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At least 217 records · Page 12Linked to original sources
PubMed2003

[Topography of the inferior alveolar nerve in relation to cystic processes of the mandible in dental MRI].

PURPOSE: Cystic processes are changing the course of the inferior alveolar nerve in the mandible. This study evaluates the possibility of demonstrating the relationship between space-occupying processes and the course of the neurovascular bundle. MATERIALS AND METHODS: Thirteen patients with cystic processes in the mandible (9 keratocystic lesions, 1 eosinophilic granuloma, 1 plasmocytoma, 2 adamantinomas) were examined by MRI (1.5-T magnet, 8-cm surface coil, PD-gradient-echo-sequences in sagittal and coronal orientation, without enhancement) and the results retrospectively evaluated. RESULTS: The entire course of the nerve could be delineated in all patients. In six patients with minor cystic processes, the nerve was identified in both sagittal and coronal orientation. In seven patients with major cystic lesions, only parts of the nerve were detected in either image orientation, but the nerve could be visualized in its entire length by evaluating coronal and sagittal images side by side. CONCLUSION: It is possible to delineate the inferior alveolar nerve in its entirety along pathologic mandibular lesions. For large cystic lesions, this requires the evaluation of both coronal and sagittal sections of multidirectional MRI.

Adolescent↗
PubMed2003

Enhancement of the fibula free flap by alveolar distraction for dental implant restoration: report of a case.

We describe the utilization of distraction osteogenesis in the free fibular microvascular bone graft to the mandible for increasing bone height for future osseointegrated dental implants. Successful reconstruction of a resected mandible requires restoration of both function and esthetic form. Although current reconstructive techniques restore anterior-posterior and lateral projection, often the graft's vertical height is not sufficient for the placement of osseointegrated dental implants and subsequent oral prosthesis. The patient was a sixteen-year-old male who was found to have a large desmoplastic fibroma of the left mandible, which was resected. The defect was successfully restored with a free fibular microvascular bone graft and reconstruction plate. Nevertheless, the patient had persistent problems with mastication and it was decided to perform a segmental osteotomy of the neomandible. Two internal vertical distraction devices were then placed in the mandible. The appliances were then activated five days postoperative, twice a day, for a total of 14 days. At that time 1.5 cm of distraction had occurred and the patient was placed in a consolidation phase for four months. The patient then had sufficient bone height and was restored with 8 osseointegrated dental implants.

Adolescent↗
PubMed2001

An interim extraoral prosthesis used for the rehabilitation of a patient treated for osteoradionecrosis of the mandible: a clinical report.

In patients with tumors of the head and neck, ionizing radiation delivered in dosages that will kill cancer cells induces unavoidable changes in normal tissue. Bone cells and vascularity may be irreversibly injured, leaving devitalized bone susceptible to the development of osteoradionecrosis. This clinical report describes the fabrication of an acrylic/rubber prosthesis retained by an orthodontic headgear. The prosthesis was used to improve the mastication, speech, and saliva control of a patient treated for osteoradionecrosis of the mandible.

Cranial Irradiation↗
PubMed1990

Cementoma--presentation predicates approach.

Cementomas are benign jaw tumors that originate from periodontal ligament elements. Four classifications of cementomas are described: periapical fibrous dysplasia, benign cementoblastoma, cementifying fibroma, and florid osseous dysplasia. Usual treatment regimens vary from observation to limited surgical resection based upon tumor type and clinical characteristics. We present an unusual case report of an extensive cementifying fibroma that required mandibular and inferior alveolar nerve resection followed by osseous and neural reconstruction.

Adult↗
PubMed2006

Giant hemangiopericytoma of mandible: a propos of a case: a variant of the surgical technique for protection of the articular fosse.

The hemangiopericytoma is a tumor of the pericytes. It represents 1% of vascular tumors. It is frequently located in inferior limbs, the pelvis, and the retroperitoneum. A painless mass of slow growth is main presentation. Imaging is not specific. Only microscopic and immunohistochemical findings can verify the lesion. The surgical treatment is elective. The search of the world medical literature revealed the publication of only four cases of hemangiopericytoma of the jaw. We present the case of a patient with a giant hemangiopericytoma that originated in the jaw. Studies showed an enormous mass and destruction of the right jaw. A right hemimandibulectomy including the condyle was performed. Mandibular reconstruction was performed with titanium plates with condyle and bone graft of the iliac crest; a piece of silastic with titanium mesh was placed in the temporomandibular articular fossa. Two years after surgery, good aesthetic and functional results were evident, and tumor recurrence was not observed.

Adult↗
PubMed1984

Mandibular reconstruction using silicone: fifteen-year follow-up.

