• Title/Summary/Keyword: Mandibular defect

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Parotid mandibular bone defect: A case report emphasizing imaging features in plain radiographs and magnetic resonance imaging

  • Hisatomi, Miki;Munhoz, Luciana;Asaumi, Junichi;Arita, Emiko Saito
    • Imaging Science in Dentistry
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    • v.47 no.4
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    • pp.269-273
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    • 2017
  • Mandibular bone depression, also known as Stafne bone cavity, is defined as a bone depression filled mainly with salivary gland tissue. Parotid gland bone defects are infrequently observed. We report the case of a 52-year-old male patient who underwent radiographic examinations due to temporomandibular joint dysfunction, and a radiolucent area was detected in the mandibular ramus, with a provisional diagnosis of traumatic bone cyst or parotid mandibular bone defect. The patient was then referred for magnetic resonance imaging, which demonstrated a hyperintense area eroding the mandibular ramus, which corresponded to glandular tissue. Although the defect was a benign lesion, radiolucencies in the mandibular ramus lead to concerns among professionals, because their radiographic features can resemble various intrabony neoplastic lesions, such as giant cell tumors or benign tumors of the parotid gland.

Developmental salivary gland defect : Literatures review and case analysis of 12 cases (발육성 타액선 골 결손의 문헌 고찰 및 증례 분석)

  • Kim Hak-Kyun;Kim Jin-Soo;Kim Jae-Duk
    • Imaging Science in Dentistry
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    • v.36 no.2
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    • pp.81-88
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    • 2006
  • Purpose : To review developmental salivary gland defect based on 12 reported cases and literature, and to guide radiographic diagnosis of this entity. Materials and Methods : The 12 cases of developmental salivary gland defect of Chosun University Dental Hospital in the last 4 years were analyzed and compared with previous reported cases. Result : 11 of the 12 cases were found in men, indicating a very strong male predilection. The peak age was in the 6th decade. These defects were situated just above or at the inferior border of mandible between the first molar and the mandibular angle, and always Inferior to the mandibular canal. Only one case was superimposed with the mandibular canal, 6 cases were superimposed with the inferior border of the mandible. Conclusion : Characteristically, these defects had a special radiographic features such as ovoid shaped well-defined radiolucency located just above or at the inferior border of the mandible between the first molar and the mandibular angle, and always inferior to the mandibular canal. The recognition of these radiographic features were diagnostically valuable.

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THE CLINICAL STUDY OF THE MAXILLOFACIAL WAR INJURIES IN KOREAN (한국인 전상환자의 악안면결손에 대한 임상적연구)

  • Choi, Kyu-Hwan;Min, Seung-Ki;Um, In-Woong;Kim, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.4
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    • pp.275-282
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    • 1992
  • Maxillofacial war injures is specific representative of severe hard and soft tissue defect. This type of injuries were different from the trauma because it may be fatal. The purpose of this study was to evaluate the injury type base on the retrograde medical record in the 104 patients from Feb. 1991 to Aug. 1992 in Korea Veterans Hospital. The obtained results were as follows. 1. Among 104 cases, 51 cases(49.0%) were classified as mandibular defects only, and 53 cases (51.0%) were classified as maxillary with mandibular defect (combined). 2. The etiologic factors of injury were gunshot, artillery and grenade or shell: 33 cases, 14cases, and 10 cases respectively in Korea War, 19 cases, 5 cases, and 8 cases respectively in Vietnam War. 3. In 57 cases of mandibular partial defect, the angle area showed the highest frequencies, 18 cases(31.6%). 4. In 42 cases of mandibular segmental defect, the area between the 1st molar and the ascending ramus showed the highest frequencies. 17 cases(40.4%), and almost all cases were unilateral defect (40 cases, 95.0%) 5. Reconstruction method performed for segmental mandibular defect were wire or plate(15 cases, 35.7%) and soft tissue closure only(12 cases, 28.7%), respectively.

