• The Journal of Advanced Prosthodontics
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• v.4 no.4
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• pp.235-238
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• 2012

Facial prosthesis is generally considered over surgical reconstruction to restore function and appearance in patients with facial defects that resulted from cancer resection. Retention of the prosthesis is challenging due to its size and weight. Retention can be achieved by using medical grade adhesives, resilient attachments, clips and osseointegrated implants. It can also be connected to obturator by magnets. This clinical report highlights the rehabilitation of a lateral midfacial defect with a two piece prosthesis that included an extra oral facial prosthesis and an intraoral obturator with the use of magnets.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.218-225
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• 1993

This is a case report and review of literature that deals with hemifacial microsomia corrected by costochondral graft, Lefort I osteotomy and bilateral intraoral sagittal split ramus osteotomy. Patient, 23 years old female, had visited to treat the esthetic problem due to a deviation of jaw. On the basis of clinical and radiographic examinations, she was diagnosed as hemifacial microsomia. First, costochondral graft was performed to bridge the defect between glenoid fossa and body of mandible. After 11 months, Patient was performed a Lefort I osteotomy and bilateral intraoral sagittal split ramus osteotomy to create a symmetric jaw. Patient was satisfied with final esthetics and there have been no evidence of infection ill now.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.4
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• pp.353-358
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• 2008

Purpose: The purpose of this clinical retrospective study was to evaluate our experience of radial forearm free flap for reconstruction of the oral cavity. Material and methods: From 1997 to 2006, 50 radial forearm free flaps were employed for head and neck reconstruction in 50 patients at department of oral and maxillofacial surgery, Yonsei University, Korea. Data were obtained from chart review, and clinical follow-up. Results: Patients' age ranged from 26 to 82 years (mean 53.2). There were 39 men and 11 women. 43 of the 50(86%) patients had squamous cell carcinoma. The total flap survival were 47(94%), complication rate were revealed for 15(30%). Conclusion: In the reconstruction of soft tissue within the oral cavity, several free flaps have been used. Because of its constant anatomy, long pedicle allows a hypothetic vascular anastomosis in the contralateral neck, contourability for various type of oral defects, pliability and can be used simultaneous reconstruction in intraoral and extra oral defects, the radial forearm free flap constitutes one of the best choice of intraoral soft tissue reconstruction.

• The Journal of the Korean dental association
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• v.49 no.9
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• pp.520-526
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• 2011

Vascularized iliac crest flap include bone tissue of good quality and quantity for mandible segmental defect. Even if fibular flap can contain longer bone tissue, iliac crest has esthetic shape for mandible body reconstruction and large height for implant. Conventional vascularized iliac crest osteomyocutaneous flap is too bulky for reconstruction of intraoral soft tissue defect. But modified flap can reduce soft tissue volume, so is good for functional reconstruction of oral mucosa. It takes only one month for completely replace oral mucosa. The final mucosal texture is much better than other skin paddle flap, especially for implant prosthesis. Donor site morbidity of this method looks same level or less with other modalities functionally and socially. In case of oral mucosa-mandible combined defect, vascularized iliac crest with internal oblique muscle flap shows good outcomes for hard and soft tissue.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.3
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• pp.214-219
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• 1995

Free grafting of oral mucosa for minor oral reconstruction was first described by Propper in ridge extension surgery. Situation calling for mucosal grafting procedures may relate to periodontal surgery, minor and major preprosthetic surgery, implant surgery, reconstruction in deformity cases after trauma, congenital cleft, gross atrophy and ablative tumor surgery. In the cases of 9 patients with mucosal defect of intraoral or orbital cavity after wide excision of tumor, preprosthetic surgery, and orbitoplasty, full-thickness mucosal graft were used to close a large defect. Four patients received buccal mucosal graft for preprosthetic surgery or orbitoplasty, one patient had benign tumor and the others had malignant tumors located on the palate or upper alveolus. Buccal mucosal graft donor site morbidity and trismus were minimal and healing of surgical defect was satisfactory. So we present the case with review of literatures.

