At present, mandibular defect repair and reconstruction is not only a simple sense of mandibular continuity restoration, but also a restoration of the physiologically positional relationship and movement balance of the upper and lower jaws. Eventually, the implantation of osseointegrated dental implants and implant-supported dental restoration should be accomplished to complete the reconstruction of the functional mandible. The technique can integrate multiple procedures such as fibular bone grafting, simultaneous dental implants and traction osteogenesis, and the perfect integration with digital technology can significantly improve the accuracy of digital dental implant traction technique. This paper will summarize and conclude the key points of the application of digital dental implant traction technique in mandibular defect reconstruction, in order to provide new ideas for the development of digital technique.
Humans ; Mandibular Reconstruction ; Dental Implants ; Dental Implantation, Endosseous/methods* ; Mandibular Neoplasms/surgery* ; Fibula/transplantation* ; Bone Transplantation/methods* ; Mandible/surgery*

Objective: To analyse the quality of life of patients receiving repair of bone defect with folded fibula flap after removal of mandibular ameloblastoma. Methods: The case data of 39 patients with ameloblastoma admitted to the First Affiliated Hospital of Zhengzhou University from August 2013 to April 2016 were retrospectively analysed, including 21 males and 18 females, from 18 to 58 years old. 3D printing and digital technology were used in flap preparation before surgery in all patients. The folded fibular flaps were used to repair mandibular defects and the implants were placed between 6-9 months after surgery. The short form-36 health survey questionnaire (SF-36) and the university of Washington quality of life questionnaire (UW-QOL) were applied to evaluate the quality of life of patients before surgery and at 6 months and 24 months after surgery. The higher the score, the better the condition. SPSS 20.0 was adopted for statistical analysis. Results: The SF-36 survey showed that the mean score of body role before surgery (72.4±11.7) was significantly higher than that at 6 months after surgery (39.6±11.1, t=23.580, P<0.05) or that at 24 months after surgery (59.8±6.4, t=8.358, P<0.001). Compared with the preoperative mean scores of Physical Pain (73.0±11.0), General Health (73.4±10.4) and Health Changes (79.2±3.9) before surgery, the mean scores Physical Pain (53.1±7.7), General Health (53.5±7.5) and Health Changes (63.9±11.7) at 6 months after surgery were decreased significantly respectively (t=13.068, 13.756 and 10.880, respectively, all P<0.05), but the mean scores Physical Pain (78.8±14.0), General Health (80.9±12.6) and Health Changes (84.4±4.6) at 24 months after surgery were increased significantly respectively (t=-2.904, -4.027 and -7.586, respectively, all P<0.05), with significant differences in the mean scores of Physical Pain, General Health and Health Changes between 6 and 24 months after surgery (t=-14.241, -16.490, -14.294, respectively, all P<0.001). The UW-QOL survey showed that the mean scores of chewing, language and taste functions decreased at 6 months after surgery (53.1±6.7, 53.0±7.7 and 62.2±9.9, respectively), but improved at 24 months after surgery (67.9±3.9, 63.9±2.9 and 68.4±11.1, respectively), with statistically significant difference (t=-16.765, -11.675 and 2.498, respectively, all P<0.001). Conclusion: The application of folded fibula flaps to repair bone defects after sugery of mandibular ameloblastoma can better meet the needs of language and chewing functions and improve the quality of life of patients.
Adolescent ; Adult ; Ameloblastoma/surgery* ; Bone Transplantation ; Female ; Fibula/surgery* ; Free Tissue Flaps ; Humans ; Male ; Mandible/surgery* ; Mandibular Neoplasms/surgery* ; Middle Aged ; Quality of Life ; Reconstructive Surgical Procedures ; Retrospective Studies ; Young Adult

BACKGROUND: Free fibular flap is one of the most useful methods in the hard tissue reconstruction of the maxilla-mandible. Free fibular flap presents some advantages in which the reconstruction of both soft and hard tissues can be done at the same time. It also provides a safe and successful bone graft for the reconstruction, along with a low rate of complications. Despite these advantages and the rarity of a postoperative complication, particularly in oral and maxillofacial surgery procedures, a prolonged operation might exhibit some complications related with rhabdomyolysis. We experienced the rare event of rhabdomyolysis after oral cancer surgery. CASE PRESENTATION: In this article, we report the case of a patient who developed rhabdomyolysis after undergoing free fibular flap surgery. CONCLUSIONS: Despite the advantages of the free fibular flap operation, clinicians must be aware of the risk of complications because there are multiple factors that could result in rhabdomyolysis, such as duration of operation, position of the subject, and pre-existing conditions of diabetes and hypertension. Once the diagnosis of rhabdomyolysis is confirmed, a prompt treatment plan should be made and applied as soon as possible. This will increase the chance of a full recovery for the patient who is exhibiting symptoms of rhabdomyolysis.
Diagnosis ; Humans ; Hypertension ; Mandibular Reconstruction ; Mouth Neoplasms ; Postoperative Complications ; Preexisting Condition Coverage ; Renal Insufficiency ; Rhabdomyolysis ; Surgery, Oral ; Transplants

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.
Aged ; Carcinoma, Squamous Cell ; Computer Simulation* ; Female ; Free Tissue Flaps ; Head and Neck Neoplasms ; Humans ; Mandible ; Mandibular Nerve ; Mandibular Reconstruction* ; Osteotomy* ; Surgery, Plastic

