Mandibular Setback as an Adjunctive Strategy for Reconstruction after Tumor Resection: A Technical Note and Case Report

  • Hassan Mirmohammadsadeghi Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Farzad Aghdashi Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Golnaz Nahvi Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Mohammad Esmaeelinejad Department of Oral and Maxillofacial Surgery, Dental School, Semnan University of Medical Sciences, Semnan, Iran
Keywords:
Ameloblastoma, Bone Transplantation, Orthognathic Surgery

Abstract

Mandibular defects due to surgical resection of pathologies are common challenges for maxillofacial surgeons. In some clinical situations, alteration or combination of different surgical procedures is needed to reduce the size of bony defects and improve the success rate of bone grafts. In the current study, an 18-year-old female with a pathological lesion (ameloblastoma) in the mandible is presented. After tumor resection, bony defect reconstruction with autogenous bone graft was combined with a mandibular setback to facilitate the procedure. In this case, the simultaneous combination of orthognathic mandibular setback movement with tumor resection in a single surgical session helped to reduce the bony defect size. The adoption of this approach led to a decrease in the volume of graft harvesting and improved the success rate of the grafting procedure.

References

1. Stypulkowska J. [Odontogenic tumors and neoplastic-like changes of the jaw bone. Clinical study and evaluation of treatment results]. [Article in Polish]. Folia Med Cracov. 1998;39(1-2):35-141.
2. Nandra B, Fattahi T, Martin T, Praveen P, Fernandes R, Parmar S. Free Bone Grafts for Mandibular Reconstruction in Patients Who Have Not Received Radiotherapy: The 6-cm Rule-Myth or Reality? Craniomaxillofac Trauma Reconstr. 2017 Jun;10(2):117-122.
3. Giridhar P, Mallick S, Upadhyay AD, Rath GK. Pattern of care and impact of prognostic factors in the outcome of ameloblastic carcinoma: a systematic review and individual patient data analysis of 199 cases. Eur Arch Otorhinolaryngol. 2017 Oct;274(10):3803-3810.
4. Avon SL, McComb J, Clokie C. Ameloblastic carcinoma: case report and literature review. J Can Dent Assoc. 2003 Oct;69(9):573-6.
5. Awad ME, Altman A, Elrefai R, Shipman P, Looney S, Elsalanty M. The use of vascularized fibula flap in mandibular reconstruction; A comprehensive systematic review and meta-analysis of the observational studies. J Craniomaxillofac Surg. 2019 Apr;47(4):629-641.
6. Hassanein AG, Kukreja P, Hassanein KAAM. Post Tumor Ablation Mandibular Reconstruction: Review Article. Cosmetol & Oro Facial Surg. 2019 Feb;5(1):1000133.
7. Rachmiel A, Shilo D. The use of distraction osteogenesis in oral and maxillofacial surgery. Ann Maxillofac Surg. 2015 Jul-Dec;5(2):146-7.
8. Philip M, Morris CG, Werning JW, Mendenhall WM. Radiotherapy in the treatment of ameloblastoma and ameloblastic carcinoma. J HK Coll Radiol. 2005;8(3):157-61.
9. Estublier M, Desoutter A, Chaux Bodard AG. Mandibular ameloblastic carcinoma: case report and literature review. J Oral Med Oral Surg. 2019 Sep;25(3):32.
10. Khojasteh A, Esmaeelinejad M, Aghdashi F. Regenerative techniques in oral and maxillofacial bone grafting. In: A Textbook of Advanced Oral and Maxillofacial Surgery. Volume 3, InTechOpen, Rijeka, 2015:513-547. Available at: https://www.intechopen.com/books/a-textbook-of-advanced-oral-and-maxillofacial-surgery-volume-2/regenerative-techniques-in-oral-and-maxillofacial-bone-grafting/
Accessed April 12, 2019.
11. Kwon IJ, Eo MY, Park SJ, Kim SM, Lee JH. Newly designed retentive posts of mandibular reconstruction plate in oral cancer patients based on preliminary FEM study. World J Surg Oncol. 2016 Nov 21;14(1):292.
Published
2020-06-24
How to Cite
1.
Mirmohammadsadeghi H, Aghdashi F, Nahvi G, Esmaeelinejad M. Mandibular Setback as an Adjunctive Strategy for Reconstruction after Tumor Resection: A Technical Note and Case Report. Front Dent. 16(6):473-477.
Section
Case Report