A patient is presented in whom a carved Dacron felt-covered silicone prosthesis was used to replace the mandible. Although not recommended as the procedure of choice for mandibular reconstruction, the prosthesis remains in place 15 years following implantation, the jaw appears and moves satisfactorily, and speech is within normal limits.

Follow-Up Studies↗
PubMed1994

Mandibular reconstruction with osseointegrated implants into the free vascularized radius.

Complete oral rehabilitation after oromandibular resection is a goal that is frequently difficult to attain. Poor speech, inability to eat a solid diet, and cosmetic deformity are all potential problems. The introduction of osseointegrated implants and free vascularized bone grafting are two techniques that have permitted improved results of oromandibular reconstruction. When used together they provide the best possibility for providing oral continence, a stable denture, and minimal cosmetic deformity. The free vascularized iliac crest has been used widely to reconstruct mandibular defects with the placement of enosseus implants. However, the radius provides a good alternative to reconstruct the mandible. We report four cases of mandibular reconstruction with the use of the free vascularized radius with subsequent placement of osseointegrated implants. The results of these cases suggest that enosseus implants can be used successfully in the radius. The radius is ideal to reconstruct small to moderate-sized defects of the lateral mandible with loss of oral mucosa.

Adult↗
PubMed1996

The dentate adult human mandible: an anatomic basis for surgical decision making.

Mandibular resection for oral cancer assumes two major forms; segmental mandibulectomy for invasion and rim mandibulectomy for margins, the extent of removal being governed by the need to ensure oncologic safety. The purpose of our study was to establish basic principles for optimal resection design in various clinical situations. Thirty-six cadaveric, adult, dentate human mandibles were examined in detail and sectioned at six points each to study the cross- sectional anatomy at these sites. The majority of bones (32 of 36) revealed a conspicuous medullary core with a thin cortical rim 2 to 4 mm in thickness. The inferior alveolar nerve was found to course consistently within the anterior segment of the ramus and to dip significantly within the body (median height at molar area 7 mm). Accordingly, rim resections cannot include the entire medullary core and nerve as currently defined, whereas segmental resections can spare the posterior segment of the ramus in appropriate cases.

Adult↗
PubMed2002

Stability of dental implants in microvascular osseous transplants.

Microvascular iliac crest and scapula transplants have been used in reconstruction of the lower jaw following tumor surgery. It has only been with the insertion of dental implants that a satisfactory prosthetic rehabilitation of the patient has been achieved. For this study, a follow-up of 38 patients with lower jaw tumors was carried out. The patients had been treated with partial resection of the lower jaw and neck dissection with microvascular iliac crest transplants (n = 20) or microvascular scapula transplants (n = 18); this was followed with dental implants (n = 143) in the region of the transplants or the local lower jaw. One hundred thirty-nine of the 143 dental implants were loaded by prosthetic superstructures. In all patients, the implant situation was evaluated on average 2 years 5 months after implantation. Periotest values, periimplant probing depths, and contact bleeding were registered, and the extent of periimplant bone loss was defined radiographically. The clinical situation in the region of the implant was compared for both types of implants and also with the nonresected lower jaw. The average Periotest values were within the normal range for all groups. In one scapula implant, however, a better average of Periotesting, -3.3, was found compared with implants of the iliac crest with Periotest values of -0.7. A measurement of -2.1 was found for the local lower jaw, similar to that of scapula implants. Pathologic probing depths were found for all three compared groups. The radiographically determined vertical loss of bone was the same for all three groups, on average 1 mm at 27 months postoperatively. The highest incidence of sulcus bleeding was found in the scapula implant group. Thus, it can be stated that the scapula transplants provide a similar transplant site to local lower jaw bone, whereas implants in iliac crest transplants show lesser bony stability. Periimplant soft-tissue conditions are worse for both types of transplants compared with local tissue of the lower jaw.

Dental Implantation↗
PubMed1999

Surgical excision margins: a pathologist's perspective.

The histopathologic status of excisional margins of malignant neoplasms has long been used as a potential indicator for recurrences and prognosis. The predictive ability of the margin, however, is far from satisfactory. Perhaps nowhere else in oncologic pathology has the significance of these margins been as intensively studied as in squamous cell carcinomas of the upper aerodigestive tracts. This review is, in part, a critique of current applications and the clinical implications of surgical margins for the removal of squamous cell carcinomas in these tracts. Specific points addressed in this article are: 1) postremoval (artifactual) changes in measurements; 2) the impact of margin status, as currently assessed, on recurrence and patient outcome; 3) margins and conservation surgery of the larynx; 4) margins and bone (mandible) invasion; and 5) molecular (p53 and eIF4E) margins.

Carcinoma, Squamous Cell↗