Reconstruction of a large lower lip defect using a combination of Abbe and staircase flaps: a case report

Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient’s oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.

USO DE HIPERPLASIA GENGIVAL FIBROSA EM REGIÃO DE TUBER COMO ALTERNATIVA PARA CORREÇÃO DE DEFEITO ALVEOLAR: RELATO DE CASO

The various preprosthetic periodontal surgical techniques proposed currently, provide a future prosthetic work with better aesthetic results and functional.The objective of this study was to report a clinical case of periodontal surgery for correction of the defect in the alveolar border, by means of the subepithelial connective tissue graft. Patient presented fibrous hyperplastic growth, in the region of the maxilla túber and lip defect in the region of the upper central incisor. After planning the event,were carried out, concomitantly, two plastic surgeries prosthetic periodontal lunches. In the first surgery, a connective tissue graft was removed from the donor area, the maxila túber and then was adapted in the anterior region, receiving area where the defect of flange. Thoughtout a postoperatory period of 45 days, that the choice of surgical technique, the type of graft used for correction of the defect of rim, were pre-requisites for the future success in aesthetic and functional prosthetic rehabilitation.

Zygomatic Implants for Restoration of Complex Nasal Defects – A Case Report and Outcome

Total rhinectomy defects pose a challenge for the reconstructive surgeon, but since the introduction of osseointegrated implants, maxillofacial implant–retained prosthetic rehabilitation has provided the patient with an alternative option that has an excellent cosmetic result. Traditionally, zygomatic implants are used for prosthodontic restoration in patients with severely atrophic maxilla or to retain an obturator after tumor ablative surgery. More recently, the nonconventional use of zygomatic implants for retention of a nasal prosthesis has been reported in cases involving rhinectomy defects where the length of conventional dental implants is a limiting factor. In this article, we describe the use and value of transversely-oriented zygomatic implants in combination with an acrylic keeper and maxillary denture to optimize retention of a complex, multi-unit prosthesis in an edentulous patient with a total rhinectomy and upper lip defect.