Application of a new type of titanium porosity plate in oral surgery.
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Adult↗
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Results for “Mandibular Prosthesis”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Immediate temporary reconstruction of mandibular continuity defects in cancer patients.
A technique is described in detail which will produce a predictable immediate temporary reconstruction of a mandibular continuity defect. The procedure is quick, inexpensive and reliable. A review of various methods of reconstruction is presented and compared with our technique. Complications are discussed. A review of our patients is presented.
Electromyography↗
Use of preformed hydroxylapatite blocks for grafting in genioplasty procedures.
Dense hydroxylapatite is a synthetic, biocompatible, immunologically inert material that can establish a chemical union with bone when placed in intimate contact in histologic studies. The following is a preliminary report of the use of preformed dense, non-resorbable hydroxylapatite blocks as a grafting material for use in advancement and vertical lengthening of the bony chin associated with orthognathic surgical procedures. In rare instances where an autogenous bone graft would be required for vertical lengthening without any advancement of bony pogonion, the need is obviated by utilization of the hydroxylapatite solid block.
Chin↗
Titanium implants as a temporary replacement of mandible. A report of 30 cases.
In a 5-year period, 30 titanium implants (Bowerman and Conroy 1969) were utilised for the reconstruction of mandibular defects following tumour operations. Of these, 20 implants were removed prematurely. Reasons for early removal were: 1. postoperative dehiscence of wound (5), 2. perforation through the skin or mucosa (5), 3. infection of graft bed (7), 4. breakage of the implant (1), 5. tumour recurrence (2). A total of 9 implants were retained for one or more years. The results are compared with those of Bowerman (1974). Reasons for the early loss as well as the clinical implications are discussed.
Biocompatible Materials↗
Clinical and experimental results of a sandwich-technique for mandibular alveolar ridge augmentation.
During the past two and a half years, thirteen patients have been operated upon using a "sandwich-technique" for mandibular alveolar ridge augmentation. This new technique was advocated by Schettler in 1974. In 3 cases, autologous rib cartilage was used, in 6 cases an autologous transplant from the iliac crest, and on four occasions, autologous "cialit"-conserved bone chips were inserted. All transplants healed without complications and no resorption was found in either the autologous or homologous transplants at the late follow-up examinations. These findings are supported by animal experiments in rabbits with the aid of the polychrome sequence marking technique using fluorochromes.
Animals↗
Ceramic augmentation of the lower jaw.
Atrophy of the lower jaw is essentially a manifestation of vertical bone resorption and must be treated in a compensatory manner. Animal experiments have shown the value of the bioactive glass ceramic Ceravital as a bone replacement material. After box-shaped or step-shaped osteotomies, we perform interpositional plastic operations with glass ceramic in order to augment the atrophied human lower jaw. Results, advantages and dangers of the method are shown in 12 patients.
Alveolar Process↗
Experience with 220 cases of mandibular reconstruction.
Extensive resections of the mandible are usually carried out for malignat tumours or non-malignant tumours with a tendency to reccur, such as ameloblastomas. These hemi-resections include the ascending and horizontal ramus of the mandible. Such mutilations have serious functional and aesthetic consequences. In order to avoid these drawbacks we use two sorts of implants. The first are made from metallic and plastic materials. They are used when patients are too weak to support a bone graft, when there is insufficient soft tissue coverage, or when a recurrence of the tumour is feared. In order to be well tolerated they must be made of materials which are fully accepted by the tissues. For the plastic part we use methyl-methacrylate and, for the metal part, "durallium". The second type is used to maintain a bone graft in good position. It is completely metallic. The pattern is made in wax and reproduced in durallium. They are made and adjusted in the same way as plastic implants. The results are analysed separately covering two periods. In the first (1955-1967), the failures have been relatively large (25%). During the second period (1967-1974), a better choice of operative indications and a more precise technique gave better results (failure: 13%).
Ameloblastoma↗
Reconstructive surgery of the mandible by means of metal plates.
Reconstructive operations for defects of the mandible arising as a consequence of tumour operations and after trauma, add considerably to the improvement of aesthetics and masticatory function. Here, we have found methods of stable osteosynthesis for transplant fixation to be very useful. The most favourable results were achieved by the application of special mandibular plates. Only homologous spongy bone of the crest of filium was used as the transplant material. The primary temporary bridging of the defect by alloplastic material after mandibular resection in cancer therapy proved very advantageous. The results of treatment permit practical conclusions.
Adolescent↗
A modified groin flap for reconstruction of oral cavity defects after tumour resection.
21 patients, suffering from carcinoma in the lower part of the oral cavity, were operated on by in-continuity resection of the mandible. The removed bone was replaced by a metal plate. The soft tissue defect was completely repaired by a modified free groin flap, transplanted with microsurgical techniques. 19 patients had a complete flap take, two flaps became necrotic. No metal plate was lost during a follow up period of 1-20 months. The functional results in respect of tongue mobility were in all cases quite favourable. Techniques of flap raising and transplantation are outlined in detail.
