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At least 199 records · Page 11Linked to original sources
PubMed1998

Functional reconstruction of the mandible: a modified titanium mesh system.

This paper describes a method for mandibular reconstruction utilizing autogenous cancellous bone in a titanium mesh. The mesh is designed preoperatively based on a duplicate of the patient's mandible which is modified to simulate an anatomically correct edentulous segment in the region to be reconstructed. The duplicate mandible is articulated with a maxillary dental cast, and a locating splint is fabricated for intraoperative use to aid the positioning of the mesh in relation to the upper teeth. The method facilitates future rehabilitation with dental implants and results in a symmetric and highly functional reconstruction of the mandible.

Adult↗
PubMed1994

Assessment of trigeminal nerve function by means of short-latency somatosensory evoked potentials after microneurosurgical repair.

In order to evaluate accurately trigeminal nerve damage and the response to microneurosurgical treatment, a reproducible, objective test of trigeminal nerve function is required. This study investigates the use of somatosensory evoked potentials as an objective monitor of trigeminal nerve function after microneurosurgical repair. We examined 10 patients, all but 1 treated for gnathic disorders, in whom a severe iatrogenic injury to the inferior alveolar nerve occurred unilaterally. One patient underwent partial mandibulectomy with sacrifice of the nerve because of a malignant tumour. A significant difference in trigeminal somatosensory evoked potential latencies after stimulation of the normal side of the lower jaw compared with the response after stimulation of the affected side was to be expected. Immediate microneurosurgical repair was carried out in 7 patients. The trigeminal somatosensory evoked potential latencies after right and left sided stimulation of the mandible did not differ significantly after subjective successful microneurosurgical repair. Somatosensory evoked potential testing appears to represent an objective method of evaluating trigeminal nerve function, in particular in relation to microneurosurgical procedures. The results of trigeminal testing should improve after technical refinement.

Adolescent↗
PubMed1991

Experience with AO reconstruction plates after partial mandibular resection involving its continuity.

A report is presented on experience with the use of 54 plates, without primary bone grafts, after resections for malignant tumours involving the continuity of the mandible, in 52 patients. There were complications in 27 cases: postoperative infection or soft tissue dehiscence occurred 20 times, chronic soft tissue perforation once, screw loosening twice, and plate fracture four times. Adjuvant radiotherapy and/or chemotherapy had no effect on the incidence of the complications. Seventeen of the plates (a good 30%) had to be removed prematurely due to the complications. Major deformity did not always occur if relative stabilization had developed through cicatrix formation. Thirty-seven plates (barely 70%) remained: in 19 cases until the death of the patient, in 3 cases until recurrence, in 12 cases until bone grafting, and in 3 cases they were still in situ up to 65 months. In principle, reconstruction plates have proven themselves. However, application and soft tissue coverage need great care and a great deal of experience.

Bone Plates↗
PubMed1988

Titanium-coated hollow screw and reconstruction plate system (THORP) in mandibular reconstruction.

Clinical results are presented which have been obtained from mandibular reconstruction with the Titanium-coated Hollow Screw and Reconstruction-Plate system (THORP) in 7 selected patients. In 3 of the patients primary bone grafting was performed with simultaneous implantation of titanium fixtures for dental reconstruction. The reconstruction-plates have shown excellent functional stability with no failures, such as loosening of screws, within an observation period up to 2 1/2 years. The system was submitted to immediate full functional loading despite the limited number of 2-3 fixation screws for each end of the plate. Among several technical advantages of the system are the possibility of lingual plate application and reconstruction with a three-dimensionally free, adjustable condylar prosthesis.

Adult↗
PubMed1989

Mandibular reconstruction with the THORP condylar prosthesis after hemimandibulectomy.

The subject of this paper is the evaluation of the advantages pertaining to the THORP (titanium hollow screw reconstruction plate) condylar prosthesis for reconstruction after hemimandibulectomy and exarticulation. The THORP condylar prosthesis is three-dimensionally adjustable, enabling the intraoperative meticulous functional adaptation of the condyle. Various designs of the condyle make it possible to achieve optimal congruency between the articular fossa and condyle. The anchorage of the prosthesis to the stump of the mandible is achieved with perforated hollow-screws rigidly fixed to the plate, thus producing optimal functional stability. The long-term follow-up of eleven cases, reconstructed with this system, confirmed the correct guidance and functional efficiency of this type of condylar prosthesis.

Adolescent↗
PubMed1998

Primary temporary AO plate reconstruction of the mandible.

