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The value of titan plate for the plasty of bone loss resulted from segmental resection of mandible

Keywords: TITANIUM PLATE , MANDIBLE RECONSTRUCTION , FREE FLAPS , LATISSIMUS DORSI FREE FLAP , FIBULA FREE FLAP

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Abstract:

BACKGROUND: Any bone loss that interrupts the continuity of the mandible has important functional and aesthetic consequences. One of the posibilities of plasty is represented by the use of the titan reconstruction plate and the optimization of results by association of free flaps. MATERIAL AND METHODS: Between 2006 - 2012, for a number of 26 patients the titan plate was used for restoring mandibular continuity for bone defects resulted from the excision of malignant tumors. RESULTS: In all cases a free flap was asociated, usually a latissimus dorsi myocutaneous flap (20 cases); in one case a radial fascio-cutaneous flap combined with a pectoralis major myocutaneous flap. In 5 cases the modelation of the fibula flap was performed on a mandibular reconstruction plate. 3 of the reconstruction plates were removed postoperative, one of them because of the necrosing of a latissimus dorsi free flap, and the other two because of cutaneous or intraoral decubitus lesions. In the rest of the patiens the results were good or very good, with the resumption of oral feeding, a good diction and restoration of facial symmetry. CONCLUSIONS: The use of voluminous muscular free flaps is followed by a reduced rate of exteriorization of the reconstruction plates, with good and very good aesthetic and functional results. The association of reconstruction plates to fibula free flaps allows the restoration of a good symmetry with good stability in time.

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