scholarly journals COMPLICATIONS OF RECONSTRUCTION PLATE INSTALLATION IN MANDIBULAR

2021 ◽  
Vol 6 (2) ◽  
pp. 223
Author(s):  
Leni Ruslaini ◽  
Asri Arumsari ◽  
Abel Tasman ◽  
Kiki Akhmad Rizki

Background: Mandibular resection will cause mandibular stability disturbance due to loss of some part of the bone. Instability of the mandible can cause aesthetic, physiological, and psychological malfunction. Installment of mandibular reconstruction plat on the remaining mandibular using screws were suggested to restore its stability. However, it is not uncommon that plat exposure occurs following mandibular reconstruction, caused by inaccurate adaptation of the plats to the mandibular bone. The aims of this report are to describe the various complications and managements after jaw resection and reconstruction with plates. Case Report: A 44 years old male patient complained the small defect in the chin, painless, and no fluid emited, accompanied by dermatitis. Intra oral examination showed no abnormalities. About 1 year ago the patient performed segmental resection of the mandible on the indication of ameloblastoma. The radiological x-ray showed all screw detached from the plat and radiolucent images appeared around the plat that attached to the mandible. The diagnosis was fistula at regio mentale, post resection and reconstruction surgery, suspected caused by titanium plate allergies. The provided therapies were fistulectomy, screw removal, and plate reconstruction. Post therapy conditions showed improvement and no patients complaints of pain. Conclusion: Plate exposure is a complication that can occur after the installation of the reconstruction plate, but besides that it can also cause an allergic reaction from the material used. Keywords: Complication, Mandibular Resection, Plate Reconstruction, Titanium Plate Allergies

2017 ◽  
Vol 5 (2) ◽  
pp. 81
Author(s):  
Maria Goreti Widiastuti ◽  
Marsetyawan HNE Soesatyo ◽  
Rahardyan Magetsari ◽  
Alva Edy Tontowi

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.


2012 ◽  
Vol 19 (2) ◽  
pp. 158
Author(s):  
Paul Sugiyo ◽  
Heriyanti Amalia Kusuma

Latar Belakang. Operasi bedah pemotongan mandibula pada kasus tumor jinak maupun tumor ganas dapat menyebabkan deviasi mandibula. Tindakan perawatan bedah tergantung pada lokasi dan perluasan tumor mandibula, tindakan perawatan bedah tersebut meliputi bedah marginal, segmental, hemimandibulectomy, dan total mandibulectomy. Tujuan. Makalah ini menjelaskan tentang perawatan rehabilitasi dengan obturator definitive mandibula. Para klinisi harus menunggu masa penyembuhan yang sempurna sebelum disarankan untuk dibuatkan onturator definitive mandibula. Sejak awal penyembuhan diperlukan intervensi prostodontis untuk mencegah deviasi mandibula. Protesa ini membantu pergerakan mandibula secara normal tanpa terjadi penyimpangan pada fungsi bicara dan pengunyahan. Laporan Kasus. Pada bulan Maret 2012, pasien laki-laki, berumur 46 tahun datang ke RSGM Bagian Prostodonsia atas rujukan dari RS. Dr. Sardjito Bagian Bedah Mulut setelah dilakukan operasi tumor ameloblastoma mandibula sinistra (post hemimandibulectomy mandibula sinistra) dengan pemasangan plat rekonstruksi tiga bulan sebelumnya untuk dibuatkan obturator definitive mandibula. Pasien mengeluh bibir bawah sebelah kiri sering tergigit, fungsi bicara, fungsi pengunyahan, dan penampilannya terganggu. Hasil. Setelah dilakukan perawatan dengan memakai obturator definitive mandibula dalam kurun waktu 8 bulan, hingga saat ini hasil perawatan ini dapat mengembalikan fungsi bicara, fungsi pengunyahan, dan fungsi estetik sehingga pasien merasa lebih nyaman dan percaya diri. Kesimpulan. Deviasi mandibula setelah operasi hemimandibulectomy diatasi dengan bedah rekonstruksi menggunakan plat rekonstruksi, kemudian segera setelah penyembuhan perlu melibatkan prostodontis untuk pemasangan obturator definitive mandibula.  Background. Surgical restion of the mandible due to presence of benign or malignant tumor is the common cause of the mandibular deviation. Depending upon the location and extent of the tumor in the mandible, various surgical treatment modalities like marginal, segmental, hemimandibulectomy, or total mandibulectomy. Purpose. This study was to deteminated of rehabilitation treatment by mandible definitive obturator. The clinicians must wait for extensive period of the time for completion of healing before considering the definitive prosthesis. During this initial healing period prosthodontic intervention is required for preventing the mandibular deviation. This case report describes management of a patient who has undergone a reconstructed hemimandibulectomy with mandible definitive obturator. The prosthesis help patient moving the mandible normally without deviation during functions like speech, mastication, and aesthetic. Case Report. On March 2012, a 46 years old man was referred from Dr. Sardjito Hospital Oral Surgery Department to Department of Prosthodontics RSGM Faculty of Dentistry Gadjah Mada University Yogyakarta, for prosthetic rehabilitation following a hemimandibulectomy sinintra reconstructed with plate reconstruction three months ago. Patient felt speech function, masticatory function, and impaired performance, lower lip frequently bitten. Results. After treated while 8 months till now by mandible definitive obturator, patient felt more comfortable and confident with recovery function of speech, mastication, and aesthetic. Conclusion. The deviation of mandible after hemimandibulectomy was reconstructed by reconstruction plate surgery. During this initial healing period early prosthodontic intervention by mandible definitive obturator. 


