57 results match your criteria Mandibular Reconstruction Plating


Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case-control study.

BMC Surg 2021 Apr 9;21(1):189. Epub 2021 Apr 9.

Division of Plastic and Reconstructive Surgery, Faculty of Medicine Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.

Background: Free osteocutaneous fibula flap (FFF) is currently considered the best option for segmental mandibular reconstruction; however, there are only a few reports comparing secondary with primary reconstructions using FFF. This study aimed to evaluate the safety and efficacy of secondary mandibular reconstruction using FFF when compared with primary mandibular reconstruction.

Methods: From October 2018 to February 2020, patients who underwent mandibular reconstruction using FFF after segmental mandibulectomy were retrospectively reviewed. Read More

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Vascularized Clavicular Bone With Supraclavicular Artery Island Flap for Oromandibular Reconstruction.

J Craniofac Surg 2021 Mar-Apr 01;32(2):765-767

Department of Otorhinolaryngology, Head and Neck Surgery, The University of Texas Health Science Center, Houston, TX.

Objective: To explore the feasibility of an original surgical technique for head and neck oncologic reconstruction utilizing a pedicled osteocutaneous supraclavicular artery island flap (SCAIF) in a cadaver model.

Method: Cadaver dissection, Review of literature.

Description: Two fresh frozen cadavers, 1 male and 1 female, were used for the dissection. Read More

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Surgical management of unilateral body fractures of the edentulous atrophic mandible.

Oral Maxillofac Surg 2020 Mar 17;24(1):65-71. Epub 2019 Dec 17.

Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.

Introduction: Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient's age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery.

Methods: This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. Read More

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Successful Reconstruction of Agnathia by Intraoral Expansion and Free Vascularized Fibula Flap.

Authors:
Kunihiro Ishida

J Craniofac Surg 2019 Mar/Apr;30(2):581-583

Department of Plastic and Reconstructive Surgery, Okinawa Chubu Hospital, Uruma City, Japan.

A successful surgical reconstruction case of a 9-year-old boy with agnathia is presented. The reconstruction was preceded by intraoral expansion of the oral lining and submandibular skin. Four months after initiation of the expansion, the mandible was reconstructed by free vascularized fibula osteocutaneous flap. Read More

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Analysis of simulated mandibular reconstruction using a segmental mirroring technique.

J Craniomaxillofac Surg 2019 Mar 30;47(3):468-472. Epub 2018 Dec 30.

Department of Otolaryngology, Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre and Guided Therapeutics (GTx) Program, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Purpose: When deforming pathology limits intraoperative plating of the mandible, three-dimensional (3D) models can be generated by digitally replacing the deformed segment of bone with an inverted segment from the contralateral unaffected mandible to adapt a reconstruction plate. The purpose of this study was to use 3D conformance analysis to evaluate the degree of accuracy of this "segmental mirroring" technique.

Methods: Using a pre-existing melanoma database (January 1, 2005-September 20, 2015), high-resolution computed tomography (CT) scans of the head and neck were obtained from patients without evidence of bony disease or defects involving the mandible. Read More

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Comparison of Modern Rigid Fixation Plating Outcomes for Segmental Mandibular Microvascular Reconstruction.

Laryngoscope 2019 05 3;129(5):1081-1086. Epub 2018 Oct 3.

Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, U.S.A.

Objectives/hypothesis: New advances in osseous microvascular mandibular rigid fixation are being employed at many institutions. These include standardized prebent/preformed reconstruction plates as well as computer-aided design/computer-aided manufacturing (CAD/CAM) custom plates that are patient specific. Our goal was to assess and compare the outcomes of both of these new technologies when utilized for mandibular microvascular reconstruction. Read More

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Clinical experience with a novel structure designed bridging plate system for segmental mandibular reconstruction: The TriLock bridging plate.

J Craniomaxillofac Surg 2018 Sep 7;46(9):1679-1690. Epub 2018 Jul 7.

Department of Oral- and Maxillofacial Surgery, Medical University of Graz, Austria.

The innovative TriLock Bridging Plate System (Medartis AG, Switzerland) was developed to reduce common complications related to conventional mandibular reconstruction plates. The novelties regarding the plating system concern the cross-strut structure in the centerpiece, the bendable side elements and the reduction of the plate's thickness to 2.0 mm 4 different models are available, which cover lateral and central segmental mandibular defects. Read More

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September 2018

On-Site 3-Dimensional Printing and Preoperative Adaptation Decrease Operative Time for Mandibular Fracture Repair.

J Oral Maxillofac Surg 2018 09 15;76(9):1950.e1-1950.e8. Epub 2018 May 15.

