Mandibular Osteotomy

下颌骨截骨术
  • 文章类型: Case Reports
    下颌骨切除术后的下颌偏斜和旋转可以显着影响口腔功能和生活质量。此处描述了一名57岁的口腔癌患者接受下颌切除术的术后过程,以及经过11年的随访观察以监测下颌位置变化的发现。根据观察,重要的是要提高对下颌骨位置持续监测的必要性的认识,以及对进行了下颌骨切除术的患者定期调整假体.
    Mandibular deviation and rotation following mandibulectomy can significantly impact oral function and quality of life. The postoperative course of a 57-year-old patient who underwent mandibulectomy for oral cancer and findings over 11 years of follow-up observation to monitor changes in the mandibular position are described here. Based on the observations, it is important to raise awareness regarding the necessity of continued monitoring of mandible position and regular adjustments of prostheses for patients who have undergone mandibulectomy.
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  • 文章类型: Review
    背景:小细胞骨肉瘤是常规骨肉瘤的一种极其罕见的组织病理学变体。由于非特异性症状,大多数颌骨骨肉瘤被误诊为根尖周脓肿,并因拔牙和引流而受到误治。
    方法:我们报告,根据我们的知识,第7例颌骨部位小细胞骨肉瘤,影响一名老年女性的下颌骨,有2个月与右下颌磨牙区相关的大疼痛肿胀史。锥形束计算机断层扫描扫描显示与下磨牙区相关的溶骨性病变,并累及下牙槽神经。切开活检,组织病理学检查和免疫组织化学染色后,诊断为小细胞骨肉瘤。颌面外科医生进行了半颌骨切除术。在撰写手稿之前,没有发现复发的临床证据。
    结论:准确的诊断非常重要,考虑到小细胞骨肉瘤与传统骨肉瘤相比预后较差,全科医生应该意识到这一实体。
    BACKGROUND: Small cell osteosarcoma is an extremely rare histopathological variant of conventional osteosarcoma. Due to nonspecific symptoms, most osteosarcomas of the jaws are misdiagnosed as periapical abscesses and mistreated by teeth extraction and drainage.
    METHODS: We report, to our knowledge, the seventh case of small cell osteosarcoma in gnathic sites affecting the mandible of an old female with history of a large painful swelling related to the right mandibular molar area for 2 months. Cone-beam computed tomography scan showed an osteolytic lesion related to the lower molar area with involvement of the inferior alveolar nerve. An incisional biopsy was taken, and after histopathological examination and immunohistochemical staining, a diagnosis of small cell osteosarcoma was reached. Hemi-mandibulectomy was performed by a maxillofacial surgeon. No clinical evidence for recurrence was noted until manuscript writing.
    CONCLUSIONS: Accurate diagnosis is very important, and general practitioners should be aware of this entity considering that small cell osteosarcoma has a poor prognosis when compared to conventional osteosarcoma.
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  • 文章类型: Case Reports
    骨瘤是一种良性骨肿瘤,很少影响动物。这种肿瘤最常见的骨骼包括下颌骨,颌面部骨骼,还有鼻窦.明确的诊断基于病理发现,可以与其他骨病变区分。
    病人,一只5岁完整的雄性Mongrel犬表现出巨大的下颌肿块,左右下颌骨都有,导致牙齿咬合.进行了射线照相,并描绘了边界边界清晰的强烈肿块,正常和异常骨骼之间的短暂过渡区,和光滑的圆形不透射线的外观。根据细针抽吸的调查显示存在椭圆形至纺锤形细胞,恶性标准较差,脂肪细胞,反应性成骨细胞,和基于梭形细胞群的破骨细胞,退化的中性粒细胞数量少,细菌,和很少的巨噬细胞。然后,影像学评估和细胞学检查结果证实了骨瘤,并进行了手术治疗。进行了单侧下颌骨切除术,病变被送到组织病理学实验室。组织病理学评估显示骨细胞增殖,无恶性特征。成骨细胞也没有显示出支持骨瘤肿瘤的非典型增殖。
    尽管小动物的下颌和颌面骨切除具有不同的耐受性,该患者成为未来更好的营养和预防面部畸形和牙齿错合的手术候选人。骨瘤后的随访是检查肿块再生的最必要的术后治疗方法之一。本报告中有大量数据应将该肿瘤视为下颌骨肿瘤的可能鉴别诊断。
    Osteoma is a benign bone tumor that rarely affects animals. The most common bones involved with this tumor included the mandible, maxillofacial bones, and nasal sinuses. Definitive diagnosis is based on pathology findings which allow for differentiation with other bone lesions.
