JAW RECONSTRUCTION

DR Jameel Kifayatullah LECTURER KHYBER COLLEGE OF DENTISTRY

PESHAWAR PAKISTAN

RECONSTRUCTION OF JAWS

RECONSTRUCTION

• Surgical removal of oral tumorOsseous defect

• Range of defect i) loss of alveolar bone ii) loss of major portion of jaw

RECONSTRUCTION

• Patient concerns i) functional ii) cosmetic

surgical reconstruction

• Loss of alveolar bone– need for osseous base for bridge/partial or complete denture

• Ridge augmentation to form an osseous base

RIDGE AUGMENTATION

AUGMENTATION OPTIONS

• BONE GRAFTS• SYNTHETIC BONE GRAFTS• COMBINATION

BONE GRAFTS

SYNTHETIC BONE GRAFTS

MAXILLARY DEFECT

• Continuation of nasal cavity or maxillary sinuses with oral cavity

• Difficulty in speaking,eating,drinking

Maxillary Defect Reconstruction

• OPTIONS1) SURGICAL2) PROSTHODONTIC

Surgical option• Less extensive defect:• Closure with available soft tissues of buccal

and palatal mucosa

Surgical option

• 2) Bone grafts :provides functional alveolar process

prosthodontic

• Very large defects• Poor surgical risks Obturators

TIMING OF RECONSTRUCTION

• Immediate(at the time of surgical removal)• Delayed • Benign tumors resection—immediate

reconstruction• Malignant tumors----delayed reconstruction

Delayed reconstruction after removal of malignant tumor

REASONS• 1) To prevent bone graft resorption if post op

radiotherpay planned• 2)more soft tissue required • 3) recurrence

Delayed reconstruction after removal of benign tumor

• Presence of simultaneous intraoral and extraoral defects

Maintenance of residual fragments

• Delayed reconstruction--- maintenance of residual fragments :

• Options i) external pin fixation ii) splints iii)IMF iv) recon plates

Maintenance of residual fragments

IMMEDIATE RECONSTRUCTION

ADVANTAGES• Viable option• Reqiring single surgical procedure• Early return to function• Minimal compromise to facial esthetics DISADVANTAGESLOSS OF GRAFT DUE TO INFECTION

DENTAL REHABILITATION

• DENTAL IMPLANTS