The rationale of mandible reconstruction in advanced oral cancer

Alloplastic material versus autogenous vascularized bone graft

Tim Mo Chen, Hsian-Jenn Wang, Tian Yeu Cheng, Ke Chung Chang, Feng Huei Lin

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Autogenous vascularized bone grafts in combination with microsurgical techniques have revolutionized mandibular reconstruction in oral cancer surgery. The vascularized bone graft carries its own blood supply, resists infection, and heals rapidly even in the irradiated bed. However, its use in advanced oral cancer patients is controversial due to the gloomy prognosis of these patients. Effective alloplastic materials such as titanium plate or tray for mandibular reconstruction is a reasonable alternative. These can easily be shaped and have sufficient structural rigidity to maintain the mandibular fragments in proper orientation. Likewise, it is a fast and reliable procedure which can obtain good oral function. However, its potential late exposure due to breakdown of overlying skin, especially after radiotherapy, is well documented. This paper discusses our experience to rescue the oral function after alloplastic material failure using the vascularized fibula osteocutaneous flap, in irradiated patients. All fibula osteocutaneous flaps survived. Symmetry and contour of the reconstructed mandible were judged to be good, and patients were able to eat without saliva drooling. Donor-site morbidity was also low. From this clinical study, we believe that in advanced oral cancer, the titanium plate or tray is a useful adjunct for immediate mandibular reconstruction after surgical resection. The vascularized bone graft should be reserved for patients with alloplastic material failure. This rationale can avoid subjecting the patient to an unnecessary extensive mandibular reconstructive procedure.

Original languageEnglish
Pages (from-to)49-58
Number of pages10
JournalMaterials Science and Engineering C
Volume13
Issue number1-2
DOIs
Publication statusPublished - Sep 1 2000
Externally publishedYes

Fingerprint

Grafts
bones
Bone
cancer
Titanium
trays
Flaps
Radiotherapy
Rigidity
Surgery
Skin
Blood
titanium
saliva
prognosis
structural stability
infectious diseases
surgery
blood
beds

Keywords

  • Alloplastic materials
  • Autogenous vascularized bone graft

ASJC Scopus subject areas

  • Materials Science(all)
  • Condensed Matter Physics
  • Mechanics of Materials
  • Mechanical Engineering

Cite this

The rationale of mandible reconstruction in advanced oral cancer : Alloplastic material versus autogenous vascularized bone graft. / Chen, Tim Mo; Wang, Hsian-Jenn; Cheng, Tian Yeu; Chang, Ke Chung; Lin, Feng Huei.

In: Materials Science and Engineering C, Vol. 13, No. 1-2, 01.09.2000, p. 49-58.

Research output: Contribution to journalArticle

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