Fixed bite plate combined with intermaxillary traction screw for free fibula flap repair of mandibular defects / 中国组织工程研究

ABSTRACT

BACKGROUND: Surgeries on maxillary sinus carcinoma, soft palate carcinoma, tonsillar cancer and other malignant tumors and surgical trauma are known to cause mandibular defects. Patients with mandibular defects usually present with chewing, swallowing and speech dysfunction and imperfect facial appearance. It is difficult to repair mandibular defects in the maxillofacial surgery.OBJECTIVE: To investigate the efficacy of fixed bite plate combined with intermaxillary traction screw in the repair of mandibular defects with free fibular flap.METHODS: Seventy-five patients with mandibular defects reconstructed using free fibular flap in the Affiliated Stomatological Medical Hospital of Southwest University of Medical Sciences from June 2014 to December 2015 were enrolled, and were than randomized to two groups 44 patients subjected to the bite plate combined with intermaxillary traction screw served as experimental group, and the others received intermaxillary traction using dental arch splint as control group. The operation time, wound healing at donor and accepting site, the survival rate of fibular flap, facial appearance, occlusion, functional speech and complications were compared between two groups.RESULTS AND CONCLUSION: The mean operation time showed significant difference between the experimental ((9.1±1.7) hours) and control ((10.2±2.1) hours) groups (P < 0.05). There were significant differences in the facial appearance (38 vs. 20), occlusion (41 vs. 22), and functional speech (39 vs. 21) between experimental and control groups (P < 0.05). The all-complication rate and the rate of maxillofacial wound dehiscence in the experimental group were significantly lower than those in the control group (P < 0.05). These results suggest that the bite plate combined with intermaxillary traction screw is simple and effective accompanied by less complications in the repair of mandibular defects.