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At least 433 records · Page 24Linked to original sources
PubMed1994

[Mandibular reconstruction using a metallo-acrylic implant prosthesis in oncology. Apropos of 40 cases].

The authors report on 40 cases using acrylic-metal prosthesis after ablative cancer surgery and compare them with the literature. The long-term complications (prosthesis extrusion or infection) are important, but the short-term follow-up (3 months) is more than 80% of success, any material used. The prosthesis keep a physiological position to the mandible, against scar sequelae. The use of soft tissue closure without post-operative radiotherapy increase the success of a simple-used and low-priced device of mandibular reconstruction.

Acrylic Resins↗
PubMed1994

[Temporomandibular joint reconstruction with free rib and iliac crest bone transplants].

From 1981-1992 we reconstructed the temporomandibular joint in 42 patients. In 33 cases reconstruction followed tumour resection of the mandible, almost advanced squamous cell carcinomas of the retromolar region. Primary reconstruction was made by an alloplastic condylar prosthesis combined with a plate for mandibular reconstruction. 2 years after first treatment secondary reconstruction followed by transplantation of a free iliac bone graft. In some cases a new condylus was formed using autogenous rib graft or allogenous cartilage. Result was adequate and painless oral aperture. For reconstruction after ankylosis, arthrosis or arthritis we use a autogenous costochondral graft. 9 patients received such treatment. In 5 or 9 cases with severe ankylosis we prefer a two-time-approach: after resection of the ankylosis we first fix an alloplastic implant (Palacos) at the skull base for distraction of the scar. Two or three years later we do secondary reconstruction with a costochondral graft. The final result strongly depends on functional postoperative treatment and the compliance of the patient.

Adolescent↗
PubMed1994

[Functional dynamic bridging plate and its use in the mandible].

The principle of the functionally dynamic bridging plate can be compared with the construction of a double bridge. The first bridge, which performs a protective function, is established by means of a plate which extends from one stump of the mandible to the other. The homogeneous, square-sectioned, central bar of the plate tolerates micromovements when stressed and demonstrates no predetermined breaking points. The second bridge ist established with the aid of the primary or secondary bone transplants, which are fixed to each other separately and to the stumps of the mandible with supplementary gracile implants. An adequate degree of functional stress on the bone transplant, i.e. the transmission of functional dynamical forces, is essential for the remodelling of the bone and must extend from one resected stump to the other. The choice of a square cross-section for the functionally dynamic bridging plate bar simplifies the three-dimensional bending and shaping of the plate on a template or the bone, thereby stressing the plate material uniformly and protecting it accordingly. This considerably facilitates the intraoral fixation of the plate. The functionally dynamic bridging plate system has proved successful in cases of partial mandibular resections, after tumour resections or in cases of defects following traumas and inflammations. It is suitable for cases with or without immediate bone reconstruction. It can be placed on the buccal side of the mandible, the caudal side or a combination of both. Positioning bone transplants can thus be carried out by a direct approach without obstruction and is consequently technically simpler.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Alloplastic implants. Their role in reconstruction of the mandible.

This article discusses the use of osseointegrated implants in mandibular reconstruction. Although the article presents the history, indications, and complications of this technique, the primary focus of the article is the technique itself, especially how the technique varies from patients not undergoing reconstruction to those who are. The effect of radiation therapy on the treatment planning of patients undergoing reconstruction also is discussed. Intraoral soft-tissue management also is addressed, as this area often differs significantly in patients undergoing radiation therapy from that in patients not undergoing radiation therapy and reconstruction.

Adult↗
PubMed1995

Osseointegration and nerve transposition after mandibular resection to treat an ameloblastoma: a case report.

This case report demonstrates the use of osseointegrated implants to replace the mandibular left second premolar and first and second molars removed during a surgical resection of a walnut-sized ameloblastoma. The first-stage surgery was performed 2 years after the oncologic surgery, and it was necessary to laterally reposition the inferior alveolar nerve prior to placement of implants. The patient has been restored to full dental function. There was no occurrence of paresthesia at any time. The treatment plan and the treatment were a collaboration of an oral surgeon, a periodontist, and a restorative dentist, located in Sweden, the United States, and Italy, respectively, and is an indication of what can be accomplished to the benefit of the patient when teamwork is exercised.

Adolescent↗
PubMed1996

[New endoprostheses for the condylar process of Russian manufacture].

Experience gained in repair of the mandibular condylar processes with titanium endoprostheses in 6 patients (8 endoprostheses) is presented. The defects were due to improperly healing fractures, ankylosis of the temporomandibular processes, and cancer. Two variants of endoprostheses differing by the fixing device are proposed. One variant is intended for replacement of defects of the condylar process only, the other permits the use of various titanium constructions to replace bone tissue defects in the branch, angle, and body of the jaw after its resection. Good immediate and late results (followed up for up to 14 months) demonstrate the efficacy of the proposed method.

