1/33. Non-free osteoplasty of the mandible in maxillofacial gunshot wounds: mandibular reconstruction by compression-osteodistraction.We have treated 33 young men with medium to large (3-8 cm) bony and soft tissue defects of the lower third of the face caused by gunshot wounds. After debridement, collapsing the proximal segments for primary approximation of soft and hard tissues and a closed osteotomy of a small fragment of mandible, we used an original compression-distraction device, designed in 1982 and tested during 1983 (analogous devices were absent at that time) to reposition the mandible and cause callus to form (during distraction) between the fragment and to use the remaining stumps of bone to fill in the defect. The soft tissues were repaired at the same time. Twenty-eight of the patients presented within a few hours of injury, and the remaining five had old injuries. The only complications were in the group with old injuries where four patients developed abscesses that required drainage, but these did not interfere with the process of osteogenesis. All 33 patients had good functional and aesthetic results within 3-4.5 months. The method allows a bloodless minimally traumatic procedure which can be carried out in one stage. The results compare very favourably with the classic methods of the treatment of mandibular gunshot injuries.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/33. Implantation-type epidermoid cyst of the mandible.The documented cases of epidermoid implantation cysts affecting the oral tissues are reviewed. A unique case involving the ramus of the mandible is presented.- - - - - - - - - - ranking = 0.83333333333333keywords = mandible (Clic here for more details about this article) |
3/33. Vertical distraction of a free vascularized fibula flap in a reconstructed hemimandible: case report.The authors report a case of vertical distraction osteogenesis of a free revascularized fibula flap used to reconstruct an hemimandible lost as a result of a gunshot injury. The reconstruction procedure and the distraction protocol are described; clinical and radiological results are presented. The vertical discrepancy between the fibula and the native right hemimandible was corrected.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
4/33. Parotid salivary fistula secondary to external pin fixation: case report.Although the use of rigid fixation techniques has become widespread for the treatment of mandible fractures, indications still remain for the utilization of biphasic external pin fixation in patients who suffer cranio-maxillofacial trauma. The treatment of continuity defects of the mandible secondary to avulsive injuries or ablative surgery is a primary indication for the utilization of biphasic external pin fixation. The placement of biphasic external pins requires an understanding of the surgical anatomy surrounding the mandible. In this article, the authors discuss the indications for, contraindications for, and complications associated with the use of biphasic external pin fixation, describe the procedure, and present a case report of a patient with parotid salivary fistula secondary to the placement of external pin fixation.- - - - - - - - - - ranking = 0.5keywords = mandible (Clic here for more details about this article) |
5/33. Facial reconstruction using a combined flap of the subscapular axis simultaneously including separate medial and lateral scapular vascularized bone grafts.With the better understanding of the blood supply to the scapula, combined flaps of the lateral scapula along with the latissimus dorsi and/or serratus anterior are well known. The medial border of the scapula, in this respect, has been underused. The authors present a case report in which a conjoined combined free flap consisting of four free tissue transfers based on the subscapular axis was used in simultaneous reconstruction of a gunshot wound to the face. This included a medial scapular osteofasciocutaneous flap for the mandible, a lateral scapular osseous flap for the anterior maxilla, a serratus anterior muscle flap for the cheek, and a separate latissimus dorsi musculocutaneous flap for the forehead. This flap was successful and provides another alternative to the resolution of complex problems needing multiple areas of both soft-tissue coverage and vascularized bone graft.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
6/33. Continuous mandibular nerve block for pain relief. A report of two cases.PURPOSE: mandibular nerve block allows surgery to be performed on the mandible. However, pain in the postoperative period needs to be treated with opioids or non-steroidal anti-inflammatory agents which have undesirable side effects. We examine the feasibility of continuous mandibular nerve block with 0.25% bupivacaine top-ups using a catheter for intraoperative and postoperative pain relief in two patients with a fracture of the mandible. methods: Using the lateral extraoral approach, the mandibular nerve was approached with an 18-gauge indwelling iv cannula in two patients undergoing repair of a fractured mandible under general anesthesia. After removing the needle, an 18-gauge epidural catheter was inserted into the cannula which was then removed. The catheter was tunnelled subcutaneously to emerge at the lateral aspect of the forehead. Two to 4 mL bupivacaine 0.25% were injected on a 12-hr basis and the catheter was kept in place for seven days. RESULTS: Both patients had excellent pain relief and no parenteral or oral analgesics were required throughout the postoperative period. No side effects were noted. CONCLUSIONS: Continuous mandibular nerve block with 2-4 mL 0.25% bupivacaine top-ups injected twice a day through a catheter provides excellent pain relief in patients with a fracture of the mandible. This method may have implications for the management of pain of other etiology in the mandibular region.- - - - - - - - - - ranking = 0.66666666666667keywords = mandible (Clic here for more details about this article) |