2017 ◽  
Vol 4 (2) ◽  
pp. 149
Author(s):  
Arya Kusuma Agraha ◽  
Masykur Rahmat ◽  
Rahardjo .

Background: In the case of mandibular resection that leaves a large mandibular bone defect, a mandibular reconstruction is required to restore functional and postoperative aesthetic factors. Mandibular reconstruction plate installation on mandibular resection is very important but difcult to achieve maximum results. The formation of reconstruction plates can be preoperative and intraoperative. Preoperative stereolithography (medical rapid prototyping/MRP) can be used to form rapid and accurate plates (precontours). Objective: Report the use of MRP as an alternative tool to precontour mandibular reconstruction plate.Case management: Reported reconstruction of mandibular defects in one case of hemimandibulectomy and two cases of segmental resection with avascular iliac bone grafts using MRP through a computer-aided design and computer aided manufacture procedure (CAD/CAM) to establish preoperative reconstruction plates (precontour) so the surgery doesn’t take long time to reconstruct, by forming a mandibular models under normal circumstances.Result: The formation of a reconstruction plates (precontour) using MRP (medical rapid prototyping) with CAD / CAM procedure gives results in accordance with the original form.Conclusions: The making of MRP through CAD / CAM procedure gives maximal result resembling the form of mandibular model. The MRP models get an accurate picture of the patient’s jaw as a pre contour tools for reconstruction plate. The formation of the reconstruction plates (precontour) with these MRP model is obtained from CAD / CAM and provides a normal jaw image, so that preoperative precontouring will give good and maximum result on the reconstruction plates made under the MRP models.


2006 ◽  
Vol 12 (4) ◽  
pp. 335-338 ◽  
Author(s):  
M. Mejdoubi ◽  
C. Dekeister ◽  
M. Irsutti ◽  
C. Cognard ◽  
J-R. Paoli

We describe the case of a 68-year-old woman who had a mandibular titanium plate reconstruction following surgery for a parotid carcinoma. Fifteen months later she presented bleeding episodes related to a pseudoaneurysm of the internal carotid artery located just above the bulb. This was probably related to the weakening of the arterial wall following friction with the mandibular plate and radiotherapy. We successfully obliterated this pseudoaneurysm using a covered stent. This rare diagnosis should be evoked in case of bleeding following a mandibular reconstruction. Stenting is an effective treatment strategy obviating the need for open surgery.


