• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.32.1-32.8
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• 2018

Background: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. Case presentation: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. Conclusions: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.584-587
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• 2014

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권1호
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• pp.43-50
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• 1994

It is a generally known fact that the patient can experience mouth opening limitation, mandibular deviation and malocclusion as a result of injury of tissues around the articular disc and complications even after successful open reduction surgery for fractured mandibular condyle. We have experienced a rare case of reconstruction using metallic condylar prostheses for a patient with complications resulted by unsuccessful management of fractured mandibular condyle. The case strongly suggested to us that careful selection of treatment methods should be taken for patient with fractured mandibular condyle. Accordingly, we are presenting a case in conjunction with reviews of fractured mandibular condyle.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권2호
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• pp.83-86
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• 2014

There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.466-472
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• 2012

The loss of mandibular continuity due to trauma, neoplasm, or infection results in major esthetic and biologic compromise. The reconstruction of the mandibular bone defect still poses a challenge to oral and maxillofacial surgeons. There have been a number of variety graft materials. Among them, free block bone graft with rigid fixation has been widely used. However, cases using free block bone grafts may lead to a marked invasion of the donor site, mal-union, and absorption of the block bone. In this respect, particulate cortical bone using a titanium mesh tray can be an effective alternative option in order to achieve a proper bone contour and good oral rehabilitation. We have developed an intraoral approach for the mandibular reconstruction method using a titanium mesh tray with autogenous particulate cortical bone graft.

• The Journal of Advanced Prosthodontics
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• 제9권6호
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• pp.470-475
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• 2017

PURPOSE. The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS. Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posterior-superior and lateral-superior direction. RESULTS. The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately $50^{\circ}$ posterior-superior and $41^{\circ}$ lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION. These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.231-233
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• 2002

Temporary reconstruction of the mandibular continuity defect resulting from the ablative tumor surgery with a reconstruction plate can be used for the preservation of normal facial contour and oral function and for periodic follow up of recurrence. Reconstruction plates are adapted to the bone before the resection and provisionally fixated with some screws. Accurate contouring and adaptation are very important for the prevention of displacement of bony stumps and decubituous skin ulcer. However, if there is large expanding buccal tumor mass in mandible, it is very difficult or even impossible to contour the plate before resection. I, therefore, introduce the reconstruction plate application technique using a simple condylar repositioning miniplate after segmental mandibular resection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.106-111
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• 1998

The aim of this article was to examine the usefulness of costochondral graft in the temporomandibular joint reconstruction. We performed costochondral grafting in the mandibular reconstruction including condyle replacement in 3 patients, which 2 of ankylosed cases and 1 destructed case. In one case, unexpected fracture of costochondral junction has developed at post-operative 2 months, but, normal mouth opening and facial appearance have been acheived by continuing exercise. These patients showed maximum mouth opening of 35-40 mm and no restriction of lateral side movement. They have been improved esthetics and function. We proposed that the costochondral graft is one of the useful method for functional reconstruction of defected mandibular condyle.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권5호
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• pp.349-356
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• 2012

Osteochondroma is one of the most common benign tumors that occur in the bone, but in the head and neck region, osteochondroma appears rarely. Malocclusion, temporomandiublar disorders and facial asymmetry can occur in most cases with osteochondroma of the mandibular condyle. Most surgeons prefer massive removal of osteochondroma and reconstruction of condyle, simultaneously, to prevent various complications, such as a lateral open bite on the contralateral side. We report a surgical treatment and reconstruction of osteochondroma on a mandibular condyle through intraoral approach.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권3호
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• pp.233-236
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• 2021

A mandibular continuity defect can be repaired using either a prosthetic device or autogenous bone. A titanium reconstruction plate can be used with a localized or vascularized flap over the defect of the mandible. Unfortunately, the plate may fail due to plate exposure, screw loosening, fracture, or infection, and will need to be removed. Plate exposure though the skin or mucosa is one of the main reasons for failure. In the present work, the authors introduced a lingually positioned reconstruction plate fabricated via three-dimensional printed bending support. This custom reconstruction plate can avoid plate re-exposure as well as reduce surgical errors and operation time.