scholarly journals Use of the Cover-Lifting Technique in Mandibular Cemento-Ossifying Fibroma Excision to Preserve the Inferior Alveolar Nerve

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1383
Author(s):  
Juan-You Qiu ◽  
Kuan-Min Huang ◽  
Nan-Chin Lin

Cemento-ossifying fibroma (also known as ossifying fibroma or cementifying fibroma) is a benign osteogenic neoplasm. Pain and paresthesia are rarely associated with cemento-ossifying fibroma; thus, nerves must be preserved during excision. With the advent of computer-aided techniques, the use of virtual surgical planning and a customized template can improve the precision of resection and reconstruction, reduce operating time, and improve postoperative outcomes. In this report, we describe a case of cemento-ossifying fibroma in a female patient who underwent segmental mandibulectomy and reconstruction with an iliac bone graft. Additionally, we describe a simple and effective way to preserve the inferior alveolar nerve.

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Eric L. Chung ◽  
Faizan Alawi ◽  
Anh D. Le ◽  
Rabie M. Shanti

A myriad of extirpative surgical protocols for the management of benign tumors of the jaws have been presented in the literature. Through significant advancements in computer-aided design and computer-aided manufacturing (CAD/CAM) technology and surgical instrumentation, today surgeons have at their disposal robust technology-driven techniques that are aimed at improving surgical outcomes. Our goal is to investigate the benefits of implementing virtual surgical planning (VSP) in conjunction with piezoelectric surgery (PES) to ensure success while minimizing the risk of complications during extirpation of tumors of the mandible. This case report describes the successful extirpation of an ossifying fibroma of the mandible in an adult patient using both VSP and PES.


2020 ◽  
Vol 4 (4) ◽  
pp. 185-192
Author(s):  
Douglas Rangel Goulart ◽  
Lucas Raineri Capeletti ◽  
Gabriel Henrique Campos Pinheiro ◽  
Mateus Veppo dos Santos ◽  
Alessandro Lourenço Januario

Purpose: To report the use of virtual surgical planning and a 3D printed drill guide for the biopsy of mandibular lesions. Case report: A 38-year-old woman presented with two bilateral lesions in the mandibular body, in close proximity to the inferior alveolar nerve and the molar roots. An incisional biopsy was planned with coDiagnostiX software using the cone beam computed tomography DICOM files and a cast model that had been digitalized using a bench scanner (7series, Dental Wings, Quebec, Canada). A tooth-supported drill guide was produced by 3D printing with digital light processing technology (Moonray S, Sprintray, CA, USA). The surgical procedure was performed under local anesthesia. No complications were observed intraoperatively or during postoperative recovery. Conclusion: The use of an intraoperative surgical 3D-printed drill guide enables a smaller surgical procedure and more precise bone biopsies.


2021 ◽  
Vol 11 (17) ◽  
pp. 7894
Author(s):  
João André Correia ◽  
José Ricardo Ferreira ◽  
Miguel Amaral Nunes ◽  
António Capelo ◽  
Miguel de Araújo Nobre ◽  
...  

Background: Marginal mandible resection is required to achieve healing in some cases of medication-related osteonecrosis of the jaws (MRONJ). Despite the sparsity of the literature, computer-aided design/computer-aided manufacturing (CAD/CAM) materials may provide superior outcomes for patients with an increased risk of mandible fracture. The aim of this study was to report a digital workflow for surgical interventions to prevent mandible fracture in MRONJ patients. Methods: We present two cases in which virtual surgical planning (VSP) and CAD/CAM surgical guides and reconstruction plates were used to prevent mandible fractures in elderly MRONJ patients submitted for marginal resection. Two osteoporotic patients, aged 73 and 84 years, presented with stage 3 MRONJ of the right mandibular body with inferior alveolar nerve involvement. The unaffected bone height was 6 mm in both cases, implying a high risk of mandible fracture. After preoperative VSP, surgery was performed through a combined intraoral–transbuccal approach. CAD/CAM-customized cutting guides and reconstruction plates were used for the marginal resection of necrotic bone and internal fixation. Results: Complete healing was achieved and the patients remained asymptomatic up to 1 year post-surgery. Conclusions: VSP and CAD/CAM-customized materials facilitated the complete resection of necrotic bone and rigid fixation in MRONJ patients, allowing a simplified approach with shorter operative times, reduced morbidity, and predictable results.


Author(s):  
Flavio Wellington da Silva Ferraz ◽  
Liogi Iwaki-Filho ◽  
Gustavo Nascimento de Souza-Pinto ◽  
Lilian Cristina Vessoni Iwaki ◽  
An Tien Li ◽  
...  

2018 ◽  
Vol 97 (3) ◽  
pp. 91-96 ◽  
Author(s):  
Stanley Yung-Chuan Liu ◽  
Douglas Sidell ◽  
Leh-Kiong Huon ◽  
Carlos Torre

Large, benign intramandibular lesions are frequently removed by resection followed by extensive free tissue transfer or delayed bone grafting. We outline a protocol to remove benign mandibular lesions using sagittal split osteotomy (SSO) with virtual surgical planning (VSP) to mitigate risks involved with this effective, tissue-saving approach. Patients with benign mandibular lesions accessed by SSO with VSP during 2014 were included in this study. Computed tomographic data were imported into VSP software. Using VSP, the exact locations of mandibular lesions and the inferior alveolar nerve canal were delineated. SSO was designed virtually and provided surgeons exact measurements to gain access to lesions and to avoid vital structures intraoperatively. SSO with VSP preserved the cortical mandibular bone and the inferior alveolar neurovascular bundle in 3 patients with benign mandibular lesions. Twelve months after surgery, no patient had pathologic fracture, prolonged paresthesia (except for the patient who required inferior alveolar nerve resection), or malocclusion. No patient required bone grafting. There were no functional or aesthetic jaw deficits. SSO is an effective approach to access intramandibular lesions. The technique does not result in loss of mandibular bone, and patients return to full masticatory function compared with those who require resection and reconstruction. VSP may mitigate technical challenges associated with SSO.


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