• The Journal of Advanced Prosthodontics
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• v.8 no.1
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• pp.70-74
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• 2016

In the maxillary anterior region, reconstruction of the localized alveolar ridge defect is very important in enhancing the esthetics of fixed partial denture. A 40-year-old female patient presented with a chief complaint of the inconvenience and unesthetic problem of 3-unit maxillary anterior prosthesis due to alveolar ridge resorption. After removal of old prosthesis, intraoral examination revealed moderate (buccolingually 4 mm) ridge deficiency in missing tooth region, leading to the diagnosis of Class I alveolar ridge defect. One of the reconstruction techniques to overcome this problem might be a technique that combines two types of soft tissue augmentation techniques. The purpose of this paper was to demonstrate the new combined technique of roll flap and combination onlay-interpositional graft utilized to acquire sufficient dimension of recipient area by one time of operation and to present the esthetic improvement of fixed partial denture by using this procedure in case of maxillary anterior localized ridge defect.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.198-204
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• 2017

Maxillofacial defect comes from congenital defect, trauma and surgical resection. Patients with intraoral defect are commonly related to maxillary defect and they need prosthetic rehabilitation. Functional reconstruction of partially edentulous mandible has many limitations. However, if both condyles are intact, maxillofacial prosthesis using partial denture give competent results. In this case, a patient of 58 year-old male has a defect on palate and left mandibular posterior teeth from gunshot. The maxillary defect of this patient is Class IV according to Aramany classification and the mandibular one is Type V according to Cantor and Curtis classification. For retention of the obturator, remaining teeth are fully utilized and artificial teeth are arranged harmoniously to provide stable occlusion. Mandibular RPD covered limited range of deformed soft tissue derived from mandibular resection surgery. With these treatments, the patient in this case showed improvements in mastication, swallowing and speech.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.254-261
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• 2000

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regenerated bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1994 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.161-163
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• 2005

In the reconstruction of the hard tissue defect of the oral cavity, the usefulness of the chin bone graft, one of the intraoral donor site, is gradually increased. The advantages include reduced resorption rate after graft due to its membranous bone nature, relatively ease to harvest under local anesthesia, reduced operative time because of the same operative field, decreased morbidity, and relatively large amount of bone can be harvested compared to other intraoral donor site. It has also postoperative complications including paresthesia of the lip or chin area, discomfort of lower anterior teeth, and facial swelling around chin area. Of these complications, facial swelling occurs more frequently, is more severe as a early postoperative discomfort, and prevents fast recover of patient's social activity since this procedure is generally accomplished in the outpatient base under local anesthesia. So we applied a modified " gull-wing" type incision to minimize this complication, and now we report this simple but effective surgical technique with clinically favorable result.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.527-537
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• 2007

To evaluate criteria, indications, and prognosis of the various reconstructive methods on the patients with intraoral soft tissue defect who had been treated at Dept. of Oral and Maxillofacial Surgery, Pusan National University Hospital from 2003 to 2005, we have reviewed the clinical data of the patients and analysed. The results were as follows: 1. Tongue flaps have been mainly applied on anterior portion of palate and maxilla. The survival rate was high percent, but the cooperation of patient was inevitable for the success. 2. Palatal mucosa rotational flaps were available on relative large defect on palate, oroantral fistula site. The side effect was a scaring band from secondary healing on denuded donor palate site. Sometimes the band came to be a hinderance to swallowing, phonation. 3. Forearm free flap was a workhorse flap for everywhere in intraoral defects. We had used the flap on cheek, floor of mouth, tongue without any significant complications. But the application of the flap was required for long operation time, which was disadvantageous to the old, weak patients. 4. Cervical platysmal flap could be easily applicable for buccal cheek, floor of mouth after excision of the cancer lesion. The design of the flap could be made simultaneously on neck dissection, but the danger of cancer remnants on the flap always might be remained. 5. Buccal fat pad pedicled flap must have been a primary flap for repair of oroantral fistula especially on posterior maxilla. The flap survival will be expected if the considerations for above reconstructive methods on site, size, condition of defects primarily could be made.