2013, Number 1
Rev Odont Mex 2013; 17 (1)
Prosthetic and surgical treatment of patient previously subjected to hemi-mandibulectomy
Sistos RJE, Jiménez CR, Benavides RA
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In general terms, the best rehabilitation options for patients previously subjected to hemi-mandibulectomy are far beyond their financial possibilities. For this reason surgical-prosthetic reconstructive approach is mainly restricted to the use of more affordable materials such as Kirschner wire and methyl-methacrylate immediate prostheses. The latter are widely recommended due to their low cost, ease of handling, and because they prevent soft tissue atrophy. A clinical case is reported in this article: 25 year old male patient seeking treatment at the Oncology Service of the Hospital General de Mexico (Mexico’s General Hospital) due to the presence of a volume increase in the area of the left mandibular angle. Microscopic analysis revealed presence of mixed malign tumor ( final histopathological diagnosis). It was decided to perform hemi-mandibulectomy of involved area, with reconstruction of lost bone segment by means of positioning an immediate methyl methacrylate prosthesis (thermosetting methyl). The prosthesis was fixated with osteosynthesis wire at both resection margins, at 3 mm above the cortex.
Frías MM, Zeichner GI, Súchil BL, Ochoa CFJ. Epidemiología descriptiva del cáncer de cavidad bucal en el Instituto Nacional de Cancerología (1985-1992). Rev Inst Nal Cancerol 1997; 43 (2): 80-85.
Ramírez AV, Esquivel PL, Ochoa CFJ, Cuapio OA, Frías MM, Meneses GA, Sánchez MG. Cancer of the mobile tongue in Mexico. A retrospective Study of 107 Patients. Oral Oncol, Eur J Cancer 1995; 31B (1): 37-40.
Sánchez MMP, Díaz VD, Aparicio CG. Frecuencia del carcinoma epidermoide en cavidad bucal en el Hospital Central Militar de 1987 a 1997. Medicina Oral 1999; 1 (1): 20-22.
Shah JP, Patel SG. Head and neck surgery and oncology. 3rd Ed. New York: Mosby; 2003: 589-592, 614-631.
Cantor R, Curtis TA. Prosthetic management of edentulous mandibulectomy patients. Part I: Anatomic, physiologic and psychologic considerations. J Prosthet Dent 1971; 25: 446.
Beumer III J, Curtis TA, Marunick MT. Maxillofacial rehabilitation. Prosthodontic and surgical considerations. St. Louis: Ishiyaku EuroAmerica, Inc.; 1996: 113-223.
Taylor TD. Clinical maxillofacial prosthetics. Chicago: Quintessence publishing Co, Inc.; 2000: 205-213.
Lee KY, Kore JM, Perry CJ. Use of the Kirschner wire for mandibular reconstruction. Arch Otolaryngol Head Neck Surg 1988; 114 (1): 68-72.
Schusterman MA, Harris SW, Raymond AK, Goepfert H. Immediate free flap mandibular reconstruction: significance of adequate surgical margins. Head Neck 1993; 15(3): 204-207.
Martin PJ, O’Leary MJ, Hayden RE. Free tissue transfer in oromandibular reconstruction. Necessity or extravagance? Otolaryngol Clin North Am 1994; 27(6): 1141-1150.
Moscoso JF, Keller J, Genden E et al. Vascularized bone flaps in oromandibular reconstruction. A comparative anatomic study of bone stock from various donor sites to assess suitability for endosseous dental implants. Arch Otolaryngol Head Neck Surg 1994; 120 (1): 36-43.
Freitag V, Hell B, Fischer H. Experience with AO reconstruction plates after partial mandibular resection involving its continuity. J Craniomaxillofac Surg 1991; 19 (5): 191-198.
Futran ND, Urken ML, Buchbinder D et al. Rigid fixation of vascularized bone grafts in mandibular reconstruction. Arch Otolaryngol Head Neck Surg 1995; 121 (1): 70-76.
Buchbinder D, Urken ML, Vickery C et al. Bone contouring and fixation in functional, primary microvascular mandibular reconstruction. Head Neck 1991; 13 (3): 191-9.
Hidalgo DA. Titanium miniplate fixation in free flap mandible reconstruction. Ann Plast Surg 1989; 23 (6): 498-507.
Herford AS, Ellis E 3rd: Use of a locking reconstruction bone plate/screw system for mandibular surgery. J Oral Maxillofac Surg 1998; 56 (11): 1261-1265.
Cordeiro PG, Hidalgo DA. Soft tissue coverage of mandibular reconstruction plates. Head Neck 1994; 16 (2): 112-115.
Foster RD, Anthony JP, Sharma A, Pogrel MA. Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: an outcome analysis of primary bony union and endosseous implant success. Head Neck 1999; 21 (1): 66-71.
Gurtner GC, Evans GR. Advances in head and neck reconstruction. Plast Reconstr Surg 2000; 106 (3): 672-82; quiz 683.
Kuriloff DB, Sullivan MJ. Mandibular reconstruction using vascularized bone grafts. Otolaryngol Clin North Am 1991; 24 (6): 1391-1418.
Sullivan MJ, Baker SR, Crompton R, Smith-Wheelock M. Free scapular osteocutaneous flap for mandibular reconstruction. Arch Otolaryngol Head Neck Surg 1989; 115 (11): 1334-1340.
Boyd JB. The place of the iliac crest in vascularized oromandibular reconstruction. Microsurgery 1994; 15 (4): 250-256.
Cordeiro PG, Disa JJ, Hidalgo DA, Hu QY. Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg 1999; 104 (5): 1314-1320.
Yim KK, Wei FC. Fibula osteoseptocutaneous flap for mandible reconstruction. Microsurgery 1994; 15 (4): 245-249.
Hidalgo DA. Fibula free flap mandible reconstruction. Microsurgery 1994; 15 (4): 238-244.
Jones NF, Monstrey S, Gambier BA. Reliability of the fibular osteocutaneous flap for mandibular reconstruction: anatomical and surgical confirmation. Plast Reconstr Surg 1996; 97 (4): 707-716.
Patel A, Maisel R. Condylar prostheses in head and neck cancer reconstruction. Arch Otolaryngol Head Neck Surg 2001; 127 (7): 842-846.
Hidalgo DA. Condyle transplantation in free flap mandible reconstruction. Plast Reconstr Surg 1994; 93 (4): 770-781
Gurlek A, Miller MJ, Jacob RF et al. Functional results of dental restoration with osseointegrated implants after mandible reconstruction. Plast Reconstr Surg 1998; 101 (3): 650-655.