Adult↗
A viable treatment alternative for hemifacial microsomia. Case report.
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Adolescent↗
Prevention of tongue prolapse by immediate stabilization in severely avulsed mandibular war injuries.
A significantly successful procedure for tongue stabilization, used in six cases of severe war injuries to the mandible, which prevents the serious complications of tongue prolapse, is here presented. The procedure consists of a the insertion of horseshoe-shaped Kirschner wire, the ends of which are fixed to the posterior mandibular segments, thus acting as a scaffolding for the lacerated soft tissues of the anterior two-thirds of the tongue, floor of the mouth and the submandibular region. This technique provides an acceptable appearance and assists feeding, reduces dribbling and dryness of the tongue, limits the likelihood of infection of the soft tissues of the floor of the mouth with subsequent contracture, affords scaffolding for the soft tissues, foundation for bone grafts, and permits greater freedom in augmenting the vermilion of the lower lip.
Bone Wires↗
Effect of experimental disc perforation in sheep temporomandibular joints.
The effect of surgical perforation of the disc on intra-articular morphology was examined using sheep. Eight sheep had bilateral perforations and 2 animals were used as controls. After 8 months the sheep were killed and the joints examined radiologically and histologically. Osteophytes were seen on all the condylar radiographs. Histologically, there were proliferative changes in both the condylar and temporal surfaces adjacent to the disc perforations.
Animals↗
Reconstruction of the lower half of the facial skeleton after removal of the mandible at autopsy.
A method for postmortem removal of the mandible without altering the facial appearance of the deceased is presented. The technique is especially developed to avoid damage to the soft tissues of the face.
Autopsy↗
Natural coral skeleton used as onlay graft for contour augmentation of the face. A preliminary report.
The skeletons of two different genera of Madreporaria were used as onlay graft material for contour augmentation of the face. With coral blocks or granules in a subperiosteal fashion, patients with hemifacial microsomia, maxillary hypoplasia, microgenia, and Treacher Collins' syndrome have been adequately treated. Sixteen augmentations were performed in 14 patients, followed up for 6-34 months. One graft had to be removed because its inadequate fixation resulted in mobility. Delayed healing was observed in another case for the same reason. Coral skeleton is a cheap, natural biomaterial with excellent biocompatibility. It can easily be prepared and shaped, and it maintained its form over the period observed.
Adolescent↗
Augmentation genioplasty with hydroxyapatite blocks. A case report.
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Adolescent↗
Vertical interpositional augmentation genioplasty with porous polyethylene.
Recent advances in the field of biomatrix porous implant technology has stirred the interest of the oral and maxillofacial surgical community. One such material (Medpor), is a biocompatible, large-pore, high-density polyethylene implant which has proven both experimentally and clinically to fulfil the criterion for maxillofacial reconstructive and aesthetic surgical grafting.
Adult↗
Titanium-coated hollow screw and reconstruction plate system for bridging of lower jaw defects: biomechanical aspects.
The biomechanical and design principles of the titanium hollow screw and reconstruction plate (THRP) system are described. Physiologically advantageous load transmission, a biocompatible implant material with sufficient strength and a surface structure favorable to biological stabilization are discussed. The design of the fixation between the cross-split screwhead and the plate hole gives a rigid and stable plate fixation even without contact between plate underside and bone. Blood perfusion and bone strength will therefore not be affected. Full functional loading with only 2-3 fixation screws for each plate end is possible. Further technical advantages of the THRP system are the possibility of lingual plate application and integration of a three-dimensional adjustable condylar prothesis.
Biomechanical Phenomena↗
Fixation with reconstruction plates under critical conditions: the role of screw characteristics.
Mandibular angular ostectomy defects in 12 sheep were bridged with a titanium plate system (THORP), designed according to the screw-plate-locking principle. Two screw designs (hollow and solid) and two rough (plasma-coated, sand-blasted)-surface and one smooth (anodized)-surface structure were tested in a critical two-screw anchorage model. Fixation with two screws only per fragment was successful in only one-third of the cases. The fixation results were superior for screws with a rough surface, either sand-blasted or plasma-coated. The hollow-screw design did not seem to offer special advantages over the solid screws with identical surface structure. In the successful cases, the bone-screw contact was maintained continuously over a period of 8 weeks, and anchorage was even enhanced by reinforcement of the cancellous structures. In the unsuccessful cases, peri-implant bone resorption seemed to be related to jeopardized bone perfusion in the vicinity of the implants. It is presumed that a plating system with locked screws has the advantage that only two screws will hold a relatively short condylar process. This study proved the assumption to be questionable. However, in view of the problems related to prosthetic replacement of the temporomandibular joint, an attempt to salvage the articular portion may still be justified in selected cases, even if the chance of success is as low as 30%.
Animals↗