Associate Professor, Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA.

Purpose: The purpose of this study was to compare the intraoperative time and operating room costs between patients with mandibular fractures treated with traditional adaptation and fixation and patients treated with preadapted plates created with on-site 3-dimensionally printed models.

Patients And Methods: We designed a prospective comparative cohort study for patients with mandibular fractures. The control group received traditional open reduction and internal fixation of their mandibular fractures. Read More

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September 2018

Mandibular reconstruction.

Oral Oncol 2018 02 4;77:111-117. Epub 2018 Jan 4.

Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KS 66160, United States.

Mandibular reconstruction presents unique functional and aesthetic challenges to the reconstructive surgeon. This review will cover current techniques for mandibular reconstruction, including the various plating strategies for rigid fixation, the choice of osseous donor site, and the concurrent reconstruction of associated soft tissue defects. Recent developments and future horizons in mandibular reconstruction including the use of virtual surgical planning and tissue engineering will also be addressed. Read More

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February 2018

Contemporary mandibular reconstruction.

Curr Opin Otolaryngol Head Neck Surg 2016 Oct;24(5):433-9

Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA.

Purpose Of Review: Multiple disease processes, including neoplasia, trauma, and medication side-effects, necessitate segmental resection and subsequent reconstruction of the mandible. As surgical techniques have advanced, several technologies have been developed with the potential to significantly transform a surgeon's approach to the restoration of mandibular continuity. The purpose of this review is to highlight many of these relatively newer tools and discuss their evolving role in mandibular reconstruction. Read More

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October 2016

Biomechanical assessment of fixation methods for segmental mandible reconstruction with fibula in the polyurethane model.

Microsurgery 2016 May 5;36(4):330-3. Epub 2016 Apr 5.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS.

Background: A variety of plating techniques are employed by microsurgeons to provide rigid fixation for vascularized bone constructs of the mandible. The aim of this study was to biomechanically compare three commonly utilized plating techniques for rigid fixation of fibula bone flaps in reconstructing lateral segmental mandibular defects.

Materials And Methods: Polyurethane mandibles with 3-cm segmental defects were reconstructed using polyurethane fibula models. Read More

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Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures.

Surg Res Pract 2015 16;2015:569030. Epub 2015 Nov 16.

University of Mississippi Medical Center, Department of Otolaryngology and Communicative Sciences, 2500 N. State Street, Jackson, MS 39216, USA.

Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Read More

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December 2015

3D Rapid Prototyping for Otolaryngology-Head and Neck Surgery: Applications in Image-Guidance, Surgical Simulation and Patient-Specific Modeling.

PLoS One 2015 2;10(9):e0136370. Epub 2015 Sep 2.

TECHNA Institute, University Health Network, Toronto, Ontario, Canada; Department of Surgical Oncology, University Health Network, Toronto, Ontario, Canada; Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.

The aim of this study was to demonstrate the role of advanced fabrication technology across a broad spectrum of head and neck surgical procedures, including applications in endoscopic sinus surgery, skull base surgery, and maxillofacial reconstruction. The initial case studies demonstrated three applications of rapid prototyping technology are in head and neck surgery: i) a mono-material paranasal sinus phantom for endoscopy training ii) a multi-material skull base simulator and iii) 3D patient-specific mandible templates. Digital processing of these phantoms is based on real patient or cadaveric 3D images such as CT or MRI data. Read More

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Biomechanical evaluation of different angle-stable locking plate systems for mandibular surgery.

J Craniomaxillofac Surg 2015 Oct 11;43(8):1589-94. Epub 2015 Jul 11.

Institute for Surgical Technology and Biomechanics, University of Bern, Switzerland.

Purpose: To compare the initial stability and stability after fatigue of three different locking systems (Synthes(®), Stryker(®) and Medartis(®)) for mandibular fixation and reconstruction.

Method: Standard mandible locking plates with identical profile height (1,5 mm), comparable length and screws with identical diameter (2,0 mm) were used. Plates were fixed with six screws according a preparation protocol. Read More

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October 2015

Recent advances in head and neck free tissue transfer.

Curr Opin Otolaryngol Head Neck Surg 2015 Aug;23(4):297-301

aDepartment of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California bHead and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Purpose Of Review: Free tissue transfer is a versatile and valuable method for reconstructing select head and neck defects following trauma or oncologic resection. Microvascular reconstructive cases are among the longest, most technically challenging, and most labor-intensive operations performed by departments of otolaryngology/head and neck surgery. However, technical advances, increased experience, and robust training programs have permitted realization of microvascular success rates in excess of 97% at most high-volume centers. Read More

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Anatomic basis for an algorithmic approach for free fibula flap donor side selection in composite oro-mandibular defects.