PURPOSE: To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center. MATERIALS AND METHODS: During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step osteotomy with thin saw blade and osteotome after plate-precontouring and combination fixation with monocortical osteosynthesis (miniplate) and bicortical osteosynthesis (maxiplate and bicortical screws), with at least 14 months postoperative follow-up, were selected and reviewed retrospectively. RESULTS: There were 8 women and 22 men with an average age of 56.5 years. All the patients involved malignancies were squamous cell carcinoma. The main primary sites of the those who underwent a mandibulotomy were the tonsil, the base of tongue, the oral tongue, the retromolar pad area, and others. Others included buccal cheek, floor of mouth, and soft palate. 23 patients received postoperative radiation therapy, and among whom 8 patients also received chemotherapy. Total four (13%) mandibulotomy-related complications occurred, only two (6.7%) requiring additional operation under general anesthesia. CONCLUSION: Our modified mandibulotomy meets the criteria for an ideal mandibulotomy technique relatively well because it requires no intermaxillary fixation, can precise preserve the occlusion in a precise way, allows early function, requires no secondary procedures, and has few complications.
Adult ; Aged ; Female ; Humans ; Male ; Mandible/*surgery ; Mandibular Osteotomy/adverse effects/*methods/standards ; Middle Aged ; Oropharyngeal Neoplasms/*surgery ; Postoperative Complications/*prevention & control ; Retrospective Studies

Adamantinoma ; pathology ; Carcinoma, Mucoepidermoid ; diagnostic imaging ; drug therapy ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Male ; Mandibular Neoplasms ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Tomography, X-Ray Computed

Unusual presentation of localized gingival enlargement associated with a subjacent tumoural pathology is reported. The patient was a 55-year-old black male, whose chief complaint was a progressive gingival overgrowth for more than ten years, in the buccal area of the anterior left mandible. According to the clinical features and the radiological diagnosis of odontogenic keratocyst, a conservative surgery with enucleation and curettage was performed. Tissue submitted for histopathological analysis rendered the diagnosis of odontogenic myxoma. After 12-month of follow-up, no evidence of recurrence was found. Clinicians should be cautious when facing any gingival enlargement to avoid diagnostic pitfalls and to indicate the appropriate treatment.
Diagnosis, Differential ; Gingival Overgrowth ; etiology ; pathology ; Humans ; Male ; Mandibular Neoplasms ; complications ; pathology ; surgery ; Middle Aged ; Myxoma ; complications ; pathology ; surgery ; Odontogenic Tumors ; complications ; pathology ; surgery

Computer-Aided Design ; Humans ; Mandibular Fractures ; diagnostic imaging ; surgery ; Mandibular Neoplasms ; diagnostic imaging ; surgery ; Mandibular Reconstruction ; methods ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed

OBJECTIVECondylectomy was performed to treat condylar osteoma or hyperplasia. Introduced two methods of condylectomy via intraoral approach and evaluated their clinical results.

METHODSThirty-five patients, aging from 22 to 57.21 years, were treated by condylectomy via intraoral approach, of which 21 were condyle osteoma, 14 hemimandibular hyperplasia and condylar hyperplasia. Intraoral vertical ramus osteotomy (IVRO) were used in 32 patients and intraoral condylectomy via coronoid process resection was used in 3 patients.

RESULTSThe treatment results including oral function and facial symmetry after the operation were good in all patients. The temporomandibular joint (TMJ) dysfunction syndrome alleviated or disappeared. The follow-up period was 6 months to 3 years, and no relapse of condylar osteoma or hyperplasia was found. The patients who had IVRO and TMJ reconstruction had some degree of transplanted bone resorption, and one patients had relapse of facial deformity. But the patients who had intraoral condylectomy via coronoid process resection only had mild condyle remodeling and no obvious bone resorption was noted.

CONCLUSIONSThe two methods of intraoral condylectomy introduced in this stugy can successfully correct the facial deformity and TMJ dysfunction caused by condylar osteoma or hyperplasia. But the surgeons need to have excellent surgical skills and careful selection of the indications.

Adult ; Facial Asymmetry ; surgery ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Male ; Mandible ; diagnostic imaging ; pathology ; surgery ; Mandibular Condyle ; diagnostic imaging ; pathology ; surgery ; Mandibular Neoplasms ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Oral Surgical Procedures ; methods ; Osteoma ; diagnostic imaging ; pathology ; surgery ; Temporomandibular Joint ; physiology ; surgery ; Temporomandibular Joint Disorders ; surgery ; Tomography, X-Ray Computed ; Young Adult

Ameloblastoma is a benign odontogenic tumor with an aggressive biological behavior, and the surgical treatment frequently results in failure for the postoperative recurrence. The aim of this article was to investigate whether the proliferative ability and prognosis of ameloblastoma could be evaluated by the radiographic boundary. The ameloblastoma cases treated by the conservative therapy in our hospital between 1981 and 2001 were divided into three groups based on the nature of the radiographic borders of the lesions. The biologic behavior was evaluated by Ki-67 antibody immunohistochemically. Comparisons of prognosis and Ki-67 expression were carried out by statistic methods. There were 24 cases of well-defined edge with sclerosis (group I), 41 cases of well-defined edge without sclerosis (group II) and 32 cases of ill-defined edge (group III). The recurrent rates were 29.2% in group I, 43.9% in group II and 62.5% in group III (P<0.05). The cells in group III expressed the highest Ki-67 level (P<0.05). The radiographic boundary could be used as one of indicators in evaluating the proliferative ability of ameloblastoma and the patient's prognosis, which was consistent with Ki-67 expression.
Adult ; Ameloblastoma ; diagnostic imaging ; pathology ; surgery ; Cell Proliferation ; Chi-Square Distribution ; Female ; Humans ; Ki-67 Antigen ; analysis ; Male ; Mandibular Neoplasms ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Observer Variation ; Prognosis ; Radiography, Panoramic ; Retrospective Studies ; Young Adult