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Reconstruction of Mandible Defect after Tumor Ablation Surgery : Versatility of Fibular Free Flap Design (광범위 종양절제술 후 발생한 하악 결손의 재건 : 결손부위에 따른 비골 유리 피판의 다양한 디자인)

  • Seul Chul-Hwan;Lee Young-Dae;Tark Kwan-Chul;Lew Dae-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.190-195
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    • 2005
  • Background and Objectives: Fibula is the flap of choice for reconstruction of wide mandible defects after tumor ablation surgery. In mandible reconstruction, restoring the mandible frame to provide mandibular contour and dental arch while restoring masticatory function are important. Even though vascularized fibula can be osteotomized freely, proper design and flap insetting is not easy because of its three dimensional structure and difference in design according to the defect sites. We reviewed patients who underwent mandible reconstruction with fibular flaps according to the defect sites and suggest proper modification methods of fibular flap according to the various defects sites after tumor ablation surgery. Materials and Methods: Twelve consecutive mandible reconstruction with fibular free flaps were performed for defects after tumor ablation surgery. Patients were classified into 4 groups according to the type of mandibular defect(Group 1 : defect on central segment including symphysis, Group 2 : defect on lateral segment(with or without central segment) confined to body, Group 3 : defect on body and ascending ramus that does not include the condyle, Group 4 : defect including the condyle). Results: We suggest different modification methods of fibular free flap for each patient group. Group 1, 3 ; contour by using multiple closing wedge osteotomy. Group 2 ; single or double barrel reconstruction without wedge osteotomy. Group 4 ; contour using single or multiple wedge osteotomy and condylar reconstruction with costochondral graft. Conclusion: Fibular free flaps can be contoured to any desired shape after multiple osteotomies to restore various mandibular defects. It is a reliable and versatile method for reconstruction of mandibular defects after tumor ablation surgery.

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.

Fibular Free Flap Mandibular Reconstruction (유리 비골 전이술을 이용한 하악골 재건술)

  • Oh, Myung-Rok;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.28-34
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    • 1999
  • The need for reconstruction of large bone, soft tissue defect of mandible has greater emphasis due to development of industry, traumatic accident and increase of tumor. The mandibular reconstruction had greatly progressed through the first and the second World Wars. The Fibular free flap by using microscope was reported in 1970 and many maxillofacial reconstructive surgeons had used. In 1988, Dr. Hidalgo first reported mandibular reconstruction by using fibular free flap. Mandibular reconstruction by using fibular free flap has several advantages. First, it provides up to 25 cm of bone, enough to reconstruct any length of mandible defect. Second, a skin island, based on a septocutaneous blood supply, is available in a size large enough to simultaneously reconstruct internal and external soft tissue defect. Third, The fibular donor site morbidity is low, fourth, it provides a esthetic effect of mandible line. And finally bone viability is good. The Fibular osteocutaneous free flap was performed after COMMANDO operation due to squamous cell cancer in oral cavity (15 cases). Therefore we report out successful operation of the mandible reconstruction by using fibular osteocutaneous free flap.

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The effect of fixation plate use on bone healing during the reconstruction of mandibular defects

  • Hong, Khang Do Gia;Kim, Seong-Gon;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.5
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    • pp.276-284
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    • 2019
  • Objectives: This study sought to compare efficiency results between the use of a customized implant (CI) and a reconstruction plate (RP) in mandibular defect reconstruction in an animal model. Materials and Methods: Fifteen rabbits underwent surgery to create a defect in the right side of the mandible and were randomly divided into two groups. For reconstruction of the mandibular defect, the RP group (n=5) received five-hole mini-plates without bone grafting and the CI group (n=10) received fabricated CIs based on the cone-beam computed tomography (CBCT) data taken preoperatively. The CI group was further divided into two subgroups depending on the time of CBCT performance preoperatively, as follows: a six-week CI (6WCI) group (n=5) and a one-week CI (1WCI) group (n=5). Daily food intake amount (DFIA) was measured to assess the recovery rate. Radiographic images were acquired to evaluate screw quantity. CBCT and histological examination were performed in the CI subgroup after sacrifice. Results: The 1WCI group showed the highest value in peak average recovery rate and the fastest average recovery rate. In terms of reaching a 50% recovery rate, the 1WCI group required the least number of days as compared with the other groups ($2.6{\pm}1.3days$), while the RP group required the least number of days to reach an 80% recovery rate ($7.8{\pm}2.2days$). The 1WCI group showed the highest percentage of intact screws (94.3%). New bone formation was observed in the CI group during histological examination. Conclusion: Rabbits with mandibular defects treated with CI showed higher and faster recovery rates and more favorable screw status as compared with those treated with a five-hole mini-plate without bone graft.