Indian J Plast Surg 2015 Jan-Apr;48(1):43-7

Department of Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India.

Introduction: Head and neck oncological resections may result in composite oro-mandibular defects involving the oral mucosa (lining), mandibular bone and the skin (cover). Reconstructive options for such defects have evolved over a period. Free fibula flap reconstruction is currently accepted the world over as the gold standard for oro-mandibular defect reconstruction. Read More

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Repositioning template for mandibular reconstruction with fibular free flaps: an alternative technique to pre-plating and virtual surgical planning.

Acta Otorhinolaryngol Ital 2014 Aug;34(4):278-82

Dept. of Oncology, University of Turin, ENT University Unit, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy.

Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. Read More

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The biomechanical aspects of reconstruction for segmental defects of the mandible: a finite element study to assess the optimisation of plate and screw factors.

J Craniomaxillofac Surg 2014 Sep 31;42(6):855-62. Epub 2013 Dec 31.

Department of Oral and Maxillofacial Surgery, University Hospitals of Leicester, Leicester, United Kingdom. Electronic address:

A bone plate is required to restore the load-bearing capacity of the mandible following a segmental resection. A good understanding of the underlying principles is crucial for developing a reliable reconstruction. A finite element analysis (FEA) technique has been developed to study the biomechanics of the clinical scenarios managed after surgical resection of a tumour or severe trauma to assist in choosing the optimal hardware elements. Read More

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September 2014

Biomechanical evaluation of a new MatrixMandible plating system on cadaver mandibles.

J Oral Maxillofac Surg 2013 Nov 5;71(11):1900-14. Epub 2013 Sep 5.

Chairman, Department of Oral and Maxillofacial Surgery, The Methodist Hospital, Houston, TX; Professor of Clinical Surgery, (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, NY.

Purpose: Current mandibular plating systems contain a wide range of plates and screws needed for the treatment of mandibular reconstruction and mandibular fractures. The authors' hypothesis was that a single diameter screw could be used in all applications in a plating system. Therefore, the purpose of this study was to test if the 2. Read More

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November 2013

Value of preoperative mandibular plating in reconstruction of the mandible.

Head Neck 2014 06 2;36(6):828-33. Epub 2013 Sep 2.

Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

Background: The purpose of this study was to evaluate the efficacy of preoperative versus intraoperative mandibular contouring using rapid prototyping technology.

Methods: Ten patients requiring mandibular reconstruction had a preoperative mandibular plate contoured to a fabricated 3D mandibular model based on preoperative imaging. A traditional intraoperative plate was also contoured. Read More

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Outcomes of the osteocutaneous radial forearm free flap for mandibular reconstruction.

JAMA Otolaryngol Head Neck Surg 2013 Feb;139(2):168-72

Departments of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USA.

Importance: Limited donor and recipient site complications support the osteocutaneous radial forearm free flap (OCRFFF) for mandibular reconstruction as a useful option for single-stage mandibular reconstruction.

Objective: To examine and report long-term outcomes and complications at the donor and recipient sites for patients undergoing the OCRFFF for mandibular reconstruction.

Design: Retrospective review. Read More

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February 2013

Fixation of mandibular angle fractures: in vitro biomechanical assessments and computer-based studies.

Oral Maxillofac Surg 2013 Dec 14;17(4):251-68. Epub 2012 Oct 14.

Department of Prosthodontics, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden,

Purpose: The purpose of this study was to review the literature regarding the evolution of current thoughts on fixation of mandibular angle fractures (MAFs), based on in vitro biomechanical assessments and computer-based studies.

Methods: An electronic search in PubMed was undertaken in August 2012. The titles and abstracts from these results were read to identify studies within the selection criteria. Read More

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December 2013

Assessment of donor site morbidity for free radial forearm osteocutaneous flaps.

Microsurgery 2012 May 31;32(4):255-60. Epub 2012 Mar 31.

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL 35294-0012, USA.

Purpose: Assessment of donor site morbidity and recipient site complications following free radial forearm osteocutaneous flap (FRFOCF) harvest and evaluation of patient perceived upper limb disability for free radial forearm osteocutaneous versus fasciocutaneous flaps (FRFF).

Methods: First a case series was undertaken of 218 patients who underwent an FRFOCF at two tertiary referral centers between February 1998 and November 2010. Outcomes included forearm donor site morbidity and recipient site complications. Read More

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Modern concepts in mandibular reconstruction in oral and oropharyngeal cancer.