7/33. ITI implants and Dolder bars in the treatment of large traumatic defect of mandible: a clinical report.The development of more sophisticated implant techniques to produce satisfying results improves the precise planning of both the surgical phase of the implantation and the following prosthetic rehabilitation. Ball and bar attachments are the main retainer systems for implant-bearing overdentures to achieve a successful treatment in the partial or full edentulism. In this clinical report, a 23-year-old male patient, presented with a large traumatic defect in the anterior mandible, was treated with ITI implant and ITI Dolder bar combinations. The reason to prefer this kind of treatment depends on the highest retention capacity and cleaning facilities of the system.- - - - - - - - - - ranking = 0.83333333333333keywords = mandible (Clic here for more details about this article) |
8/33. The vascularized fibular flap for mandibular reconstruction.Vascularized fibular bone grafts have advantages over other bone grafts in the restoration of the contour and function of defective mandibles. The fibular graft can be tailored to fit even major mandibular defects; in combination with preformed temporomandibular joint prostheses total mandibular reconstruction can be performed in a single procedure. The fibular transplant is considered ideal for the insertion of implants to support dental suprastructures to obtain maximal oral rehabilitation. We have used fibular grafts in eight cases for primary or secondary reconstruction of a variety of mandibular defects resulting from cancer, chronic osteomyelitis or gunshot injuries. The results have been most encouraging with respect to function and cosmetic appearance. There have been no transplant failures and minimal donor site complications.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
9/33. Single osteotomized iliac crest free flap in anterior mandible reconstruction.While the iliac crest flap provides a natural contour for the lateral segment of the mandible, for the anterior segment en bloc, the use of the iliac graft, even harvested in a V shape, fails to yield a three-dimensional natural-shaped reconstruction. In this report, we present our experience with reconstruction of the anterior segment of the mandible using a single osteotomized free iliac crest flap in 5 patients. The study comprised 4 male patients and 1 female patient, their ages ranging between 34-82 years. In all patients, composite iliac osteomusculocutaneous flaps were harvested based on the deep circumflex iliac artery in the standard manner, and the bony segment of the flap was divided into two segments, performing a single osteotomy. The fixation of bone segments was performed in new positions, sliding the segments in different planes to provide the original shape of the resected mandible segment, and in a manner appropriate to the defect. The overall flap success rate was 100%. In no cases were wound infections or hematomas observed. x-rays showed bone healing without resorption. In conclusion, the use of a single osteotomy for an iliac crest flap in the reconstruction of the anterior segment of the mandible is a simple and safe procedure, and provides a natural and acceptable jaw appearance. The risk of devascularization is quite low when compared with the multiple osteotomy procedure, and it does not need to be fixed with complex devices such as reconstruction plates or external fixators.- - - - - - - - - - ranking = 1.3342428286759keywords = mandible, jaw (Clic here for more details about this article) |
10/33. Vertical distraction of fibula transplant in a case of mandibular defect caused by shotgun injury.This case demonstrates the successful aesthetic and functional reconstruction of a complex facial gun-shot injury with extended bone defects and soft tissue destructions using a 3-step procedure. Initially, a reconstruction plate was inserted, later a fibula transplant enabled the basic reconstruction and finally was distructed in a 3rd session. The rationale behind the sequencing of surgical sessions was the extended bony defect and soft-tissue destruction. The main problem in this type of wound is hypoxia or anoxia of the receptor bed for the transplant. A microvascular anastomosized bone transplant is necessary for sufficient oxygen tension in the recipient site. The anatomical dimensional disproportion of the transplanted free fibula graft and the shape of the mandible were corrected prior to the insertion of dental implants by means of vertical distraction.- - - - - - - - - - ranking = 0.16666666666667keywords = mandible (Clic here for more details about this article) |
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