2017 ◽  
Vol 2 (1) ◽  

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.


Author(s):  
Deepak Kaul ◽  
Farahnaz Muddebihal ◽  
Mohammed Anwar Ul Haque Chand

Osteomyelitis of maxillofacial skeleton is common in developing countries such as India. This case report describes successful surgical treatment of chronic suppurative osteomyelitis {CSO} of the mandible of a 35yr old female. The precipitating factor was thought to be eventful extraction in the {left } posterior body at the inferior border of mandible. Methods: Presurgical course of antibiotics ( Amoxycillin and metronidazole for 7 days and later followed by doxycycline for 1 month).Surgical debridement of the affected bone and reinforcing it with reconstruction plate using AO principles was done . Patient was kept on a high nutrient diet consisting of proteins. Conclusion: The case report demonstrates the typical features of CSO . The combination of the antibiotics therapy and surgical debridement was successful in the treatment of chronic suppurative osteomylitis.


1970 ◽  
Vol 3 (1) ◽  
pp. 27-34
Author(s):  
Lucas Tavares Dos Santos ◽  
Tânia Massini Evangelista

Introdução: A hérnia diafragmática congênita é a falha do fechamento embrionário do músculo diafragmático, resultando em um defeito de continuidade. Esta patologia pode ocorrer pela passagem de estruturas do abdome através de um defeito no diafragma, ou haver herniação parcial do estômago através do hiato esofágico, paralisia frênica com deslocamento do conteúdo abdominal para cima, mas sem herniação, e, eventração do diafragma. Casuística: Foi relatado um caso de hérnia diafragmática congênita, hérnia de Bochdalek, em um recém – nascido do sexo feminino, que nos ultra-sonografias da gestante apresentavam sem alterações. O diagnóstico da patologia foi feito apenas após a realização de raios-X de tórax e abdome para confirmar a posição do cateterismo umbilical venoso. Discussão/Conclusão: A apresentação clínica da hérnia de diafragmática congênita inclui desconforto respiratório moderado a grave com repercussão sistêmica. O diagnóstico, em cerca de 80% dos casos, é feito por ultrassom pré-natal. O tratamento proposto foi intubação endotraqueal com ventilação mecânica e programação para correção cirúrgica da hérnia. Após correção cirúrgica da patologia, a paciente permaneceu na unidade de terapia intensiva neonatal por 21 dias para acompanhamento de pós – operatório e intercorrências na evolução. Palavras-chave: hérnia diafragmática congênita, recém-nascido, hérnia de BochdalekABSTRACTIntroduction: Congenital diaphragmatic hernia is the failure of embryonic closure of the diaphragm, resulting in a lack of continuity. This condition can occur by passing structures of the abdomen through a defect in the diaphragm, or be part herniation of the stomach through the esophageal hiatus, phrenic paralysis with displacement of abdominal contents up but no herniation, and eventration of the diaphragm. Case Report: We report a case congenital diaphragmatic hernia, such as Bochdalek hernia, in a new - born female that in ultrasounds of pregnant women showed without change. The diagnosis of the disease was made only after conducting X-ray of the chest and abdomen to confirm the position of umbilical venous catheterization. Discussion/Conclusion: Clinical presentation of congenital diaphragmatic hernia includes moderate to severe respiratory distress with systemic repercussions. The diagnosis in about 80% of the cases is done by ultrasound prenatally. The proposed treatment was endotracheal intubation with mechanical ventilation and programming for surgical correction of the hernia. After surgical pathology, the patient remained in neonatal intensive care unit for 21 days to monitor post - operative complications and evolution.  Keywords: congenital diaphragmatic hernia, newborn, Bochdalek hernia 


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.


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