinical retrospective research over a 10-year period. Head Neck Oncol. 2011;3:23.Fariña R, Alister JP, Uribe F, Olate S, Arriagada A. Indications of Free Grafts in Mandibular Reconstruction, after Removing Benign Tumors: Treatment Algorithm. Plast Reconstr Surg Glob Open. 2016;4(8):e845.Fariña R, Plaza C, Martinovic G. New transference technique of position of mandibular reconstructing plates using stereolithographic models. J Oral Maxillofac Surg. 2009;7(11):2544-48.Mooren RE, Merkx MA, Kessler PA, Jansen JA, Stoelinga PJ. Reconstruction of the mandible using preshaped 2.3-mm titanium plates, autogenous cortical bone plates, particulate cancellous bone, and platelet-rich plasma: a retrospective analysis of 20 patients. J Oral Maxillofac Surg. 2010;68(10):2459–67.Brown JS, Barry C, Ho M, Shaw R.A new classification for mandibular defects after oncological resection. Lancet Oncol. 2016;17(1):23-30Urken ML, Weinberg H, Vickery C, Buchbinder D, Lawson W, Biller HF. Oromandibular reconstruction using microvascular composite free flaps. Report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects. Arch Otolaryngol Head Neck Surg. 1991;117(7):733-44.Shnayder Y, Lin D, Desai SC, Nussenbaum B, Sand JP, Wax MK. Reconstruction of the Lateral Mandibular Defect: A Review and Treatment Algorithm. JAMA Facial Plast Surg. 2015;17(5):367-73.Wei FC, Celik N, YangWG, Chen IH, Chang YM, Chen HC. Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap. Plast Reconstr Surg. 2003;112(1):37-42.Li BH, Jung HJ, Choi SW, Kim SM, Kim MJ, Lee JH. Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation. J Craniomaxillofac Surg. 2012;40(8):293-300.

scholarly journals EVALUASI KOMPLIKASI PLATE EXPOSURE PASCA RESEKSI AMELOBL ASTOMA MANDIBULA DENGAN REKONSTRUKSI PELAT TITANIUM DI RSUP DR. SARDJITO YOGYAKARTA

2017 ◽  
Vol 5 (2) ◽  
pp. 81
Author(s):  
Maria Goreti Widiastuti ◽  
Marsetyawan HNE Soesatyo ◽  
Rahardyan Magetsari ◽  
Alva Edy Tontowi
Keyword(s):  
Case Report ◽  
Bone Defect ◽  
Mandibular Reconstruction ◽  
Titanium Plate ◽  
Reconstruction Plate ◽  
Cutaneous Fistula ◽  
Mandibular Bone ◽  
Oral Plate ◽  
Bone Damage ◽  
Left Mandible

Resection of the jaw is a primary option of treatment in mandibular ameloblastoma with bone damage. Mandibular resection will cause mandibular stability disturbance due toloss of some part of the bone. Instability of the mandible can cause aesthetic, physiological, and psychological malfunctioning. To restore its stability, installment of mandibular reconstruction plate on the remaining mandibular by using screws. However, it is not uncommon that plate exposure occurs following mandibular reconstruction, caused by inaccurate adaptation of the plates to the mandibular bone. A  3D stereolithography modelcan help provide the best assesment on the bone defect, plan the making of the more easily pre-operative curved plates and provide more accurate faster surgery time. Objective: To evaluate plate exposure after mandibular resection with titanium reconstruction plates in Dr. SardjitoHospital. Case report: A case was reported on mandibular reconstruction after resection of ameloblastoma with titanium plate performed in Dr. Sardjito Hospital that experienced intra-oral plate exposure and oro-cutaneous fistula on the left mandible. The clinical evaluation showed the curved titanium plate did not adapt well with the remaining mandibular bone; therefore, the titanium plate was removed without replacing it with a new plate. Inappropriate adaptationof curved titanium plate is one of the main causes of plate exposure. The use of a 3D stereolithography model is very helpful for the success of mandibular reconstruction.

scholarly journals Topology optimization of a mandibular reconstruction plate and biomechanical validation

2021 ◽  
Vol 113 ◽  
pp. 104157
Author(s):  
David C. Koper ◽  
Carine A.W. Leung ◽  
Lars C.P. Smeets ◽  
Paul F.J. Laeven ◽  
Gabriëlle J.M. Tuijthof ◽  
...  
Keyword(s):  
Topology Optimization ◽  
Mandibular Reconstruction ◽  
Reconstruction Plate
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