Abstract:
The mandible (lower jaw) bone is aesthetically responsible for shaping the lower face, physiologically in charge of the masticatory movements, and phonetically accountable for the articulation of different phonemes. Thus, pathologies that result in great damage to the mandible severely impact the lives of patients. Mandibular reconstruction techniques are mainly based on the use of flaps, most notably free vascularized fibula flaps. However, the mandible is a craniofacial bone with unique characteristics. Its morphogenesis, morphology, physiology, biomechanics, genetic profile, and osteoimmune environment are different from any other non-craniofacial bone. This fact is especially important to consider during mandibular reconstruction, as all these differences result in unique clinical traits of the mandible that can impact the results of jaw reconstructions. Furthermore, overall changes in the mandible and the flap post-reconstruction may be dissimilar, and the replacement process of the bone graft tissue during healing can take years, which in some cases can result in postsurgical complications. Therefore, the present review highlights the uniqueness of the jaw and how this factor can influence the outcome of its reconstruction while using an exemplary clinical case of pseudoarthrosis in a free vascularized fibula flap.
摘要:
下颌骨在美学上负责塑造下面部,生理上负责咀嚼运动,在语音上对不同音素的发音负责。因此,导致下颌骨极大损伤的病理严重影响患者的生活。下颌骨重建技术主要基于皮瓣的使用,最著名的是游离血管化腓骨皮瓣。然而,下颌骨是一种具有独特特征的颅面骨。它的形态发生,形态学,生理学,生物力学,遗传概况,和骨免疫环境不同于任何其他非颅面骨。这一事实在下颌骨重建过程中尤其需要考虑,因为所有这些差异导致下颌骨的独特临床特征,可以影响下颌骨重建的结果。此外,下颌骨和皮瓣重建后的整体变化可能不同,骨移植组织在愈合过程中的替换过程可能需要数年时间,在某些情况下可能导致术后并发症。因此,本综述强调了颌骨的独特性,以及该因素如何影响颌骨重建的结果,同时在游离血管化腓骨皮瓣中使用一例假性关节病的临床病例。