医学
放射性骨坏死
前庭
牙科
沟
自由襟翼
软组织
骨整合
外科
放射治疗
植入
放射科
前庭系统
作者
Jebrane Bouaoud,Pierre Descols,Quitterie Le Gal de Kerangal,Jean‐François Honart,A. Aupérin,Stéphane Temam,Jean-Jacques Brau,Grégoire D’Andréa,Nadia Benmoussa
标识
DOI:10.1016/j.jormas.2021.10.011
摘要
Vestibuloplasty is fundamental to restore an oral vestibule for immediate dental implantation in fibular free flap (FFF) for oral cancer patients undergoing mandibulectomy reconstruction. Double surgical team including reconstructive head and neck surgeon and a dental surgeon is fundamental. The first step of the vestibuloplasty is to identify the skin perforator. The second step is to thin the FFF skin island as much as necessary to facilitate: i-the reinset into the gingivobuccal sulcus while creating enough space in the oral vestibule for the future dental prosthesis and ii-the exposition of dental implants. The third step is to create a percutaneous access to the implants through the FFF skin paddle using a dermatologic punch while preserving a large oral vestibule. The fourth step is the skin reinsertion into the gingivobuccal sulcus and closure. Realizing vestibuloplasty before radiotherapy allows prevention of soft tissue contraction and osteoradionecrosis while reducing the necessary time for a complete dental rehabilitation and improving patient quality of life.
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