Investigation of a pre-clinical mandibular bone notch defect model in miniature pigs: clinical computed tomography, micro-computed tomography, and histological evaluation

  • Carlisle, Patricia L.;Guda, Teja;Silliman, David T.;Lien, Wen;Hale, Robert G.;Baer, Pamela R. Brown
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.20-30
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    • 2016
  • Objectives: To validate a critical-size mandibular bone defect model in miniature pigs. Materials and Methods: Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks. Results: In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the autograft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect. Conclusion: The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.

Reconstruction plates used in the surgery for mandibular discontinuity defect

  • Seol, Guk-Jin;Jeon, Eun-Gyu;Lee, Jong-Sung;Choi, So-Young;Kim, Jin-Wook;Kwon, Tae-Geon;Paeng, Jun-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.266-271
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    • 2014
  • Objectives: The purpose of this study was to analyze the survival rate of reconstruction plates that were used to correct mandibular discontinuity defects. Materials and Methods: We analyzed clinical and radiological data of 36 patients. Only discontinuous mandibular defect cases were included in the study. Reconstruction plate survival rate was analyzed according to age, gender, location of defect, defect size, and whether the patient underwent a bone graft procedure, coronoidectomy, and/or postoperative radiation therapy (RT). Results: Plate-related complications developed in 8 patients, 7 of which underwent plate removal. No significant differences were found in plate survival rate according to age, gender, location of defect, defect size, or whether a bone graft procedure was performed. However, there were differences in the plate survival rate that depended on whether the patient underwent coronoidectomy or postoperative RT. In the early stages ($9.25{\pm}5.10months$), plate fracture was the most common complication, but in the later stages ($35.75{\pm}17.00months$), screw loosening was the most common complication. Conclusion: It is important to establish the time-related risk of complications such as plate fracture or screw loosening. Coronoidectomy should be considered in most cases to prevent complications. Postoperative RT can affect the survival rate and hazard rate after a reconstruction plate is fitted.

Mandibularl Reconstruction with Various Methods Including Iliac and Fibular Osteocutaneous free Flaps (유리 피판술을 포함한 다양한 방법의 하악골의 재건술)

  • Kim, In Chul;Minn, Kyoung Won;Kim, Chin Whan;Park, Chul Gyoo;Lee, Yoonho;Kim, Suk Wha;Kwon, Sung Tack;Kim, Ji Hyuk;Lee, Min Goo
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.6-14
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    • 2000
  • Reconstruction of the composite mandibular defect resulting from ablative resection of tumor involved jaw has been challenging task to the plastic surgeon. A wide variety of different techniques were used with limited success until the advent of microsurgery. The high success rate of microsurgical procedures has allowed for significant improvement in both functional and aesthetic results. A variety of free flap donor sites have been used successfully for mandibular reconstruction. Between April of 1991 and August of 1998, 20 mandibular reconstructions were performed for oncologic defects. 4 patients underwent mandibular reconstruction with pectoralis major flap, 3 patients with free nonvascularized bone graft, 1 patient with metal plate. 12 patients underwent microvascular mandibular reconstruction(8: fibula, 4: ilium). The type of free flap was determined by the requirements of the defect. Satisfactory aesthetic and functional results were achieved in all cases without significant complications. So microvascular mandibular reconstruction should be considered as primary choice in all mandibular defect without hesitation.

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