Alternative Approach in Mandibular Reconstruction for Benign Disease

Shetawi, Al Haitham Al; Fernandes, Rui

doi:10.1016/j.joms.2017.06.041

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…20 Segmental resection and reconstruction of ameloblastoma often performed via an extraoral approach, leaving a large transcervical scar, which has a significant psychological impact on patients' appearance. 21 Because of this disadvantage, the approach does not fulfill one of the important goals for adequate reconstruction as stated by Myers 22 "Secondary cosmetic deformities should be avoided unless no other alternative is satisfactory in the situation". To overcome this drawback, multiple investigators have reported their successful experience with the resection and reconstruction of mandibular ameloblastoma via the less invasive intraoral approach.…”

Section: Discussionmentioning

confidence: 99%

Three dimensional accuracy of mandibular reconstruction by pre-bent reconstruction plate using intra oral versus extra oral approaches following mandibular resection in patients with extensive ameloblastoma

Mohamed

2020

Egyptian Dental Journal

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Purpose: This prospective study aimed to compare the intraoral placement of the pre-bent reconstruction plate with that inserted via the extraoral approach, to evaluate their impact on the three-dimensional (3D) position of the proximal segment, after continuity resection of mandibular ameloblastoma.Patients and methods: Patients were divided into two equal groups. In group 1, the mandible was reconstructed with a pre-bent reconstruction plate via an intraoral approach. In group 2, an extraoral approach was used. The primary outcome variables were the need for intraoperative plate readjustment, the time needed for plate insertion, total operation time, difficulties encountered during surgery, and the postoperative stability of the proximal segment. Distances between corresponding anatomical landmarks on the mandibular angle and condyle (A-A`, B-B`, C-C`, B-C`) as well as the intercondylar angle (ICA) and B`XC angle, were measured. The difference between the pre-and postoperative measurements was used to evaluate the reconstruction accuracy. The results of the two groups were compared and analyzed by t-test.Results: Thirty patients were enrolled in this study. In group 1, four plates required minor readjustment. In group 2, only two cases required re-adaptation. The mean time for plate placement was 38 ± 5.8 and 27.5 ± 7.5 minutes in groups 1 and 2, respectively (p = 0.0001). The intraoral insertion of the pre-bent plates revealed a decrease in the linear measurements, resulting in mandibular compression. On contrary, the extraoral approach showed increase in the measurements, resulting in widening of the mandible. However, this width difference was statistically insignificant. Concerning the ICA and B`XC angle, no significant difference could be ascertained between the two groups. Conclusion:Intraoral approach is more conservative procedure, thereby achieving the best esthetic outcomes and resulting in a more accurate 3D mandibular reconstruction. This approach is considered the treatment of choice for resection and reconstruction of mandibular ameloblastoma. However, if the reconstruction plate cannot be inserted intraorally, then extraoral approach is advised.

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Section: Discussionmentioning

confidence: 99%

Three dimensional accuracy of mandibular reconstruction by pre-bent reconstruction plate using intra oral versus extra oral approaches following mandibular resection in patients with extensive ameloblastoma

Mohamed

2020

Egyptian Dental Journal

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“…Free online article at www.dtjournal.org Outcomes of total or near-total lip reconstruction with microvascular tissue transfer; Margin analysis: sarcoma of the head and neck; The cervicofacial flap in cheek reconstruction: a guide for flap design; Alternative approach in mandibular reconstruction for benign disease [3][4][5][6]. The list goes on.…”

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confidence: 99%

One of the Highest World Privileges

Fesenko

2018

J. Diagn. Treat. Oral Maxillofac. Pathol.

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Royal College of Surgeons of Edinburgh (RCSEd) is one of the oldest surgical corporations (professional oragization) in the world and traces its origins to 1505 [1]. The ad hominem fellow distinction is the most prestigious designation a surgeon can receive from the college. Of the more than 10,000 U.S. surgeons in his specialty, Rui P. Fernandes, MD, DMD, is just the third to be inducted as one (Fig 1) [2]. Consulting Editor of the highly prestigious Journal Oral and Maxillofacial Surgery Clinics of North America. Textbooks: Local & Regional Flaps in Head & Neck Reconstruction: A Practical Approach (Fernandes) – published in 2014; Oral, Head & Neck Oncology & Reconstructive Surgery (Bell, Fernandes, Andersen) – published in 2017. Co-author in the cutting-edge articles: Outcomes of total or near-total lip reconstruction with microvascular tissue transfer; Margin analysis: sarcoma of the head and neck; The cervicofacial flap in cheek reconstruction: a guide for flap design; Alternative approach in mandibular reconstruction for benign disease [3-6]. The list goes on. He don’t stop to relax. He continue to do that again, and again, and again... To move a surgery forward.

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