Journal of Surgery

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The Use of Reconstruction Plates and Add-on Condyles with an Alloplastic Unmatched Fossa, Following Partial Mandibulectomy with Disarticulation

Received: 22 January 2019    Accepted: 09 April 2019    Published: 06 May 2019
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Abstract

The reconstruction of a mandible after ablative surgery poses many challenges. This is particularly true if the temporomandibular joint (TMJ) has been sacrificed, and the intention is to replace the mandibular defect and the joint with an alloplastic reconstruction plate and add-on condyle. A metal only condyle poses serious complication risk, and thus function against a prosthetic fossa is desirable. Currently, no stock matched prosthesis exists to fulfil this role. Aim: a series of cases are presented, whereby unmatched add-on condyles and alloplastic fossas were used safely and effectively. Materials and method: nine patients that received hemi-mandibulectomies and subsequent reconstruction with reconstruction plates, add-on condyles and alloplastic TMJ fossas, were retrospectively reviewed. The radiographs were reviewed for structural integrity of the prostheses, or the formation of heterotypic bone; and the patients were clinically evaluated for localised signs of sepsis or dehiscence. Results: all nine patients showed no sign of clinical or radiographic failure of the hybrid prostheses. Conclusion: it appears as though the use of unmatched TMJ fossas and reconstruction plates with add-on condyles, are an acceptable method of treating an ablated TMJ after hemi-mandibulectomy with disarticulation.

DOI 10.11648/j.js.20190702.11
Published in Journal of Surgery (Volume 7, Issue 2, April 2019)
Page(s) 31-34
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Mandibular-Reconstruction, Add-on Condyle, Alloplastic Fossa, Temporomandibular Joint

References
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[2] Westermark A, Koppel D, Leiggener C. Condylar replacement alone is not sufficient for prosthetic reconstruction of the temporomandibular joint. Int J Oral Maxillofac Surg 2006;35(6):488-492
[3] Van Loon J-P, Otten E, Falkenström CH, de Bont LGM, Verkerke GJ. Loading of a unilateral temporomandibular joint prosthesis: a three dimensional mathematical study. J Dent Res 1998;77(11):1939-1947
[4] Westermark A, Hedén P, Aagaard E, Cornelius C-P. The use of TMJ concepts prostheses to reconstruct patients with major temporomandibular joint and mandibular defects. Int J Oral Maxillofac Surg 2011;40:487-496
[5] Mercuri LG. Alloplastic temporomandibular joint reconstruction. Oral Surg Oral Med Oral Pathol 1998;85(6):631-637
[6] Lindqvist C, Sӧderholm AL, Hallikainen D, Sjӧvall L. Erosion and heterotopic bone formation after alloplastic temporomandibular joint reconstruction. J Oral Maxillofac Surg 1992;50:942-949
[7] Gilles HD. Plastic surgery of the face. London: Oxford; 1920
[8] Kaban LB, Bouchard C, Troulis MJ. A protocol for management of temporomandibular joint ankylosis in children. J Oral Maxillofac Surg 2009;67:1966-1978
[9] Perrot DH, Umeda H, Kaban LB. Costochondral graft construction/reconstruction of the ramus condyle unit: long term follow up. Int J Oral Maxillofac Surg 1994;23:321-328
[10] Mario JI, Aaron L. Temporomandibular joint reconstuction. Curr Opin Otolaryngol Head Neck Surg 2016;24:336-342
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[13] Mercuri LG, Wolford LM, Sanders B et al. Custom CAD/CAM total temporomandibular joint reconstruction system: preliminary multicenter report. J Oral Maxillofac Surg 1995;53:106-115
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[15] Garrett WR, Abbey PA, Christensen RW. Temporomandibular joint reconstruction with a custom temporomandibular joint prosthesis: use in the multiply operated patient. In Szabo Z, Leis JE, Fantini GA, editors. Surgical technology international. San Francisco, CA: Universal Medical 1997. pp. 347-354
Author Information
  • Department of Maxillofacial and Oral Surgery, University of Pretoria, Tshwane, South Africa

