Versatility of Transport Distraction Osteogenesis for Reconstruction of Lateral Mandibular Ablative Defects.

Introduction: The reconstitution of form and function after maxillofacial tumor resection or traumatic bony defects is a challenge when considering reconstructive options. The reconstructive options will depend upon whether the tissues to be replaced included bone alone or both bone and soft tissue (composite resection). Methodology: This study was carried out on nine patients who with benign tumors or cysts of the mandible that required segmental resection. Mandibular reconstruction using mandibular transport distraction osteogenesis was performed for all the cases. Depending on whether the condyle was spared or sacrificed, the type of mandibular transport distractor either fixed on the remnant condyle-ramus unit or had a condylar component replacing the resected condyles. Depending on the location of the defect, transport distraction was carried our anterior to posterior or posterior to anterior. Results: A total of nine cases of benign mandibular pathologies were operated. Segmental resection with condylar preservation was carried out in seven cases, segmental resection with condylar resection was carried out in two cases. In cases with condylar resection, the reconstruction plate of the distractor device had a condylar component. Anterior to posterior transport distraction was carried out in seven cases, and posterior to anterior transport distraction carried out in two cases. The amount of distracted bone ranged from 38 to 46 mm. Conclusion: Mandibular transport distraction osteogenesis offers a modality of reconstruction where the patient's native host bone is osteotomized and gradually distracted to induce the formation of regenerated osseous structure and soft tissue. Being cost-effective, not requiring a steep learning curve/long operative time, and not technically demanding as vascularized bone grafts/flaps, it is feasible in the Indian setup as a practical reconstructive option for benign jaw tumors.

Short-Term Evaluation of Gustatory Changes After Surgical Removal of Mandibular Third Molar-A Prospective Randomized Control Trial.

PURPOSE: The present study was carried out to prospectively determine the incidence and severity of suprathreshold taste changes after surgical removal of mandibular third molars. MATERIALS AND METHODS: Sixty patients who required removal of impacted third molars were included in the study. Based on the Winter criteria of angulation of impacted mandibular third molars, 15 patients each with mesioangular, distoangular, horizontal, and vertical impacted third molars were selected. The chemo-gustometry chart in pentagon scheme was used to represent the results of gustometry and to establish a correlation between the difficulty index of impacted third molar removal and the incidence of gustatory changes. All patients underwent spatial taste testing preoperatively and 1 week postoperatively. RESULTS: The highest incidence of taste changes was noted in category 3 (difficulty score, 7 to 8) and mostly for distoangular and vertically impacted teeth. CONCLUSION: In their extensive patient analysis of 4 different taste sensations, the authors found that suprathreshold taste changes do occur after surgical removal of an impacted mandibular third molar, with a high difficulty index score indicating the highest prevalence for altered taste sensations for distoangular and vertical impactions.