Mandible reconstruction

Abstract

This review, while affirming the evolution and the good results found with the actual approaches, emphasizes the negative aspects that still subsist. Thus, it shows that mandible reconstruction is not a closed issue. On the contrary, it remains as a research field where new findings could have a direct positive impact on patients' life quality. The identification of the persistent problems reveals the characteristics to be considered in a new prosthetic device. This could overcome the current difficulties and result in more comfortable solutions. Medical teams have the responsibility to keep patients informed about the predictable problems related with each elected approach, even understanding that a perfect reconstruction is a secondary goal when compared with maintenance of life.

Reconstruction of a mandibular segmental defect with a customized 3-dimensional–printed titanium prosthesis in a cat with a mandibular osteosarcoma

“…11 The increase in the availability of CT planning has resulted in advances in the management of mandibular defects in humans, including creation of 3-D models of the affected mandible for surgical planning (such as prebending and improved fitting of titanium plates, optimization of bone-to-bone contact, and shorter duration of surgery), 9,[12][13][14][15][16][17][18][19] creation of prefabricated intraoperative guides (for optimization of the length and number of fibular grafts, improved fitting of titanium plates, and improved postoperative cosmetic appearance and function), 9,16,[19][20][21] and development of CAD-CAM customized and patientspecific 3-D-printed reconstruction plates 9,22 and prostheses. 23 Customized 3-D printing of mandibular prostheses provides several theoretical advantages over other techniques, such as the ability to design the prosthesis to match the geometry and weight of the original mandible to better withstand the bending, torsion, and shear forces associated with mastication as well as the incorporation of tissue engineering technology into the prosthesis to promote its osseous integration. 23 However, despite isolated Web-based reports of the use of customized 3-D-printed prostheses for the reconstruction of mandibular defects in humans, there are no peer-reviewed publications describing the use of a CAD-CAM customized 3-Dprinted prosthesis for mandibular reconstruction in any other species.…”

“…23 Customized 3-D printing of mandibular prostheses provides several theoretical advantages over other techniques, such as the ability to design the prosthesis to match the geometry and weight of the original mandible to better withstand the bending, torsion, and shear forces associated with mastication as well as the incorporation of tissue engineering technology into the prosthesis to promote its osseous integration. 23 However, despite isolated Web-based reports of the use of customized 3-D-printed prostheses for the reconstruction of mandibular defects in humans, there are no peer-reviewed publications describing the use of a CAD-CAM customized 3-Dprinted prosthesis for mandibular reconstruction in any other species.…”

Osteosarcoma of the Jaw: Classification, Diagnosis and Treatment

“…When dealing with defects following extensive mandibular resection, it is mandatory to evaluate which components of the hard and soft tissue are missing in order to select the best reconstruction method (from simple rigid internal ixation to microvascular free tissue transfer). It is also crucial to grant an adequate bone vertical height and to contour clearly the margins of the alveolar bone, in order to achieve both an aesthetically appealing result and to restore mastication to the patient [75,76].…”

“…Healthy transposed soft tissue with an adequate height can adequately restore the facial contour, providing correct coverage of the underlying framework reconstruction [64,76].…”

Computer-Assisted Surgery for Mandibular Reconstruction Using a Patient-Specific Titanium Mesh Tray and Particulate Cancellous Bone and Marrow

“…Defects of the mandible caused by tumor, osteomyelitis, or severe trauma affect patients' quality of life both physiologically and psychologically. Various approaches for mandibular reconstruction, including reconstructive titanium plates, nonvascularized or vascularized bone grafts, and autogenous iliac bone grafts in combination with a ready-made titanium mesh trays, have been tried [10] [11]. The most common approach for mandibular reconstruction today is a vascularized-bone graft from the fibula and iliac crest [6]- [8].…”