1/11. Midface distraction.Since the initial application of distraction osteogenesis to the human mandible by McCarthy, distraction osteogenesis has been used for gradual lengthening of the midface in children with syndromic craniosynostosis, cleft lip and palate, hemifacial microsomia, and midface hypoplasia from other causes. Both external and internal devices are available that permit midface distraction. The background of midface distraction and the development of a Modular Internal Distraction (MID) system that permits widespread use of easily customized, buried distraction devices throughout the craniofacial region are presented. The relative and potential clinical indications for distraction, treatment planning, patient preparation, and possible surgical orthodontic interactions during distraction, as well as a variety of case examples showing the MID system, are discussed.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/11. Release of extra-articular ankylosis by coronoidectomy and insertion of a free abdominal flap: case report.INTRODUCTION: It is generally agreed that an effective treatment for extra-articular ankylosis may be coronoidectomy and excision of scar tissue. But these conventional procedures have shown a high rate of recurrence of ankylosis due to heterotopic bone and fibrous tissue formation. OBJECTIVE AND PATIENT: We report a case in whom a coronoid osteotomy and insertion of a free abdominal flap was used to treat ankylosis of the mandible following radiotherapy for maxillary cancer. RESULTS: This procedure prevented recurrence of ankylosis by heterotopic bone and fibrous tissue formation. In addition, this flap reduced the risk of postoperative infection and promoted primary healing. CONCLUSION: The procedure, coronoidectomy and insertion of a free flap, was successful because the well-vascularized musculocutaneous flap occupied the dead space, and replaced the shortage of oral mucosa consequently inhibiting the recurrence of extra-articular ankylosis.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
3/11. Ultrasound features of osteosarcoma of the mandible--a first report.Ultrasound imaging is becoming widely used in the head and neck region as a first-line investigation to assess soft tissue swellings. Clinicians should be aware of the potential of diagnostic ultrasound to identify important signs of malignant disease involving bone.Involvement of the mandible by osteosarcoma is uncommon. A young adult patient presented with facial swelling and an apparently infected lower third molar extraction socket. Subtle signs were missed on dental radiographs. Diagnostic ultrasound investigation was pivotal in identifying sinister signs: namely, soft tissue mass associated with bone thinning, erosion, expansion, and the "sunray" appearance of the buccal cortex, which were suggestive of osteosarcoma. These findings enabled priority to be given to subsequent investigations using other modalities. We present a first report of the ultrasound features of osteosarcoma of the mandible and consider this to be a useful modality in an initial investigation.- - - - - - - - - - ranking = 6keywords = mandible (Clic here for more details about this article) |
4/11. A case of rupture of the internal jugular vein caused by postoperative infection of functional neck dissection.A 68-year old diabetic man with gingival cancer of the lower jaw underwent resection of the mandible and functional neck dissection. Swabs of a postoperative wound infection revealed methicillin-resistant staphylococcus aureus (MRSA). The wound was irrigated, and antibiotics administered. The pathogens isolated were sensitive to the antibiotics used, but the infection failed to respond to treatment. Bleeding ensued on the 14th postoperative day (#14POD), when the wound was opened to reveal thrombosis and rupture of the right internal jugular vein. The patient's condition improved after ligation and surgical debridement of the right internal jugular vein. Our experience underlines the importance of early radiological investigation for possible thrombus formation in the internal jugular vein in cases of postoperative wound infection follows functional neck dissection with conservation of the internal jugular vein. It is also important to actively treat this condition surgically, including ligation of internal jugular vein for suppressing inflammation.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
5/11. Use of an orthopaedic fixator for external fixation of the mandible.A patient presented with a chronically infected, non-united fracture of the mandible, with considerable bone loss. He was treated with a metacarpal fixator, the miniPennig external fixator. The fixator is stable and smaller than conventional mandibular fixators. It can be applied and removed under local anaesthesia, if necessary, requires little maintenance and produces minimal scarring. The successful outcome in this patient is encouraging and we commend the use of the fixator in similar difficult cases.- - - - - - - - - - ranking = 5keywords = mandible (Clic here for more details about this article) |
