Functional reconstruction of dento-palatal and maxillary defect using staged operation of prefabricated scapular free flap and dental implants
Journal of the Korean Association of Oral and Maxillofacial Surgeons
;
: 301-307, 2004.
Article
Dans Coréen
| WPRIM
| ID: wpr-186706
ABSTRACT
The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Orbite
/
Réadaptation
/
Scapula
/
Peau
/
Implants dentaires
/
Appareils de prothèse dentaire
/
Palais osseux
/
Régime alimentaire
/
Lambeaux tissulaires libres
/
Péri-implantite
Limites du sujet:
Adulte
/
Humains
/
Mâle
langue:
Coréen
Texte intégral:
Journal of the Korean Association of Oral and Maxillofacial Surgeons
Année:
2004
Type:
Article
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