Sassi's leveling instrument: A novel device to maximize the tridimensional symmetry in maxilla bone reconstructive surgery (original) (raw)
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Journal of Plastic, Reconstructive & Aesthetic Surgery, 2014
Ameloblastoma is a locally aggressive and disfiguring oral cavity tumour and surgical management is the mainstay of treatment. The ideal management of ameloblastoma should minimise recurrence, restore function and appearance and present minimal donor site morbidity. Conservative management is associated with minimal downtime but high recurrence rates. By contrast, segmental mandibulectomy with appropriate margins have much lower recurrence rates but presents the challenge of reconstruction. Osseointegrated (OI) implants and permanent dental prosthesis, while ideal, are not always available. We conducted a retrospective review on 30 consecutive patients at our centre with unicystic and multicystic ameloblastoma who were treated with segmental mandibular resection and free fibula flap reconstruction. Only three patients underwent OI implant insertion, with 40% of the patients not receiving any form of dental rehabilitation. We performed a functional and aesthetic outcome survey to determine patient satisfaction with this form of treatment. At an average follow-up of 5 years, there were no recurrences of tumour in our population. Of the 26 patients who responded to the survey, 96% of the patients reported that they were satisfied with their appearance, 88% reported an absolutely normal diet and 93% of the patients reported no problems with donor site function. Overall, we found that low uptake of dental rehabilitation did not adversely affect patient satisfaction and outcomes.
ABSTACT Ameloblastoma is benign but locally invasive odontogenic tumor. More than eighty percent of cases of ameloblastoma occur in mandible. A substantial number of the patients of ameloblastoma present when the tumor has significantly grown in size resulting in severe malocclusion, facial asymmetry and pathological fractures of the jaw. There are several types of amelablastomas but the correct diagnosis can be easily made with the help of plain x-rays and tissue biopsy. The standard management of amelobastoma is marginal resection but some times a large tumor requires complete resection of affected part of mandible. This results in a large defect causing significant facial disfigurement. The case presented here involves a young lady with the chief complaint of facial asymmetry and inability to chew the food. A diagnosis of unicysticameloblastoma was made on biopsy and resection of mandible was carried out. The mandibular reconstruction was carried out in the same surgery with non-...
Mandibular ameloblastoma treated by bone resection and imediate reconstruction Summary
2006
Mul ticystic ameloblastoma mainly affects adult patients between the third and seventh decades of life, frequently in the posterior region of the mandible. The resection of a mandible segment without adequate reconstruction produces serious esthetic and functional sequelae leading to a loss of quality of life. The objective of this study is to show that multidisciplinary treatment of ameloblastomas helps in total lesion excision associated with complete reconstruction of the damaged area. We present a 47-year-old male patient with an ameloblastoma in the posterior mandible who was treated with complete resection of a mandibular segment. Reconstruction, carried out during the same surgical procedure, was performed using an iliac crest bone graft fixed with titanium plates and screws. Rehabilitation was completed eight months later with teeth implants in the grafted area. The advantages of this procedure include recurrence risk reduction due to segmental resection, reliable mandibular reconstruction and less surgical procedures, allowing full rehabilitation within a shorter period of time.
Indian Journal of Dental Advancements
Reconstruction following mandibular resection is still very challenging for prosthodontist. Mandible defects could be the consequence of ablative surgery for malignancies, huge jaw cysts, infection and trauma. In patients with oral cancers such as ameloblastoma, the correct planning of surgery for the tumor resection as well as prosthetic rehabilitation are crucial. Resection of the mandible may compromise orofacial function and often lead to patients' psychological disorders. Despite very frequent use of microvascular flaps, autogenous bone grafts are still very reliable technique for mandible reconstruction. Comprehensive therapy means not only mandible reconstruction, but prosthodontic rehabilitation supported by dental implants, which can significantly improve patients' quality of life. The aim of this paper was to present a patient who had been submitted to mandible resection and reconstruction with autogenous iliac bone graft and subsequent prosthodontic rehabilitation with segmental implant supported overdenture anchoraged by ball-socket implants.
Implant-supported rehabilitation of a patient with mandibular ameloblastoma
Annali di stomatologia, 2012
this report describes the masticatory implant- supported rehabilitation of a patient undergoing resection for mandibular ameloblastoma. in the reported case the patient underwent resection and reconstruction with a fibula flap for masticatory rehabilitation of 7 implants at the level of the mandible. ameloblastoma is a benign locally invasive tumor of maxillary bones that often causes facial disfigurement. The dental management of the patient requires a collaboration of various specialists such as anesthetists, maxillofacial surgeons, and dentists. in patients with oral cancers such as ameloblastoma, the correct planning of surgery for the tumor resection as well as prosthetic rehabilitation are crucial. Osseointegrated implants open a new perspective of treatment to improve the quality of life of patients resected for cancer.
Maxillary ameloblastomas are rare odontogenic tumours. This case report describes a patient who presented with an ameloblastoma in the maxillary molar region. In this case, bone surrounding tooth 28 was removed together with the tooth itself and the cystic mass to perform an augmentation at 11 for subsequent implant placement. Histological examination of the mass revealed it to be an ameloblastoma. This called for an extensive follow-up resection at tooth 28 and removal of the augmentation material at 11.
Journal of Gazi University Health Sciences Institute
Ameloblastomas are locally invasive and benign odontogenic tumors with a high long-term recurrence rate. These lesions can cause serious anomalies in the facial area and alveolar bones, leading deformity and deterioration of functions. Wide local excision and reconstruction are required for the surgical treatment of these tumors. Aggressive resection effectively eliminates tumors; however, this approach may cause various problems that need reconstruction to restore the oral functions. In the present case report, the rehabilitation of surgically reconstructed partially edentulous mandible with iliac crest graft after ameloblastoma resection with an implant-supported “Toronto Prosthesis” is presented. In the surgical procedure, mandible was partially resected and simultaneous iliac bone graft was applied. Then, four dental implants were inserted into the reconstructed bone and implant-supported Toronto prosthesis was fabricated. The patient was satisfied with the final result of the t...