Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery
Identifieur interne : 001074 ( Ncbi/Curation ); précédent : 001073; suivant : 001075Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery
Auteurs : José L. Cebrian-Carretero [Espagne] ; Jorge Gui Ales-Díaz De Cevallos [Espagne] ; José A. Sobrino ; Tomás Yu ; Miguel Burgue O-García [Espagne]Source :
- Medicina Oral, Patología Oral y Cirugía Bucal [ 1698-4447 ] ; 2014.
Abstract
The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality. Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses. In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result.
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DOI: 10.4317/medoral.19116
PubMed: 25129241
PubMed Central: 4259378
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José A. Sobrino<affiliation><nlm:aff id="A3">MD, DDS. Private practice</nlm:aff><wicri:noCountry code="subfield">DDS. Private practice</wicri:noCountry></affiliation><affiliation><nlm:aff id="A3">MD, DDS. Private practice</nlm:aff><wicri:noCountry code="subfield">DDS. Private practice</wicri:noCountry></affiliation>Le document en format XML
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reconstruction with free flaps. The role of implant guided surgery</title><author><name sortKey="Cebrian Carretero, Jose L" sort="Cebrian Carretero, Jose L" uniqKey="Cebrian Carretero J" first="José L." last="Cebrian-Carretero">José L. Cebrian-Carretero</name><affiliation wicri:level="3"><nlm:aff id="A1">MD, DDS. Faculty, Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>MD, DDS. Faculty, Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Gui Ales Diaz De Cevallos, Jorge" sort="Gui Ales Diaz De Cevallos, Jorge" uniqKey="Gui Ales Diaz De Cevallos J" first="Jorge" last="Gui Ales-Díaz De Cevallos">Jorge Gui Ales-Díaz De Cevallos</name><affiliation wicri:level="3"><nlm:aff id="A2">MD. Trainee, Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>MD. Trainee, Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Sobrino, Jose A" sort="Sobrino, Jose A" uniqKey="Sobrino J" first="José A." last="Sobrino">José A. Sobrino</name><affiliation><nlm:aff id="A3">MD, DDS. Private practice</nlm:aff><wicri:noCountry code="subfield">DDS. Private practice</wicri:noCountry></affiliation></author><author><name sortKey="Yu, Tomas" sort="Yu, Tomas" uniqKey="Yu T" first="Tomás" last="Yu">Tomás Yu</name><affiliation><nlm:aff id="A3">MD, DDS. Private practice</nlm:aff><wicri:noCountry code="subfield">DDS. Private practice</wicri:noCountry></affiliation></author><author><name sortKey="Burgue O Garcia, Miguel" sort="Burgue O Garcia, Miguel" uniqKey="Burgue O Garcia M" first="Miguel" last="Burgue O-García">Miguel Burgue O-García</name><affiliation wicri:level="3"><nlm:aff id="A4">MD. Head of Department, Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>MD. Head of Department, Oral and Maxillofacial Surgery Department, University Hospital La Paz, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author></analytic><series><title level="j">Medicina Oral, Patología Oral y Cirugía Bucal</title><idno type="ISSN">1698-4447</idno><idno type="eISSN">1698-6946</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality.
Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses.
In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result.
</p><p><bold> Key words:</bold>Oral cancer, mandibulectomy, maxillectomy, microvascular reconstruction, fibula flap, dental implant, guided surgery.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hidalgo, Da" uniqKey="Hidalgo D">DA Hidalgo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Head, C" uniqKey="Head C">C Head</name></author><author><name sortKey="Alam, D" uniqKey="Alam D">D Alam</name></author><author><name sortKey="Sercarz, Ja" uniqKey="Sercarz J">JA Sercarz</name></author><author><name sortKey="Lee, Jt" uniqKey="Lee J">JT Lee</name></author><author><name sortKey="Rawnsley, Jd" uniqKey="Rawnsley J">JD Rawnsley</name></author><author><name sortKey="Berke, Gs" uniqKey="Berke G">GS Berke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Little, Jw3rd" uniqKey="Little J">JW3rd Little</name></author><author><name sortKey="Mcculloch, Dt" uniqKey="Mcculloch 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