6/11. Chronic submasseteric abscess: anatomic, radiologic, and pathologic features.Herein we present five cases of submasseteric abscess that most commonly occurred in patients with a history dental disease. CT has been the main imaging method for diagnosing lesions in the masticator space and adjacent to the mandible; however, we found that, in some of our cases, CT defined the lesion poorly or not at all. In some cases, MR imaging defined the lesion better. Radiologic manifestations of this condition and pathologic correlations are discussed.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
7/11. Microvascular free tissue transfer for treatment of osteoradionecrosis of the maxilla.head and neck tumors often require radiotherapy as part of the treatment protocol. Although it improves the survival rate in cancer patients, it may cause osteoradionecrosis, especially in the mandible and maxilla. Twelve patients with osteoradionecrosis of the maxilla were treated with microsurgical free tissue transplantations between April of 1996 and August of 2002. There were 10 male and two female patients, with a mean age of 60.2 years. The mean radiotherapy dose was 6674 cGy. The radiation dose could not be traced in three patients because radiotherapy was performed elsewhere. Radical sequestrectomy, soft-tissue debridement, and pathologic proof of no tumor recurrence were performed before microsurgical reconstruction. Free flaps used included the following: anterolateral thigh (n = 7), radial forearm (n = 2), rectus femoris musculocutaneous (n = 2), and supracondylar chimeric (n = 1) flaps. All flaps survived completely and reconstruction succeeded. During a mean 25-month follow-up period, ectropion, plate exposure, and mild infection were encountered in three patients and treated successfully. Radical debridement and obliteration of dead space with well-vascularized tissue are essential for successful treatment of maxillary osteoradionecrosis. The anterolateral thigh flap is most versatile for almost all types of soft-tissue defect reconstruction in the head and neck region.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
8/11. actinomycosis complicating fibula flap mandible reconstruction: a report of two cases.Two patients undergoing fibula flap mandible reconstruction developed chronic intraoral wounds and salivary fistulae. After initial attempts at salvage, tissue biopsies demonstrated actinomycosis infection. With antibiotic treatment and debridement, one reconstruction was salvaged while one was lost. actinomycosis infection should be considered a possible agent in chronic wounds complicating mandible reconstructions with microsurgical flaps.- - - - - - - - - - ranking = 6keywords = mandible (Clic here for more details about this article) |
9/11. Early loading of interforaminal implants immediately installed after extraction of teeth presenting endodontic and periodontal lesions.BACKGROUND: Infection in tooth extraction sites has traditionally been considered an indication to postpone implant insertion until the infection has been resolved. PURPOSE: The aim of this study was to evaluate the survival rate of early-loaded implants placed immediately after extraction of teeth with endodontic and periodontal lesions in the mandible. MATERIALS AND methods: Twenty patients in need of mandibular implant treatment and with teeth showing signs of infection in the interforaminal area were included in the study. The patients received four to six implants (Branemark System, Nobel Biocare AB, Goteborg, sweden) in or close to the fresh extraction sockets and received a provisional prosthesis within 3 days. Final prostheses were delivered after 3 to 12 months. The surgical protocol paid special attention to the preservation of high implant stability and control of the inflammatory response. The patients were followed up for 15 to 44 months. RESULTS: No implants were lost, resulting in a 100% survival rate. A mean marginal bone loss of 0.7 mm (SD 1.2 mm) was registered during the observation period. No signs of infection around the implants were detected at any follow-up visit. CONCLUSION: A high survival rate can be achieved for immediately placed and early-loaded implants in the mandible despite the presence of infection at the extracted teeth.- - - - - - - - - - ranking = 2keywords = mandible (Clic here for more details about this article) |
10/11. osteoradionecrosis of sphenoid and temporal bones in a patient with maxillary sinus carcinoma: a case report.A case of radionecrosis of sphenoid and temporal bones is reported. The patient received a combination of surgery, radiotherapy, and chemotherapy for his left maxillary sinus carcinoma. After the combined therapy, necrosis accompanying inflammation developed in the maxillary and temporal regions. Excision of the necrotic tissues was done, and the left ascending ramus of the mandible was resected because of persistent tumor mass at the left infratemporal fossa. Although the excision wound of the maxilla healed by epithelialization, an area of nonvital bone remained exposed in the temporal region, where progressive osteonecrosis with infection led to breakdown of the skin. The necrotic bones of the zygomatic arch and the sphenotemporal sutural region became visible through the skin defect, and computerized tomography scan revealed bone necrosis involving the inferolateral area and the base of the skull. Excision of the necrotic bone and reconstruction with sternocleidomastoid myocutaneous flap were performed.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
| | Next -> |