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Tran KL, Yang DH, Wang E, Ham JI, Wong A, Panchal M, Dial HS, Durham JS, Prisman E. Dental implantability of mandibular reconstructions: Comparing freehand surgery with virtual surgical planning. Oral Oncol 2023; 140:106396. [PMID: 37068411 DOI: 10.1016/j.oraloncology.2023.106396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Khanh Linh Tran
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - David H Yang
- Faculty of Dentistry, University of British Columbia, 2151, Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Edward Wang
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Jennifer Inseon Ham
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Angela Wong
- Faculty of Dentistry, University of British Columbia, 2151, Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Maharshi Panchal
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Harkaran Singh Dial
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - James Scott Durham
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Eitan Prisman
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
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Pediatric Mandible Reconstruction: Controversies and Considerations. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3285. [PMID: 33425597 PMCID: PMC7787291 DOI: 10.1097/gox.0000000000003285] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022]
Abstract
Mandibular reconstruction in pediatric patients has some unique considerations. The method of reconstruction has to factor in the growth potential of the neo-mandible, the native mandible, and the donor site. The condyle is considered the main growth center of the mandible. Current literature indicates that fibula, iliac crest, and scapula osseous flaps do not have the ability to grow. Costochondral grafts exhibit growth because of the costal cartilage component, although the growth is unpredictable. Preservation of the mandibular periosteum can result in spontaneous bone regeneration. Fibula bone harvest in a child mandates close follow-up till skeletal maturity, to monitor for ankle instability and valgus deformity. Dental rehabilitation maintains occlusal relationships, which promotes normal maxillary development. Elective hardware removal should be considered to facilitate future dental implant placement and possible revision procedures. After completion of growth, if occlusion or symmetry is not satisfactory, secondary procedures can be performed, including distraction osteogenesis, orthognathic-type bone sliding operations, and segmental ostectomy.
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Onlay bone augmentation and bilateral open sinus lifting with simultaneous implant placement in a cherubic patient. J Craniofac Surg 2015; 25:e193-6. [PMID: 24621770 DOI: 10.1097/scs.0000000000000433] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A 20-year-old edentulous woman, who was previously treated with the shave of the inferior border of the mandible and malar prominent region for aesthetic facial contouring, was selected for full mouth rehabilitation of the maxillomandibular region. The patient was treated with bilateral open sinus lifting through a lateral approach in the posterior of the maxilla and an onlay bone graft with lateral ramus as a donor site in the mandible anterior. Eight implants in the maxilla and 7 in the mandible were inserted, and implant-supported prostheses were fabricated. The 18-month follow-up showed good bone condition that suggests graft interventions and implant treatment as a good treatment modality for patients with cherubism.
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Assessment of functional improvement with implant-supported prosthetic rehabilitation after mandibular reconstruction with a microvascular free fibula flap: A study of 25 patients. J Prosthet Dent 2015; 113:140-5. [DOI: 10.1016/j.prosdent.2014.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 08/25/2014] [Accepted: 08/25/2014] [Indexed: 11/22/2022]
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Carbiner R, Jerjes W, Shakib K, Giannoudis PV, Hopper C. Analysis of the compatibility of dental implant systems in fibula free flap reconstruction. HEAD & NECK ONCOLOGY 2012; 4:37. [PMID: 22721258 PMCID: PMC3448503 DOI: 10.1186/1758-3284-4-37] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 06/07/2012] [Indexed: 12/02/2022]
Abstract
As a result of major ablative surgery, head and neck oncology patients can be left with significant defects in the orofacial region. The resultant defect raises the need for advanced reconstruction techniques. The reconstruction in this region is aimed at restoring function and facial contour. The use of vascularised free flaps has revolutionised the reconstruction in the head and neck. Advances in reconstruction techniques have resulted in continuous improvement of oral rehabilitation. For example, endosteal implants are being used to restore the masticatory function by the way of prosthetic replacement of the dentition. Implant rehabilitation usually leads to improved facial appearance, function, restoration of speech and mastication. Suitable dental implant placement’s site requires satisfactory width, height and quality of bone. Reconstruction of hard tissue defects therefore will need to be tailored to meet the needs for implant placement. The aim of this feasibility study was to assess the compatibility of five standard commercially available dental implant systems (Biomet 3i, Nobel Biocare, Astra tech, Straumann and Ankylos) for placement into vascularised fibula graft during the reconstruction of oromandibular region. Radiographs (2D) of the lower extremities from 142 patients in the archives of the Department of Radiology in University College London Hospitals (UCLH) were analysed in this study. These radiographs were from 61 females and 81 males. Additionally, 60 unsexed dry fibular bones, 30 right sided, acquired from the collection of the Department of Anatomy, University College London (UCL) were also measured to account for the 3D factor. In the right fibula (dry bone), 90% of the samples measured had a width of 13.1 mm. While in the left fibula (dry bone), 90% of the samples measured had a width of 13.3 mm. Fibulas measured on radiographs had a width of 14.3 mm in 90% of the samples. The length ranges of the dental implants used in this study were: 7-13 mm (Biomet 3i), 10-13 mm (Nobel biocare), 8-13 mm (Astra Tech), 8-12 mm (Straumann ) and 8-11 mm (Ankylos). This study reached a conclusion that the width of fibula is sufficient for placement of most frequently used dental implants for oral rehabilitation after mandibular reconstructive procedures.
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Affiliation(s)
- Ramin Carbiner
- Head and Neck Centre, University College London Hospitals, London, UK
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Bidra AS, Hofstede TM, Skoracki RJ, Jacob RF. Maxillofacial rehabilitation of a 7-year-old boy with osteosarcoma of the mandible using a free fibula flap and implant-supported prosthesis: A clinical report. J Prosthet Dent 2009; 102:348-53. [DOI: 10.1016/s0022-3913(09)60190-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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