Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction
Abstract Background Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical sit...
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doaj-3be3a57c34534a30a6e6279e225a44362020-11-25T03:52:53ZengSpringerOpenMaxillofacial Plastic and Reconstructive Surgery2288-85862020-06-014211610.1186/s40902-020-00266-3Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstructionDong-Hun Lee0Seong Ryoung Kim1Sam Jang2Kang-Min Ahn3Jee-Ho Lee4Department of Oral and Maxillofacial Surgery, Asan Medical CenterDepartment of Oral and Maxillofacial Surgery, Asan Medical CenterCoreline SoftDepartment of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of UlsanDepartment of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of UlsanAbstract Background Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical site can cause severe fibrosis and atrophy of soft tissue in the head and neck region. Case presentation Here, we report a case of severe soft tissue atrophy that appeared along with scar formation after mandibular reconstruction through the fibular free flap procedure. This led to normal occlusion collapse after it was established, and the midline of the mandible became severely deviated to the affected side that was replaced with the fibula free flap, leading to facial asymmetry. We corrected the malocclusion with a secondary operation: a sagittal split ramus osteotomy on the unaffected side and a sliding osteotomy on the previous fibula graft. After a healing time of 3 months, implants were placed on the fibula graft for additional occlusal stability. Conclusion We report satisfactory results from the correction of malocclusion after fibula reconstruction using sliding fibula osteotomy and sagittal split ramus osteotomy. The midline of the mandible returned to its original position and the degree of facial asymmetry was reduced. The implants reduced difficulties that the patient experienced with masticatory function.http://link.springer.com/article/10.1186/s40902-020-00266-3Mandible reconstructionFibula free flapSagittal split ramus osteotomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dong-Hun Lee Seong Ryoung Kim Sam Jang Kang-Min Ahn Jee-Ho Lee |
spellingShingle |
Dong-Hun Lee Seong Ryoung Kim Sam Jang Kang-Min Ahn Jee-Ho Lee Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction Maxillofacial Plastic and Reconstructive Surgery Mandible reconstruction Fibula free flap Sagittal split ramus osteotomy |
author_facet |
Dong-Hun Lee Seong Ryoung Kim Sam Jang Kang-Min Ahn Jee-Ho Lee |
author_sort |
Dong-Hun Lee |
title |
Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction |
title_short |
Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction |
title_full |
Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction |
title_fullStr |
Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction |
title_full_unstemmed |
Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction |
title_sort |
correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction |
publisher |
SpringerOpen |
series |
Maxillofacial Plastic and Reconstructive Surgery |
issn |
2288-8586 |
publishDate |
2020-06-01 |
description |
Abstract Background Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical site can cause severe fibrosis and atrophy of soft tissue in the head and neck region. Case presentation Here, we report a case of severe soft tissue atrophy that appeared along with scar formation after mandibular reconstruction through the fibular free flap procedure. This led to normal occlusion collapse after it was established, and the midline of the mandible became severely deviated to the affected side that was replaced with the fibula free flap, leading to facial asymmetry. We corrected the malocclusion with a secondary operation: a sagittal split ramus osteotomy on the unaffected side and a sliding osteotomy on the previous fibula graft. After a healing time of 3 months, implants were placed on the fibula graft for additional occlusal stability. Conclusion We report satisfactory results from the correction of malocclusion after fibula reconstruction using sliding fibula osteotomy and sagittal split ramus osteotomy. The midline of the mandible returned to its original position and the degree of facial asymmetry was reduced. The implants reduced difficulties that the patient experienced with masticatory function. |
topic |
Mandible reconstruction Fibula free flap Sagittal split ramus osteotomy |
url |
http://link.springer.com/article/10.1186/s40902-020-00266-3 |
work_keys_str_mv |
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