• Title/Summary/Keyword: maxillary defect

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A Case of Maxillary Carcinoma Recontruction with a Fibular Osteocutaneous Free Flap (비골 골-피부 유리 피판을 이용한 상악동 암종 재건 1례)

  • Sun, Dong-Il;Kim, Min-Sik;Kwon, Yong-Jae;Cho, Seung-Ho
    • Korean Journal of Bronchoesophagology
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    • v.6 no.1
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    • pp.118-126
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    • 2000
  • A radical maxillectomy causes a defect of the alveolar bone, gingiva, palate, and orbital floor and causes cosmetical problems and masticatory and phonatory functions. Defect after a radical maxillectomy was reconstructed with skin or dermis graft was introduced, but recently wide resection of the tumor and functional reconstruction with free flap was introduced by several methods. The defect due to radical maxillectomy was reconstructed with scapula, iliac crest, radius. But reconstruction with a fibular osteocutaneous free flap was rarely introduced to defect of radical maxillectomy. The fibular osteocutaneous free flap was firstly introduced by Taylor. The fibular osteocutaneous free flap has several advantages. We experienced the first case of radical maxillectomy and reconstruction with the fibular osteocutaneous free flap, so we reported that case with literatures. The patient has a right maxillary sinus squamous carcinoma (T2N0M0), and performed a radical maxillectomy with right supraomohyoid neck dissection, and reconstruction with fibular osteocutaneous free flap. Donor site morbidity was little, and phonatory and masticatory function were nearly normalized. And cosmetical result was very acceptable.

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Orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft

  • Baek, Seung-Hak;Park, Yoon-Hee;Chung, Jee Hyeok;Kim, Sukwha;Choi, Jin-Young
    • The korean journal of orthodontics
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    • v.48 no.2
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    • pp.113-124
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    • 2018
  • The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important.

Reconstruction of Large Orbital Floor Defect Caused by Maxillary Sinus Mucocele

  • Pyo, Seung Bum;Song, Jin Kyung;Ju, Hong Sil;Lim, Seong Yoon
    • Archives of Craniofacial Surgery
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    • v.18 no.3
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    • pp.197-201
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    • 2017
  • Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately $2.5{\times}3.3cm$. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.

Ridge augmentation and implant placement on maxillary anterior area with deficient alveolar ridge : case report (상악전치부 결손부에서 골유도재생술식을 동반한 임플란트 수복의 증례보고)

  • Hong, Eun-jin;Goh, Mi-Seon;Jung, Yang-Hun;Yun, Jeong-Ho
    • The Journal of the Korean dental association
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    • v.57 no.3
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    • pp.149-160
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    • 2019
  • Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.

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Management of apicomarginal defect in esthetic region associated with a tooth with anomalies

  • Meharwade, Vinayak Venkoosa;Shah, Dipali Yogesh;Mali, Pradyna Prabhakar;Meharwade, Vidya Vinayak
    • Restorative Dentistry and Endodontics
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    • v.40 no.4
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    • pp.314-321
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    • 2015
  • Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.

Removable prosthetic rehabilitation in patient with maxillofacial defects caused by gunshot: A case report (총상으로 인한 악안면 결손을 가진 환자에 대한 가철성 보철물 수복증례)

  • Lee, Donggyu;Kang, Jeongkyung
    • 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.

ANALYSIS OF PROSTHODONTIC AND SURGICAL TREATMENT OF ACQUIRED PALATAL DEFECT AFTER MAXILLECTOMY (상악절제술 후 외과적 재건과 보철적 치료의 비교)

  • Kwon, Ho-Beom;Hong, Jong-Rak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.143-151
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    • 2007
  • One of the treatment methods for maxillary cancers or infections in maxilla is maxillectomy. Palatal defect can be resulted from this operation and it may cause functional problems with swallowing and speech, and psychological problems of patients. After maxillectomy, as rehabilitation, there can be two options. One is a prosthodontic treatment using obturator and the other is surgical reconstruction of defect with graft. As both methods have advantages and disadvantages, in determining treatment method after maxillectomy, various factors have to be considered. The purpose of this study is to compare the prosthodontic group to surgical group after maxillectomy with elapsed days prior to commencement of postoperative oral feeding, and to analyze the results of prosthodontic treatment and surgical treatment. During the period from March of 2000 to June of 2006, 74 patients were treatment by prosthodontic methods for maxillary defect. Among these patients, patients who had only velopharyngeal deficiency after surgery, whose data were incomplete, whose causes of palatal defect were not the treatment of diseases in maxilla, and who already had palatal defect due to previous surgery were excluded in this study. The patients who underwent maxillectomy for the treatment of diseases in the maxilla and were treated immediately after operation using surgical reconstruction or prosthodontic rehabilitation were included in this study. The records of 43 patients were reviewed to compare and to analyze the prosthodontic treatment and surgical reconstruction after maxillectomy. The median of days elapsed prior to commencement of postoperative oral feeding in the prosthodontic group was compared with data of surgical group. The data was analyzed using the Mann-Whitney test (${\alpha}$=.05). Days elapsed prior to postoperative oral feeding commencement in the prosthodontic group were less than those in the surgical group.