Curr Opin Otolaryngol Head Neck Surg 2011 Apr;19(2):119-24

Mayo Clinic, Phoenix, Arizona, USA.

Purpose Of Review: This article reviews literature pertaining to advances in oromandibular reconstruction in the context of a 30-year background of microvascular free tissue transfer, which still represents the current standard of care.

Recent Findings: Most literature reiterates established patterns of reconstruction. Notable exceptions address these key areas: the use of computer-assisted modeling to more closely and efficiently design the excision of the mandible, to produce the template and to contour the fibula bone to fit the defect; the evolution of plating techniques to maximize the bony repair; distraction osteogenesis; tissue engineering; and optimal techniques for dealing with osteonecrosis, from both radiation and bisphosphonate use. Read More

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Nonunion of mandibular midline osteotomy after tumor surgery and radiation repaired by endosseous implants.

J Oral Maxillofac Surg 2010 Apr 30;68(4):833-6. Epub 2009 Dec 30.

Oral and Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

Nonunion of the mandible after microvascular flap reconstruction of defects resulting from tumor surgery is a known but rare complication, occurring in 5% of cases. When nonunion results with the use of microvascular flaps, rigid internal fixation, and radiotherapy, other options to treat the nonunion carry a greater risk of osteomyelitis, osteoradionecrosis, and/or persistent nonunion. Although endosseous implants have been reported to cause mandibular fracture in some cases, our case proposes and supports the use of implants for immobilization and/or prevention of nonunion of the mandible in patients who have a high probability of this complication developing, thereby avoiding plating across the nonunion site with the risk of plate exposure and osteoradionecrosis. Read More

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Plating in microvascular reconstruction of the mandible: can fixation be too rigid?

J Craniofac Surg 2009 Sep;20(5):1451-4

Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, 550 First Avenue, New York, NY 10003, USA.

Objective: Determine long-term loss of mandible height with use of stress-shielding reconstruction plates for free fibula flap mandible reconstruction.

Design: Retrospective single-blinded medical record review.

Subjects: Seventy patients who had fibula free flap mandible reconstructions performed for 10 years. Read More

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September 2009

Reconstruction of the zygomatic arch using a mandibular adaption plate.

J Craniofac Surg 2009 Jul;20(4):1193-6

Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.

Zygomatic complex fractures are one of the most common facial fractures treated by maxillofacial surgeons. Because of the importance of the zygomatic complex in midfacial skeletal orientation, comminuted zygomatic arch fractures can lead to significant morbidity and deformity. Common repair modalities include closed reduction via a Gilles approach, open reduction and internal fixation with screws and/or plating systems, primary bone grafting, and/or biosynthetics. Read More

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Comparison of miniplates and reconstruction plates in fibular flap reconstruction of the mandible.

Plast Reconstr Surg 2008 Dec;122(6):1733-1738

Omaha, Neb. From the Department of Otolaryngology, Division of Plastic Surgery, and Department of Biostatistics, University of Nebraska Medical Center, and University of Nebraska Medical School.

Background: Mandibular reconstruction using free fibular flaps can be performed using various plating techniques. Miniplates (2. Read More

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December 2008

A biomechanical evaluation of plating techniques used for reconstructing mandibular symphysis/parasymphysis fractures.

J Oral Maxillofac Surg 2008 Oct;66(10):2012-9

Department of Oral and Maxillofacial Surgery, University of Louisville, Louisville, KY 40536, USA.

Purpose: The purpose of this investigation was to evaluate and compare the biomechanical behavior of 5 different methods used to repair mandibular symphysis/parasymphysis fractures.

Materials And Methods: Sixty synthetic polyurethane mandible replicas (Synbone, Laudquart, Switzerland) were used in this investigation. Ten controls and 10 each of the experimental groups were tested by subjecting 5 constructs in each group to vertical loading at the incisal edge and 5 constructs to torsional loading at the molar region by an Instron 1331 (Instron, Canton, MA) servohydraulic mechanical testing unit. Read More

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October 2008

Use of finite element analysis in presurgical planning: treatment of mandibular fractures.

Ir J Med Sci 2008 Dec 18;177(4):325-31. Epub 2008 Sep 18.

Centre for Applied Biomedical Engineering Research (CABER), University of Limerick, Limerick, Ireland.

Background: The current clinical procedure for mandible fracture fixation is plate application. 3D reconstructions are used to validate procedures numerically preceding experimental analysis. This study outlines the methods used to reconstruct a numerical model of the mandible. Read More

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December 2008