Mandibular reconstruction with microvascularized graft after ameloblastoma resection: case series

Authors

DOI:

https://doi.org/10.33448/rsd-v10i15.22594

Keywords:

Ameloblastoma; Bone transplantation; Mandible; Microcirculation.

Abstract

Ameloblastoma is a locally aggressive and highly infiltrative tumor with a high recurrence rate. Its multicystic form the recommended treatment is resection with a safety margin, which results in significant facial defects with esthetic and functionals repercussions. Microvascular surgery revolutionized the reconstruction of significant defects because these grafting techniques allow a more satisfactory aesthetic and functional restoration. This study aimed to report a series of cases of reconstructions of mandibular defects using microvascularized fibular graft after ameloblastoma resection. Six patients were included in this study, and we collected data related to the surgical procedure, diagnosis, complications and follow-up. The patients were characterized as four women and two men, with a mean age of 23.8 years, with a diagnosis of mandibular ameloblastoma located mainly in the body, angle and mandibular ramus. These patients underwent lesion resection, resulting in defects larger than 5 cm, which justified using a microvascularized fibular graft for its reconstruction. The patients evolved well, with good results and without recurrences or complications in a postoperative follow-up of 2 to 5 years. Ameloblastoma is a lesion that reaches large dimensions and causes excellent cosmetic and functional damage. The microvascularized graft is an alternative in reconstructing significant defects and allows satisfactory morphofunctional reestablishment with minimal complications.

References

Alfaro, F. H., Magaz, V. R., Chatakun, P., Martínez, R. G. (2012) Mandibular reconstruction with tissue engineering in multiple recurrent ameloblastoma. Int J Periodontics Restorative Dent, 32, 82–86.

Amaral, F. Z., Ros, T., Oliveira, P. A. D., Castro, C.H.B.C, Moraes, G. M., Almeida, S.M.C.G., Brito, A. A. (2018) Reconstrução de mandíbula com retalho livre da fíbula em um caso de ameloblastoma. Rev Odontol Bras Central, 27(83), 257-261.

Bak, M.; Jacobson, A. S., Buchbinder, D., Urken, M. L. (2010) Contemporary reconstruction of the mandible. Oral oncology, 46, 71-76, 2010.

Condezo, A. F. B.; Guilinelli, J. L.; Curi, M. M. Portinho, C.P., Silveira, V. S., Burzlaff, J. B., Calcagnotto, T. (2017) Reabilitação dentária e reconstrução mandibular com retalho microvascularizado de fíbula. Rev. Cir. Traumatol. Buco-Maxilo-Fac., 17(3), 38-41.

França, A. J. B.; Jardim, V. B. F; Vasconcellos, R. J. H., Barboza, K. O., Leite-Segundo, A. V., Nogueira, E. F. C. (2016) Enxerto ósseo microvascularizado na reconstrução mandibular: relato de caso. Rev. Cir. Traumatol. Buco-maxilo-fac. 16 (1), p. 45-49.

Freire, R. G, Prata-Júnior, A. R., Albuquerque-Júnior, Souza, L. M. A. (2021) Ameloblastoma em região anterior de mandíbula. Rev Cubana Estomato., 58(1), 3391.

Galve, Y. H, Oliveira P. A. D, Jauregui, J. A. (2021) Ameloblastoma mandibular: resultados del tratamento quirúrgico. Anales de la academia de ciências de Cuba, 11(1).

Goetze, E.; Gielisch, M.; Moergel, M.; Al-Nawas, B (2017) Accelerated workflow for primary jaw reconstruction with microvascular fibula graft. 3D Print Med, 3(3).

Head, C.; Alam, D.; Sercarz, J. A.; Lee, J. T.; Rawnsley, J. D.; Berke, G. S.; Blackwell, K. E. (2003) Microvascular flap reconstruction of the mandible: A comparison of bone grafts and bridging plates for restoration of mandibular continuity. Otolaryngology Head and Neck Surgery, 129(1):48-54. DOI:10.1016/S0194-5998(03)00480-7

Khachatryan, L.; Khachatryan, G.; Hakobyan, G. (2018) The Treatment of Lower Jaw Defects Using Vascularized Fibula Graft and Dental Implants. J Craniofac Surg. 29(8), 2214-2217. doi: 10.1097/SCS.0000000000005015.

Kain, J. J.; Birkeland, A. C.; Bewley, A. F.; (2021) Bony contouring in head and neck microvascular reconstruction. Plast Aesthet Res, 21 (8).

Liu, A.; Garg, R., Steinberg, J.; Odono, L.; Hammoudeh, J. (2020) Microvascular Mandibular Reconstruction with an Endoprosthesis: Optimizing Bone Height and Border Contour. Journal of Oral and Maxillofacial Surgery. 78 (10), E96-E97.

Marechek, A.; Jun, J.; Pack, S.; Patel, H.; Quereshy, F. A.; Baur, D. A. (2018) Retrospective Analysis of Mandibular Segmental Defects Treated with Non-Vascularized Bone Grafts and Their Outcomes, Journal of Oral and Maxillofacial Surgery, 76(10), e22-e23.

Melo, R. B.; Carneiro, N. C. M.; Fonseca, W. L. M., Lima, J. F., Araújo, H. P. S., Pontes, H. A. R. (2016) Tratamento cirúrgico de ameloblastoma sólido convencional: relato de caso clínico. RFO, 21(2), 246-250.

Milmann, T., Ying, G. S., Pan, W., Livolsi, V. (2016) Ameloblastoma: 25 Year experience at a single institution. Head and Neck Pathol, 10, 513-520.

Moraes, F. B, Rodrigues S. V., Dutra, M. V. F., Pereira, U. R., Borges, T. R. S. A. (2014) Ameloblastoma: uma análise crítica e terapêutica. Rev Bras Ortop, 49(3), 305-308.

Neville, W. B., Damm, D. D, Allen, C.M. Bougout, J.E. (2009) Patologia oral e maxilofacial, Rio de Janeiro, Guanabaraa Koogan, 3ªedição.

Pastore, G. P.; Martins, I. S. M, Goulart, D. R., Prati, A. J., Moraes, M., Pastore, P. R., Toledo, M. C. (2016). Surgical management of mandibular ameloblastoma and immediate reconstruction with nonvascularized boné graft and hyperbaric oxygen therapy. Int J Odontostomat, 1(3), 409-417.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da Pesquisa Científica (1 ed ed.). Núcleo de Tecnologia Educacional da Universidade Federal de Santa Maria.

Siqueira, A. S.; Torres, L. H. S.; Diniz, J. A.; Rodriguez, E. D. R., Uchôa, C. P., Pereira-Filho, V. A., Gomes, A. C. A., Silva, E.D. O. (2019) Sequela de cirurgia para reconstrução mandibular após ressecção de ameloblastoma. Arch Health Invest, 8(8), 425-429.

Vorrasi, J.S., Kolokythas, A. (2017) Controversies in traditional oral and maxillofacial reconstruction. Oral maxillofacial surg clin, 29, 401-413.

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Published

24/11/2021

How to Cite

PONTES, K. T.; NASCIMENTO, Y. L.; LÔBO, M. V. .; ANDRADE, T. I. de .; OLIVEIRA, J. A. V. de .; BRAINER, D. L. B. . Mandibular reconstruction with microvascularized graft after ameloblastoma resection: case series. Research, Society and Development, [S. l.], v. 10, n. 15, p. e217101522594, 2021. DOI: 10.33448/rsd-v10i15.22594. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/22594. Acesso em: 24 apr. 2024.

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Section

Health Sciences