  • Advanced Orofacial Surgery, Rosebank, South Africa

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  • APA Style

    Jameel Desai, Coelette Smit. (2019). The Use of Reconstruction Plates and Add-on Condyles with an Alloplastic Unmatched Fossa, Following Partial Mandibulectomy with Disarticulation. Journal of Surgery, 7(2), 31-34. https://doi.org/10.11648/j.js.20190702.11

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    ACS Style

    Jameel Desai; Coelette Smit. The Use of Reconstruction Plates and Add-on Condyles with an Alloplastic Unmatched Fossa, Following Partial Mandibulectomy with Disarticulation. J. Surg. 2019, 7(2), 31-34. doi: 10.11648/j.js.20190702.11

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    AMA Style

    Jameel Desai, Coelette Smit. The Use of Reconstruction Plates and Add-on Condyles with an Alloplastic Unmatched Fossa, Following Partial Mandibulectomy with Disarticulation. J Surg. 2019;7(2):31-34. doi: 10.11648/j.js.20190702.11

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  • @article{10.11648/j.js.20190702.11,
      author = {Jameel Desai and Coelette Smit},
      title = {The Use of Reconstruction Plates and Add-on Condyles with an Alloplastic Unmatched Fossa, Following Partial Mandibulectomy with Disarticulation},
      journal = {Journal of Surgery},
      volume = {7},
      number = {2},
      pages = {31-34},
      doi = {10.11648/j.js.20190702.11},
      url = {https://doi.org/10.11648/j.js.20190702.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.20190702.11},
      abstract = {The reconstruction of a mandible after ablative surgery poses many challenges. This is particularly true if the temporomandibular joint (TMJ) has been sacrificed, and the intention is to replace the mandibular defect and the joint with an alloplastic reconstruction plate and add-on condyle. A metal only condyle poses serious complication risk, and thus function against a prosthetic fossa is desirable. Currently, no stock matched prosthesis exists to fulfil this role. Aim: a series of cases are presented, whereby unmatched add-on condyles and alloplastic fossas were used safely and effectively. Materials and method: nine patients that received hemi-mandibulectomies and subsequent reconstruction with reconstruction plates, add-on condyles and alloplastic TMJ fossas, were retrospectively reviewed. The radiographs were reviewed for structural integrity of the prostheses, or the formation of heterotypic bone; and the patients were clinically evaluated for localised signs of sepsis or dehiscence. Results: all nine patients showed no sign of clinical or radiographic failure of the hybrid prostheses. Conclusion: it appears as though the use of unmatched TMJ fossas and reconstruction plates with add-on condyles, are an acceptable method of treating an ablated TMJ after hemi-mandibulectomy with disarticulation.},
     year = {2019}
    }
    

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    T1  - The Use of Reconstruction Plates and Add-on Condyles with an Alloplastic Unmatched Fossa, Following Partial Mandibulectomy with Disarticulation
    AU  - Jameel Desai
    AU  - Coelette Smit
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    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
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    AB  - The reconstruction of a mandible after ablative surgery poses many challenges. This is particularly true if the temporomandibular joint (TMJ) has been sacrificed, and the intention is to replace the mandibular defect and the joint with an alloplastic reconstruction plate and add-on condyle. A metal only condyle poses serious complication risk, and thus function against a prosthetic fossa is desirable. Currently, no stock matched prosthesis exists to fulfil this role. Aim: a series of cases are presented, whereby unmatched add-on condyles and alloplastic fossas were used safely and effectively. Materials and method: nine patients that received hemi-mandibulectomies and subsequent reconstruction with reconstruction plates, add-on condyles and alloplastic TMJ fossas, were retrospectively reviewed. The radiographs were reviewed for structural integrity of the prostheses, or the formation of heterotypic bone; and the patients were clinically evaluated for localised signs of sepsis or dehiscence. Results: all nine patients showed no sign of clinical or radiographic failure of the hybrid prostheses. Conclusion: it appears as though the use of unmatched TMJ fossas and reconstruction plates with add-on condyles, are an acceptable method of treating an ablated TMJ after hemi-mandibulectomy with disarticulation.
    VL  - 7
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