Mandibular Reconstruction Following Central Giant Cell Granuloma Resection in Primary Dentition: A Case for the Use of a Costochondral Graft

Abstract

Central giant cell granuloma is a benign, intraosseous lesion that may affect the pediatric craniofacial skeleton, particularly the mandible. When surgery is indicated, the role of the craniofacial surgeon is to ameliorate the sequelae of ablative surgery by restoring facial symmetry, ensuring appropriate postoperative occlusion, and allowing for adequate interincisal opening, all in the setting of a growing craniofacial skeleton. Herein, we report the case of a 3-year-old female presenting for reconstruction after resection of the right hemimandible proximal to the unerupted first permanent molar. We highlight the various reconstructive challenges associated with mandibular reconstruction during primary dentition and make a case for the use of a costochondral graft, with a successful outcome demonstrated at 2 years of follow-up.

An Oncoplastic Approach to Primary Pediatric Pterygomaxillary Osteosarcoma

“…We have previously reported on the latter in a complex case of central giant cell granuloma of the mandible in a 3 year-old child, in which a costochondral graft was utilized in a similar manner to its well described role in hemifacial microsomia. 20 For our 6 year-old patient in this report, the oncoplastic approach involved separate osteotomies of the zygomatic body and arch via typical incisions employed in trauma cases (e.g., bicoronal incision, subtarsal incision, and intraoral maxillary vestibular incision). Corodonidectomy was also performed via an intraoral mandibular vestibular incision to access the inferior portion of the tumor with the mouth maximally propped open, akin to what would be performed for a case of pediatric temporomandibular joint ankylosis.…”

“…While "oncoplastic" approaches have been described in other anatomic regions for soft tissue surgery (e.g., breast cancer surgery), analogous approaches in craniomaxillofacial surgery have heretofore not been emphasized. [18][19][20] The current case also represents an example of the incorporation of mixed reality and computeraided design/computer-aided manufacturing (CAD/CAM) technologies in the planning of pterygomaxillary tumor resection and reconstruction.…”

Versatility of Patient Specific Implants in Reconstruction of Maxillofacial Defect: A Case Report of Central Giant Cell Granuloma

“…described two types of clinical progression (Table 1). 5 Surgery is considered the rst therapeutic option for CGCG, 4 however, reconstruction of these ablative defects is challenging, and a wide variety of reconstructive procedures have been described. This case report presents a case of mandibular reconstruction following resection of a CGCG using a Patient Speci c Implant.…”

Injertos óseos no vascularizados para la reconstrucción de defectos óseos mandibulares. Revisión sistemática

“…[9][10][11][12] Los defectos óseos mandibu-www.medigraphic.org.mx lares causados por cirugía de diversas patologías, traumatismos faciales o sus secuelas pueden ser tratados con una amplia variedad de opciones en la actualidad. [13][14][15][16][17][18][19][20] Una alternativa para la reconstrucción de defectos mandibulares es el uso de injertos óseos autólogos no vascularizados. 21 Los injertos óseos autólogos ofrecen grandes y mayores beneficios comparados con los aloinjertos, xenoinjertos o aloplásticos empleados para la reconstrucción de defectos óseos mandibulares.…”