    The patient, a 5-year-old intact male Mongrel dog presented with a huge mandibular mass that involved both the right and left mandible, and led to dental occlusion. The radiography was performed and depicted the intense mass with a well-demarcated edge, a short transitional zone between normal and abnormal bone, and a smooth rounded radiopaque appearance. The investigation according to the fine needle aspiration showed the presence of oval to spindle shape cells with poorly malignancy criteria, fatty cells, reactive osteoblasts, and osteoclasts based on a population of spindle-shaped cells, and low numbers of degenerated neutrophils, bacteria, and few macrophages. Then, the radiographic assessments and cytology findings demonstrated the osteoma and were referred for surgical intervention. A unilateral mandibulectomy was performed, and the lesion was sent to the histopathology laboratory. The histopathology evaluation showed osteocyte proliferation without malignancy features. The osteoblast cells also showed no atypical proliferation that endorses the osteoma tumor.
    Although mandibular and maxillofacial bone resection in small animals have different tolerations, this patient became a candidate for surgery for future better nutrition and prevention of facial deformity and dental malocclusion. Follow-up after osteoma is one of the most necessary post-operation treatments to check the regeneration of the mass. There are considerable data in this report that should regard this tumor as a possible differential diagnosis for mandibular tumors.
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  • 文章类型: Case Reports
    对两名接受虚拟手术计划工作流程进行手术并随访4年的患者进行下巴翼截骨术。
    通过牙齿和面部照片评估了两名正常咬合的后颌骨患者,锥形束计算机断层摄影和牙弓数字化。通过使用DolphinImaging软件模拟下巴翼截骨术进行虚拟手术计划。接下来,将三维模型导入计算机辅助设计系统(Rhino6),用于设计两个混合(牙骨支撑)切割和重新定位指南。使用切割引导件进行下巴翼截骨术,并使用L形板和螺钉在重新定位引导件的辅助下放置截骨段。骨移植物两侧插入下颌角区域。在这两种情况下,患者报告了美学和功能上的良好结局.
    Chin翼截骨术是正常咬合患者下颌后下颌骨的适当治疗方法,并且没有其他差异,因为该技术提供了下巴的前移和面部轮廓的改善。术后结果显示虚拟计划和外科手术的可靠工作流程,在类似情况下可以作为替代方案。
    UNASSIGNED: To present a chin wing osteotomy in two patients who had undergone a virtual surgical planning workflow for surgical procedures and were followed up for 4 years.
    UNASSIGNED: Two retrognathic patients with normal occlusion were evaluated by means of dental and facial photographs, cone beam computed tomographs and digitization of dental arches. Virtual surgical planning was performed by using the Dolphin Imaging software to simulate the chin wing osteotomy. Next, three-dimensional models were imported into computer-aided design system (Rhino 6) for designing two hybrid (dental-bone supported) cutting and repositioning guides. Chin wing osteotomies were carried out by using the cutting guides and the osteotomized segments were placed by using L-shaped plates and screws assisted by the repositioning guides. Bone grafts were interposed in the mandibular angle region bilaterally. In both cases, the patients reported aesthetically and functionally favorable outcomes.
    UNASSIGNED: Chin wing osteotomy is an appropriate treatment for retrognathic mandible in patients with normal occlusion and no additional discrepancies as the technique provided chin advancement and improvement in facial contour. The post-operative outcomes showed reliable workflow of virtual planning and surgical procedures, which could be adopted as an alternative in similar cases.