A CASE REPORT OF ORBITAL FLOOR RECONSTRUCTION WITH TEMPORAL MUSCLE-CORONOID PROCESS FLAP (측두근-오훼돌기 피판을 이용한 안와저의 재건 예)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Choi, Jae-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.1
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    • pp.1-6
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    • 1993
  • The maxillary squamous cell carcinoma is major part of maxillary malignant tumor. The treatment of maxillary malignancy tumor is the maxillectomy in combination with radiation therapy and chemorherapy. When tumor invasion is occured to the orbit, orbital exenteration is required. But if the periosteum of the orbital floor is intact, the orbit can be preserved. There are many orbital floor reconstruction materials for the prevention of ptosis of the orbital content. The patients on this paper were diagnosised as squamous cell carcinoma on maxilla, we performed the partial maxillectomy including the orbital floor, and we used temporalis muscle-coronoid process flap for the reconstruction of the orbital floor after partial maxillectomy and obtained good esthetic and functional results, as followed. 1. We obtained sufficient flap width for defect of orbital floor. 2. It permits good blood supply and no necessary other donor site. 3. It gives a solid base for the support the globe and the orbital floor. 4. It gives minimal postoperative morphorogical defect and functional disturbance.

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Reconstruction of alveolar bone defect in bilateral cleft lip and palate using bifocal distraction-compression osteosynthesis (양측성 구순구개열 환자의 치조골 결손부의 재건치료를 위한 distraction-compression osteosynthesis)

  • Lee Jin-Kyung;Baek Seung-Hak;Lee Jong-Ho
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.1
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    • pp.47-61
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    • 2004
  • The closure of a wide alveolar cleft and fistula in cleft patients and the reconstruction of a maxillary dentoalveolar defect in bilateral cleft lip and palate (BCLP) patients are challenging for both orthodontists and oromaxillofacial surgeons. It is due to the difficulty in achieving complete closure by using local attached gingiva (palatal flap) and the great volume of bone required for the graft. In this article, the authors used bifocal distraction-compression osteosynthesis(BDCO) to create a segment of new alveolar bone and attached gingiva for the complete approximation of a wide alveolar cleft/fistula and the reconstruction of a maxillary dentoalveolar defect. Since the alveoli and gingivae on both ends of the cleft were approximated after BDCO, the need for extensive alveolar bone grafting was eliminated. It also could create new alveolar bone and gingiva for orthodontic tooth movement and implant.

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A RADIOGRAPHIC STUDY OF EXPERIMENTALLY PRODUCED BONE DEFECTS IN THE POSTERIOR WALL OF THE MAXILLARY SINUS (상악동 후벽의 실험적 골결손부에 관한 방사선학적 연구)

  • Choi Eui-Hwan;Park Won-Kyl
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.26 no.2
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    • pp.153-163
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    • 1996
  • The purpose of this study was to evaluate the ability of radiographs in detecting experimental bony defect in the posterior wall of the maxillary sinus. For this study, experimentally five skulls were used, the bony defects with a diameter of 5mm were created at different locations in the posterior wall of the right maxillary sinus and the bony defects of 10mm were created at different locations in the posterior wall of th maxillary sinus. Panoramic view, panoramic sinus view, water's view, and computed tomogram were taken and the results analyzed. The obtanined results were as follows: 1. The panoramic view was superior to the panoramic sinus view in detecting the bony defects in the posterior wall of the maxillary sinus. 2. Panoramic view, panoramic sinus view, and waters's view were limitation to the detection of the bony defects in the posterior wall of the maillary sinus. 3. All the bony defects in the posterior wall of the maxillary sinus were excellently visualized on the computed tomogram.

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