New method of alloplastic reconstruction of the mandible after subtotal mandibulectomy for medication-related osteonecrosis of the jaw

Bräuer, Christian; Lauer, G; Leonhardt, H

doi:10.1016/j.bjoms.2018.04.004

Cited by 3 publications

(5 citation statements)

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“…It is common when resecting MRONJ‐affected bone to have to adapt from the presurgical plan, and therefore with preoperatively fabricated spacers, inaccurate fit of the spacer is a significant problem 25 . With our technique for intra‐operative creation of the bone spacer, 9 any change in the resection margins from the preoperative planning can be adequately addressed by oversizing the temporary mold and filling the resection defect with low‐viscosity bone cement. Using a custom‐shaped low viscosity bone cement, the original, three‐dimensional shape of the jaw is preserved which counteracts tissue shrinkage and this reduction in soft tissue contraction has a positive effect on facial aesthetics 22 .…”

Section: Discussionmentioning

confidence: 99%

“…The first cohort was treated according to the method described by Bräuer et al 9 The second cohort was treated with an update of the method. Both methods are described below.…”

Section: Methodsmentioning

confidence: 99%

“…The outer part of the mold was temporarily attached, and the defect was filled in with PALACOS® LV + G Bone Cement. Thus, the mini plates in the defect area were completely covered by bone cement and the mandible was reconstructed in the former dimensions and contour 9 …”

Section: Methodsmentioning

confidence: 99%

“…Thus, the mini plates in the defect area were completely covered by bone cement and the mandible was reconstructed in the former dimensions and contour. 9…”

Section: Operative Technique-first Cohortmentioning

confidence: 99%

“…Alloplastic reconstruction with reconstruction plate alone often leads to plate exposure or fracture, and does not permit dental rehabilitation 7,8 . Because of this, we introduced in 2018 a technique for alloplastic reconstruction of the mandible in patients not suitable or willing to undergo osseous‐free flap reconstruction, which aimed to preserve the form and function of the mandible 9 . Although satisfactory results could be achieved in most patients during the initial follow‐up period, plate fractures at the interface of implant to bone were observed over the longer term (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

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Alloplastic reconstruction of the mandible after subtotal mandibulectomy for medication‐related osteonecrosis of the jaw: An update of the method

Bräuer,

Ullmann,

Lauer

et al. 2023

Head & Neck

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BackgroundReconstruction of continuity defects following osteonecrosis in multimorbid patients is challenging. In all cases of the predescribed palliative treatment method for alloplastic mandible reconstruction, plate fractures were detected in follow‐up. We hypothesized that a modification could avoid these fractures, leading to stable long‐term results.MethodsThis retrospective study compares the original method with a modification using single, laser‐sintered CAD–CAM plates instead of manually bent miniplates. The predescribed shuttering technique was used to reconstruct the mandible in its original shape with bone cement.ResultsUneventful wound healing was observed in 86% of the cases after modification of the method. No implant or plate fracture occurred.ConclusionsThe presented method should be considered as a treatment option for mandible reconstruction in elderly, multimorbid patients in palliative situations. The results of this study suggest that the modification of the method leads to significantly improved long‐term stability. Donor site morbidity is avoided with this method of palliative surgery.

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Section: Discussionmentioning

confidence: 99%

“…The first cohort was treated according to the method described by Bräuer et al 9 The second cohort was treated with an update of the method. Both methods are described below.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Thus, the mini plates in the defect area were completely covered by bone cement and the mandible was reconstructed in the former dimensions and contour. 9…”

Section: Operative Technique-first Cohortmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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