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  • 文章类型: Case Reports
    未经证实:近年来,手术优先方法(SFA)彻底改变了正颌手术的趋势,因为它首先解决了牙面畸形,使患者依从性和结果更可预测。
    未经证实:一名22岁的女性担心她的牙齿向前放置。
    UNASSIGNED:她的牙周组织受损,伴有骨骼II类错牙合和牙齿错牙合。
    UNASSIGNED:执行SFA计划,拔除所有第一前磨牙,然后进行术后正畸治疗。
    UNASSIGNED:在11个月时达到了最佳的功能和牙面美学。
    UNASSIGNED:研究认为SFA优于传统的三相方法,已被证明对牙周病受损的个体有益,因为它旨在主要通过稳定组织完整性来缓解任何创伤性闭塞。对于寻求以尽可能短的持续时间进行快速转变的患者,这是最有利的。
    UNASSIGNED: The surgery-first approach (SFA) has revolutionized orthognathic surgery in recent years and in trend because it addresses the dentofacial abnormalities first, making the patient compliant and outcome more predictable.
    UNASSIGNED: A 22-year-old female was concerned about her forwardly placed teeth.
    UNASSIGNED: She had a compromised periodontium with a skeletal Class II malocclusion and dental malocclusion.
    UNASSIGNED: A SFA plan was executed with the extraction of all first premolars followed by postsurgical orthodontic treatment.
    UNASSIGNED: Optimal functional and dentofacial esthetics were achieved by 11 months.
    UNASSIGNED: Research has attributed several advantages of SFA over the conventional triphasic approach, which has proven to be beneficial in periodontally compromised individuals as it intends to relieve any traumatic occlusion primarily by stabilizing tissue integrity. It is most favorable in patients seeking a quick transformation with the least possible duration.
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  • 文章类型: Journal Article
    接受节段性下颌骨切除术治疗的患者通常需要复杂的康复。维持下颌连续性和提供足够的软组织和硬组织体积是良好临床结果所需的两个关键因素。此外,过度的咬合间恢复空间是这些患者的常见问题。该病例报告描述了通过在70岁的口腔鳞状细胞癌患者中使用创造性的两层固定植入物假体,从广泛的手术切除到最终康复的假体康复过程。
    Patients treated with segmental mandibulectomy often require complicated rehabilitation. Maintenance of mandibular continuity and provision of adequate soft and hard tissue volumes are two key factors required for good clinical outcomes. Moreover, excessive interocclusal restoration space is a common problem in these patients. This case report describes the process of prosthetic rehabilitation from extensive surgical excision to final rehabilitation by using a creative two-layer fixed implant prosthesis in a 70-year-old patient with oral squamous cell carcinoma.
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  • 文章类型: Case Reports
    颗粒松质骨和骨髓(PCBM)移植物与钛(Ti-)网状托盘结合已成为最受欢迎的下颌骨重建方法之一。该技术已应用于节段下颌骨切除术后的下颌骨不连续性缺陷。据我们所知,没有关于在半脑切除术后使用该技术的报道,在此期间进行广泛的下颌骨切除术,包括髁,执行。这里,我们首先报道一例半关节切除术后下颌骨重建,使用钢板和无软组织皮瓣,其次是钛网和从双侧后伊利亚收获的PCBM,这是成功的。该病例报告首次揭示了半脑切除术后使用PCBM和Ti网盘在下颌骨重建中临床上如何发生骨吸收。我们还揭示了半关节切除术后使用PCBM和Ti网状托盘进行下颌骨重建的高度可预测性。我们的报告还提供了指导原则,以克服半关节切除术后使用PCBM和Ti网状托盘进行下颌骨重建的局限性。然而,我们的手稿证据有限,作为病例报告。
    A particulate cancellous bone and marrow (PCBM) graft combined with titanium (Ti-) mesh tray has become one of the most popular mandibular reconstruction methods. The technique has been applied to the mandibular discontinuity defects after segmental mandibulectomy. To the best of our knowledge, there are no reports on using the technique after hemimandibulectomy, during which a wide mandibular resection, including the condyle, is performed. Here, we first report a case of mandibular reconstruction after hemimandibulectomy, using a plate and soft-tissue free flap, followed by a Ti-mesh and PCBM harvested from the bilateral posterior ilia, which was successful. This case report first revealed how bone resorption occurred clinically in mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. We also revealed the high predictability of the mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. Our report also provides a guiding principle to overcome the limitation of mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. However, our manuscript has limited evidence, being a case report.