Adult↗
PubMed1995

Mental nerve dysfunction: a symptom of diverse mandibular disease.

Paraesthesia and anaesthesia of the mental nerve may result from a variety of pathological conditions, and in persistent cases of orofacial sensory disturbance thorough clinical assessment, including CT scanning, is vital to exclude underlying systemic or neoplastic disease. This paper presents three patients with right mental nerve dysfunction, and reviews the aetiology of mental nerve paraesthesia and anaesthesia.

Adult↗
PubMed1996

[The use of titanium plates and endoprostheses for the mandibular condyles in reconstructive surgery of the mandible].

Potentialities of titanium plates and endoprostheses of the condyle processes in replacement of the postoperative defects of mandibular bone tissue are discussed. A recently developed Russian kit of titanium plates and instruments and specificities of plasty to repair bone defects using this kit are described. The results of surgical repair in 5 patients subjected to resection of the mandible with exarticulation for tumors or osteomyelitis aftereffects were good: the oval of the face and mandibular function were repaired.

Adult↗
PubMed1997

[A clinical x-ray analysis of the results of using titanium mandibular endoprostheses].

Late results of repair surgery are analyzed in 40 patients with segmented mandibular defects of different origin. Titanium constructions were used for repair of defects in 21 patients and in 19 others combined endoprostheses were used, consisting of the crest of the patient's iliac bone and a titanium carcass. Check-ups 1.5-2 years after repair showed a higher reliability of combined endoprostheses.

Adolescent↗
PubMed1998

Implants in mandibular resection.

This clinical report presents a method of satisfactorily restoring a patient with a Class V mandibular defect. Conventional restoration of this patient would have consisted of a soft tissue-supported prosthesis with its inherent instability and associated problems. The use of implants has provided stability and function unobtainable with conventional prosthesis for this patient.

Bone Transplantation↗
PubMed1998

Primary reconstruction of mandible in head and neck cancer with silastic implant--a review of 69 cases.

Different methods of primary mandibular reconstruction carried out at the Tata Memorial Cancer Hospital range from the pectoralis major myocutaneous or osteomyocutaneous composite flap, which is the most frequently performed procedure, to a free vascularised composite tissue transfer with microvascular anastomosis, including, iliac crest free vascularised bone grafts or radial artery forearm flap free vascularised radius bone grafts, free vascularised fibular bone grafts and silastic mandibular implants. The clinical results of immediate mandibular reconstruction with a silastic mandibular implant (SMI) in 69 patients is presented. Out of the 69 cases, 2 patients died in the early post-operative period. Twenty (30%) SMI were retained for a period of 1 year to 5 years. Forty seven (70%) SMI were retained for a period of less than 1 year. These implants have been used in a variety of cases, with or without major flap reconstruction, where a skeletal support was indicated, especially after mandibular arch resection. The results of this series indicates the importance of these implants as a short term spacer, even in advanced, fungating lesions of head and neck cancer where the risk of infection, haematoma and salivary leak is very high. Bone replacements were undertaken at a later date in suitable cases. The effects of preoperative chemotherapy and radiotherapy on the retention of these implants has also been studied.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Experimental bone metastasis model of the oral and maxillofacial region.

Metastasis of the oral and maxillofacial region frequently causes serious morbidity. Despite the importance of the clinical problem, little is known about the pathophysiological mechanisms of this metastatic process. Therefore, we examined whether the intracardiac injection of human breast cancer cells reproductively leads to jaw metastases developing an adequate experimental model. Human breast cancer MDA-MB-231 (MDA-231) cells (1 x 10(5)) were injected into the left heart ventricle of 4-week-old, female nude mice. Jaw metastases were examined radiographically and histologically 4 weeks after the cancer cell inoculation. At this time, the nude mice showed a marked body weight loss and cachexia. Osteolytic bone metastases were commonly observed in limbs, vertebral bone, pelvis and scapulae. In maxillofacial bones, breast cancer cells metastasized in 11 of 12 nude mice (91.7%). The lesions were radiographically determined at the mandible (11/12), maxilla (8/12) and zygomatic arch (2/12). Metastasis frequently occurred at the molar and angle regions of the mandible and at the palatal suture as well as around the root of the incisal teeth of the maxilla respectively. Histological examination revealed that numerous osteoclasts were present along the trabecular bone surfaces with aggressive bone resorption. This experimental model may be useful not only for the investigation of the mechanism of jaw metastasis formation but also for the screening of potential therapeutic agents for osteolytic bone metastasis.

Animals↗