Microvascular free tissue transfer has been one of the greatest milestones in reconstruction of the mandible and maxilla after tumor ablative surgery. Although fibula free flap reconstruction allows for immediate bony reconstruction, dental rehabilitation usually requires 6 to 12 months before it is completed. This can have a serious psychological impact on patients because they go without teeth during this timeframe. The "jaw-in-a-day" procedure was previously described by a group at New York University Medical Center. It allowed for tumor removal and full jaw reconstruction and dental rehabilitation in 1 surgery. This report describes 3 patients treated with this novel technique and adds to the 4 cases previously reported in the literature. To their knowledge, the authors are the second group to report on this technique. A series of photographs and videos are referenced in this article to illustrate the different steps used in this procedure.
Although measurement of maximum voluntary biting force is an important indicator of health of the masticatory system, few commercially available transducers have been validated for routine clinical use. The T-Scan III system records distribution of relative forces around the tooth row during clenching, but not absolute forces. This study assesses the reliability of T-Scan sensors with and without protection materials and develops calibration curves that allow measurement of absolute forces with the T-Scan III.
Although it is well known that conventional denture wearers have lower maximum bite forces than dentate subjects, no previous studies have compared the strength of the jaw muscles between these two groups. This study compared maximum bite forces, electromyographic (EMG) activity and estimated jaw muscle strength among three groups: (i) 17 edentulous subjects using newly acquired implant-retained overdentures (seven men, 10 women; mean age 60.3 +/- 13.0 years); (ii) 10 age-matched, fully dentate subjects (five men, five women; mean age 57.9 +/- 11.0 years); and (iii) 39 young, fully dentate subjects (19 men, 20 women; mean age 24.4 +/- 3.5 years). Electromyographic activity was recorded from subjects' bilateral superficial masseter and anterior temporalis muscles while they generated maximum voluntary bite forces at the right central incisor, right first premolar and right first molar positions. Jaw muscle strength was estimated as the ratio of average EMG activity for all four muscles to the maximum bite force. At all three bite positions, edentulous subjects produced maximum bite forces that were less than half that of dentate subjects. Edentulous subjects also produced significantly less EMG activity and had significantly lower estimated jaw muscle strength. Our results suggest that weakened jaw muscles are one factor contributing to lower maximum bite forces among users of conventional dentures.
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