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  • 文章类型: Case Reports
    背景:婴儿期黑素细胞神经外胚层肿瘤(MNTI)是一种罕见的良性色素沉着肿瘤,起源于神经c并具有侵袭性生长模式。它主要见于1岁以下的婴儿,最常见的受累部位是上颌骨。目前接受的治疗是通过手术切除切除。在这里,我们报告了一例MNTI病例,该病例涉及6个月大的婴儿下颌骨前牙槽。
    方法:一例6个月大的男童,下颌骨前牙槽脊有巨大肿块。
    方法:在切开活检后获得的活检标本上使用组织病理学和免疫组织化学技术诊断肿瘤。根据调查结果,建立了MNTI的最终诊断。
    方法:对肿瘤进行根治性切除,在通过参考使用术前CT数据创建的下颌3D模型确定切除范围后。
    结果:术后进展顺利,迄今为止,在手术后超过4年没有观察到复发。
    结论:本病例强调早期诊断和根治性手术是有效治疗的关键,MNTI表现出快速和破坏性的增长。由于复发率高,还需要仔细和密切的随访。
    BACKGROUND: Melanocytic neuroectodermal tumor of infancy (MNTI) is a rare benign pigmented neoplasm that arises from the neural crest and has an aggressive growth pattern. It is predominantly seen in infants under 1 year of age, and the most common site of involvement is the maxilla. The currently accepted treatment is removal by surgical resection. Herein, we report a case of MNTI that involved the anterior alveolar ridge of the mandible in a 6-month-old infant.
    METHODS: A case of a 6-month-old male child with a huge mass in the anterior alveolar ridge of the mandible.
    METHODS: The tumor was diagnosed using histopathological and immunohistochemical techniques on the biopsy specimen obtained following incisional biopsy. Based on the findings, a final diagnosis of MNTI was established.
    METHODS: Radical resection of the tumor was performed, after determining the extent of resection by referring to the mandibular 3D model created using the pre-operative CT data.
    RESULTS: The postoperative course was uneventful, and no recurrence has been observed to date for more than 4 years after surgery.
    CONCLUSIONS: This case emphasizes that early diagnosis and radical surgery are critical to the effective treatment, as MNTI exhibits rapid and destructive growth. It also requires careful and close follow-up because of high recurrence rates.
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  • 文章类型: Case Reports
    口腔恶性黑色素瘤是罕见的口腔肿瘤,具有明显的诊断歧义。病因尚不清楚,尽管遗传对黑素细胞的刺激,表观遗传,以及在病因病因学中提出的创伤性原因。临床上,它表现为色素性肿胀或生长,直到发展到后期才保持无症状。它是高度侵入性的,转移迅速;因此,预后极差,生存率仅为7%.肿瘤的早期诊断和彻底检查不仅对于及时治疗是必要的,而且对于良好的预后也是必要的。
    Oral malignant melanomas are rare neoplasms of the oral cavity which present significant diagnostic ambiguity. The etiology is unclear though the stimulation of melanoblasts by genetic, epigenetic, and traumatic causes that have been proposed in etiopathogenesis. Clinically, it presents as a pigmented swelling or growth which remains asymptomatic until it advances to later stages. It is highly invasive and metastasizes quickly; hence, it has a very poor prognosis with a survival rate of only 7%. Early diagnosis of the neoplasm and thorough investigation is not only necessary for prompt treatment but also necessary for a favorable prognosis.
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  • 文章类型: Journal Article
    Surgical resection of the lower jaw due to the presence of a benign or malignant tumor is the most frequent cause of mandibular deviation. Location and extent of the tumor decide the surgical modality of mandibulectomy to be performed. The clinician must wait for an adequate span of time for completion of the healing and acceptance of the osseous graft before considering a definitive prosthesis. During the inceptive healing period, prosthodontic intervention is of utmost priority for preventing the mandibular deviation. A corrective appliance termed \"guide flange prosthesis (GFP)\" is indicated to limit this clinical manifestation. The basic intention of rehabilitation is to train the mandibular muscles and to re-establish an acceptable occlusal relationship so that the patient can adequately control the opening and closing movements. This case series describes early prosthodontic management of three patients who had undergone hemimandibulectomy, with different techniques of fabrication of a GFP. The three techniques described consist of two conventional methods of fabrication while the third technique is a new innovative approach.
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