Reconstruction of Mandibular Segmental Detects Using Transport Disk Distraction Osteogenesis

Li, Tao; Man, Yi; Bi, Ruiye; Jiang, Nan; Li, Yunfeng

doi:10.1097/scs.0000000000004167

Cited by 9 publications

(7 citation statements)

References 28 publications

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“…It has advantages in bone defect reconstruction of no requirement of bone grafting, avoiding complications at the second surgical and donor sites, less trauma, and high osteogenesis quality. [5] In the present case,the preoperative design helped to ensure precise contact of the anterior and posterior segments of the mandible after closure of the distractor. This precise contact was similar to an osteotomy suture created during osteotomy in DO.…”

Section: Discussionmentioning

confidence: 80%

“…[2][3][4] TDDO offers an advantage in bone defect reconstruction of avoiding complications at the second surgical and donor sites. [5] However, complications such as transport disk necrosis, resorption at the boundary of the compressed end of the transport disk, suboptimal osteogenesis between the transport disk and the jaw segment, and movement of the teeth on the transport disk with distraction are inevitable. [5,6] Compared to monofocal DO, TDDO is a more complicated procedure because osteotomies at a bone segment at one or both ends of the bone defect are required to form transport disks and because the distractor occasionally requires a customized design.…”

Section: Introductionmentioning

confidence: 99%

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Mandibular reconstruction after excision of recurrent odontogenic keratocyst using a novel mandibular distraction osteogenesis method– a case report

Lin

Zhong

Zhou

et al. 2023

Preprint

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Background Odontogenic keratocyst is one of the most common benign odontogenic neoplasms with a high recurrence rate. Its resection has the potential to lead to mandibular segmental defects. In this case report, we describe a patient with odontogenic keratocyst who underwent radical resection using a novel distraction osteogenesis (DO) method to reconstruct mandibular segmental defect.Case presentation: This case report describes a 19-year-old woman with odontogenic keratocyst of the mandible that recurred after multiple curettages and eventually necessitated radical resection. Mandibular segmental defect after radical resection was reconstructed using a novel DO method that involved directly contacting the segment ends of the defect without the transport disk. However, the distractor broke during the retention period, and a molding titanium plate was used for fixation. This novel distraction method achieved mandibular reconstruction and restored mandibular function and contour.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Mandibular reconstruction after excision of recurrent odontogenic keratocyst using a novel mandibular distraction osteogenesis method– a case report

Lin

Zhong

Zhou

et al. 2023

Preprint

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“…In this technique, the osteotomized bone part (transport disc) is slowly transported from the bone remainder, following the adapted plate installed, stimulating tissue neoformation. [ 1 5 6 ] Defects involving bone, teeth, and temporomandibular joint (TMJ) demand a laborious treatment plan; therefore, in addition to the need to restore facial contour, the restoration of the masticatory and speech functions should be considered.…”

Section: Introductionmentioning

confidence: 99%

Distraction osteogenesis and customized temporomandibular joint prosthesis in the reconstruction of a large mandibular defect - A case report

Cavalcante¹,

Espinheira²,

Sardinha³

et al. 2021

Ann Maxillofac Surg

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The Rationale: Mandibular resections involve esthetic and functional impairment and impose a challenge during the reconstruction. This case report is a successful reconstruction with distraction osteogenesis (DO) and customized temporomandibular joint (TMJ) prosthesis. Patient Concerns: A 51-year-old male patient presented with a complaint of facial asymmetry, mastication, and speech difficulties. Diagnosis: As the patient had undergone a hemimandibulectomy procedure 20 years ago, clinical examination showed facial asymmetry. Radiographic examination exhibited the defect and a radiopaque image representing Kirschner's wire. Treatment: DO by bone transport was performed, followed by dental implant and TMJ prosthesis placement. Outcomes: DO is a viable treatment option in resections, even when the defect was generated by an ancient injury. The follow-up is around 7 years after the osteogenic distraction, with no complaints and functional capacity. Take-away Lessons: The major challenge in mandibular reconstructions through DO is to reproduce the curve of the arch.

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“…Mild invasive approaches include enucleation, decompression, or marsupialization. More invasive approaches are specially applied for recurrent odontogenic keratocysts and include enucleation with peripheral ostectomy, in the past enucleation with Carnoy‘s solution, and marginal or segmental resection 1,11 …”

mentioning

confidence: 99%

“…More invasive approaches are specially applied for recurrent odontogenic keratocysts and include enucleation with peripheral ostectomy, in the past enucleation with Carnoy's solution, and marginal or segmental resection. 1,11 Three-dimensional (3D) diagnostic and cone-beam computed tomography (CBCT) has become an important tool for treatment planning and progress control of patients with odontogenic keratocysts and their recrudescence. For 3D and volumetric measurements of CBCT images, the open-source software ITK-SNAP offers a useful and validated tool that has been assessed in previous studies on odontogenic keratocysts.…”

mentioning

confidence: 99%

A Volumetric and Morphological Analysis of Recurrent Odontogenic Keratocysts by Semiautomatic Segmentation

Lentzen

Riekert

Zirk

et al. 2021

Journal of Craniofacial Surgery

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The authors conducted this study to provide morphological and volumetric data of recurrent odontogenic keratocysts of the upper and lower jaw to emphasize risk factors in accordance with their radiological appearance and guide clinical decisions for jeopardized patients. Methods: By applying the open-source software ''ITK-Snap'' on cone-beam computed tomography images, volumetric measurements of histopathologically diagnosed recurrent odontogenic keratocysts could be performed. For statistical investigations, descriptive statistics and independent Student t test were performed. The intraclass correlation coefficient was used to assess intra-and inter-rater reliabilities. P values P < 0.05 were considered significant. Results: Forty patients (24 male and 16 female) were included in this study. Recurrent odontogenic keratocysts had a mean maximum diameter of 28.91 mm AE 12.00 mm and a mean volume of 4.48 cm 3 AE 4.29 cm 3 . According to morphology, irregular shape (P ¼ 0.001; P ¼ 0.005), unclear margin (P ¼ 0.001; P ¼ 0.001), multilocular morphology (P ¼ 0.001; P ¼ 0.001), and cortical bone exceedance (P ¼ 0.001; P ¼ 0.007) are statistically significantly associated with a larger cyst diameter and volume. Furthermore, significant differences by diameter and volume could be shown between patients with and without iliac crest graft reconstruction (P ¼ 0.001; P ¼ 0.001). Conclusions: Volumetric analysis reveals that recurrent odontogenic keratocysts show large diametric and volumetric extension that leads to complex reconstruction by iliac crest grafts, adding an argument that special attention should be paid to this entity and its recurrence. in case of difficult histopathological examination, lesions with irregular shape and margin, multilocular morphology, cortical bone exceedance, and clinically visible symptoms should be considered for close morphological and volumetric clinicoradiological follow-up.

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Reconstruction of Mandibular Segmental Detects Using Transport Disk Distraction Osteogenesis

Abstract: Results in this study suggest the clinical feasibility and efficiency of TDDO for reconstruction of segmental defect of mandible and further dental implant treatment.

Cited by 9 publications

References 28 publications

Mandibular reconstruction after excision of recurrent odontogenic keratocyst using a novel mandibular distraction osteogenesis method– a case report

Mandibular reconstruction after excision of recurrent odontogenic keratocyst using a novel mandibular distraction osteogenesis method– a case report

Distraction osteogenesis and customized temporomandibular joint prosthesis in the reconstruction of a large mandibular defect - A case report

A Volumetric and Morphological Analysis of Recurrent Odontogenic Keratocysts by Semiautomatic Segmentation

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