A simple technique for repositioning of the mandible by a surgical guide prepared using a three-dimensional model after segmental mandibulectomy.
10.1186/s40902-017-0113-5
- Author:
Akinori FUNAYAMA
1
;
Taku KOJIMA
;
Michiko YOSHIZAWA
;
Toshihiko MIKAMI
;
Shohei KANEMARU
;
Kanae NIIMI
;
Yohei ODA
;
Yusuke KATO
;
Tadaharu KOBAYASHI
Author Information
1. Department of Tissue Regeneration and Reconstruction, Division of Reconstructive Surgery for Oral and Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-Dori, Cyuo-ku, Niigata, 951-8514 Japan. funayama@dent.niigata-u.ac.jp
- Publication Type:Original Article
- Keywords:
Segmental mandibulectomy;
Repositioning of the condylar head;
Surgical device;
Autopolymer resin;
Mandibular reconstruction
- MeSH:
Hand;
Head;
Mandible*;
Mandibular Osteotomy*;
Mandibular Reconstruction
- From:Maxillofacial Plastic and Reconstructive Surgery
2017;39(6):16-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Mandibular reconstruction is performed after segmental mandibulectomy, and precise repositioning of the condylar head in the temporomandibular fossa is essential for maintaining preoperative occlusion. METHODS: In cases without involvement of soft tissue around the mandibular bone, the autopolymer resin in a soft state is pressed against the lower border of the mandible and buccal and lingual sides of the 3D model on the excised side. After hardening, it is shaved with a carbide bar to make the proximal and distal parts parallel to the resected surface in order to determine the direction of mandibular resection. On the other hand, in cases that require resection of soft tissue around the mandible such as cases of a malignant tumor, right and left mandibular rami of the 3D model are connected with the autopolymer resin to keep the preoperative position between proximal and distal segments before surgical simulation. The device is made to fit the lower border of the anterior mandible and the posterior border of the mandibular ramus. The device has a U-shaped handle so that adaptation of the device will not interfere with the soft tissue to be removed and has holes to be fixed on the mandible with screws. RESULTS: We successfully performed the planned accurate segmental mandibulectomy and the precise repositioning of the condylar head by the device. CONCLUSIONS: The present technique and device that we developed proved to be simple and useful for restoring the preoperative condylar head positioning in the temporomandibular fossa and the precise resection of the mandible.