OBJECTIVE: This study assessed the incidence of complications and revisions after primary temporary AO plate reconstructions of the mandible performed from 1971 through 1996. STUDY DESIGN: In a retrospective record review, the data of 51 patients undergoing primary temporary AO plate reconstructions after composite mandibular resection were analyzed according to age, gender, date of reconstruction, anatomic location of reconstruction, use of additional radiotherapy and/or flap surgery, and incidence of associated complications and revisions. RESULTS: Associated complications and revisions accompanying primary temporary AO plate reconstructions were evaluated through use of the incidence rates of associated complications (IACs) and revisions (IARs), which are reported as the numbers of associated complications and revisions, respectively, per 100 patients. Of the entire sample, the highest incidence rate of associated complications was associated with infection (33.5); this was followed by the rates for plate exposure (27.9) and plate fracture (10.7). With an overall incidence rate of 38.3 revisions per 100 patients, the corresponding site-related incidence rates of associated revisions were found to be 55.0 for reconstructions of the anterior mandible crossing the midline, 37.1 for those of the body segment of the mandible, and 31.1 for reconstructions involving the ramus and/or condyle area of the mandible. Revision rates were observed to be significantly higher in irradiated (53.6 vs 31.5) and non-flap-added reconstructions (43.2 vs 24.8). Analysis of treatment group-related incidences revealed irradiated non-flap-added reconstructions to be associated with the highest failure rates, whereas additional flap surgery resulted in a significant reduction in complications (50.0 vs 108.0) and revisions (20.0 vs 65.7). CONCLUSIONS: This study showed primary temporary AO plate reconstructions after composite mandibular resection to be associated with a high rate of complications and revisions. The results emphasize the need to relate outcome measures to site-related and treatment-related parameters.

Adult↗
PubMed1999

Pulmonary metastasis of ameloblastoma: case report and review of the literature.

Ameloblastomas are benign tumors of odontogenic epithelial origin. There is a high incidence of local recurrence associated with these tumors, and distant metastasis is rare. A review of the English literature shows that there have been 41 prior reports of pulmonary metastases from ameloblastomas of the oral cavity. We present another case of ameloblastoma metastatic to the lung and review the histopathology and mechanism of metastatic spread.

Ameloblastoma↗
PubMed2002

Fracture of mandibular reconstruction plates used after tumor resection.

PURPOSE: We assessed the incidence of fractured plates after primary temporary AO plate reconstruction of the mandible following tumor resection. PATIENTS AND METHODS: One hundred ten patients were retrospectively evaluated according to the extent of the tumor, anatomic location of the reconstruction, type of plate, additional use of radiotherapy or flap surgery (or both), and the incidence of fractured plates. RESULTS: Fractured plates occurred in 8 of 110 patients. Most occurred less than 6 months after surgery. All of the 8 patients had a malignant tumor; 2 had received radiation therapy and 4 had skin flaps placed. The fractured plate was the straight type in 1 patient and the angular type in 7 patients. Among patients who had fractured plates, the average number of remaining teeth was 12.8 in the maxilla and 9.5 in the mandible. CONCLUSIONS: Fractured plates were more common among patients with oral cancer with a segmental defect that did not cross the midline in whom an angular-type plate was used and no bone grafting was performed.

Adolescent↗
PubMed2000

Vascularized transplantation of the long thoracic nerve for sensory reinnervation of the lower lip.

Microsurgical techniques have improved functional and morphological reconstruction of the face in recent years. An important factor is the re-establishment of neuronal function. The aim of this study was a follow-up of the regeneration of sensation in the inferior alveolar nerve after partial resection of a tumour and reconstruction with a vascularized long thoracic nerve graft. Five patients were examined in monthly intervals to assess the degree of re-establishment of sensation. Pressure and pain responses were elicited as early as three months postoperatively, sense of touch and vibration were found after five months, and sensitivity to temperature after seven months postoperatively. In four patients nine months postoperatively, sensory qualities in the region of the mental nerve were identical on both sides. The vascularized long thoracic nerve is therefore an adequate nerve graft for covering defects as a result of resection of the inferior alveolar nerve patients with tumours.

Aged↗
PubMed2002

Long-term functional outcome of mandibular reconstruction with stainless steel AO reconstruction plates.

Mandibular continuity defects are usually reconstructed with bone grafts. However, factors associated with the tumour and the patient can still be reasons to choose reconstruction plates. The aim of this study was to find out the results of mandibular reconstructions with stainless steel AO reconstruction plates after a long follow-up period. The records of 36 patients were reviewed for personal data and the history of disease, treatment and complications. Patients with failed reconstructions were compared with those in whom the procedure had been successful. Patients and surgeons gave their opinion on the functional and cosmetic results. The mean follow-up was 39 months (range 4-99); 4 patients were withdrawn because they developed early recurrent disease and in 17 patients the reconstruction failed. We found no significant differences between the successful and the failed group. Fourteen patients could be evaluated for functional outcome, 10 of whom were totally or satisfactorily rehabilitated. Therefore, stainless steel reconstruction plates can be used in patients when other options are inappropriate.

Adult↗