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G. Lauer
6. Gellrich N-C, Kwon TG, Lauer G, Fakler O, Gutwald
R, Otten J-E, Schmelzeisen R. The lateral upper
arm free ap for intraoral reconstruction. Int J Oral
Maxillofac Surg. 2000;29:104–11.
7. Leonhardt H, Mai R, Pradel W, Markwardt J, Pinzer
T, Spassov A, Lauer G.Free DIEP-ap reconstruction
of tumour related defects in head and neck. J Physiol
Pharmacol. 2008;59(Suppl 5):59–67.
8. Soutar DS, Scheker LR, Tanner NSB, McGregor
IA. The radial forearm ap: a versatile method for
intraoral reconstruction. Br J Plas Surg. 1983;36:1–8.
9. Umeda T. Experimental autotransplantation of
full thickness skin into the mouth. Oral Surg.
1969;23:709–15.
10. Medawar PB. The cultivation of adult mammalian skin epithelium in vitro. Quart J Micr Sci.
1948;89:187–90.
11. Peehl DM, Ham RG.Clonal growth of human keratinocytes with small amounts of dialyzed serum. In
Vitro. 1980;16:526–40.
12. Rheinwald JG, Green H.Serial cultivation of strains
of human epidermal keratinocytes: the formation
of keratinizing colonies from single cells. Cell.
1975;6:331–44.
13. Gallico GG, O’Connor NE, Compton CC, Kehinde O,
Green H.Permanent coverage of large burn wounds
with autologous cultured human epithelium. N Engl J
Med. 1984;311:448–51.
14. O’Connor NE, Mulliken JB, Banks-Schlegel S,
Kehinde O, Green H.Grafting of burns with cultured
epithelium prepared from autologous epidermal cells.
Lancet. 1981;10:75–9.
15. DeLuca M, Albanese E, Megna M, Cancedda R,
Mangiante PE, Cadoni A, Franzi AT. Evidence that
human oral epithelium reconstituted in vitro and
transplanted onto patients with defects in the oral
mucosa retains properties of the original donor site.
Transplantation. 1990;5:454–9.
16. Langdon JD, Leigh IM, Navsaria HA, Williams
DM. Autologous oral keratinocyte grafts in the
mouth. Lancet. 1990;335:1472–3.
17. Raghoebar GM, Tomson AM, Scholma J, Blaauw EH,
Witjes MJ, Vissink A.Use of cultured mucosal grafts
to cover defects caused by vestibuloplasty: an invivo
study. J Oral Maxillofac Surg. 1995;53:872–6.
18. Arenholt-Bindslev D, Jepsen A, Mac Callum DK,
Lillie JH. The growth and structure of human
oral keratinocytes in culture. J Invest Dermatol.
1987;88:314–9.
19. Lauer G.Autografting of feeder-cell free cultured gingival epithelium—method and clinical application. J
Craniomaxillofac Surg. 1994;22:18–22.
20. Southgate J, Williams HK, Trejdosiewicz LK, Hodges
GM. Primary culture of human oral epithelial cells.
Growth requirements and expression of differentiated
characteristics. Lab Inv. 1987;56:211–23.
21. Lauer G, Otten JE, von Specht BU, Schilli W.Cultured
gingival epithelium. A possible suitable material
for pre-prosthetic surgery. J Craniomaxillofac Surg.
1991;19:21–6.
22. Lauer G, Siegmund C, Hübner U. Inuence of
donor age and culture conditions on tissue engineering of mucosa autografts. Int J Oral Max Surg.
2003;32:305–12.
23. Johnson MC, Meyer AA, de Serres S, Herzog S,
Peterson HD.Persistence of fetal bovine serum proteins in human keratinocytes. J Burn Care Rehabil.
1990;11:504–9.
24. Lauer G. Autogenous serum for culturing keratinocyte autografts. In: Phillips GO, von Versen R,
Strong DM, Nather A, editors. Advances in tissue
banking, vol. 1. Singapore: World Scientic; 1997.
p.183–7.
25. Green H. Cyclic AMP in relation to proliferation of the epidermal cell: a new view. Cell.
1978;15:801–11.
26. Gutwald R, Lauer G, Otten JE, Schilli W.Epithelzellen
und Fibroblasten der Gingiva auf resorbierbaren
Membranen—Gewebetransfer zur Wundheilung?
Dtsch Zahnärztl Z. 1994;49:1015–8.
27. Pradel W, Blank A, Lauer G. Klinischer Einsatz
von im Tissue Engineering hergestellten
Gingivakeratinozyten-GingivafibroblastenKonstrukten als Weichgewebsersatz. Dtsch Zahnärztl
Z. 2002;57:709–12.
28. Thomson RC, Giordano GG, Collier JH, Ishaug SL,
Mikos AG, Lahiri-Munir D, Garcia CA.Manufacture
and characterization of poly (α-hydroxy ester) thin
lms as temporary substrates for retinal pigment epithelium cells. Biomaterials. 1996;17:321–7.
29. Hotta T, Yokoo S, Terashi H, Komori. Clinical and
histopathological analysis of healing process of intraoral reconstruction with exvivo produced oral mucosa
equivalent. Kobe J Med Sci. 2007;53:1–14.
30. Izumi K, Feinberg SE, Iida A, Yoshizawa M.Intraoral
grafting of an exvivo produced oral mucosa equivalent: a preliminary report. Int J Oral Max Surg.
2003;32:188–97.
31. El Ghalbzouri A, Lamme E, Ponec M.Crucial role
of broblasts in regulating epidermal morphogenesis.
Cell Tissue Res. 2002;310:189–99.
32. Karing T, Lang NP, Loe H.The role of connective
tissue in determining epithelial differentiation. J
Periodontal Res. 1975;10:1–10.
33. Ouhayoun JP, Sawaf MH, Goffaux JC, Etienne D,
Forest N.Re-epithelialization of a palatal connective
tissue graft transplanted in a non-keratinized alveolar mucosa: a histological and biochemical study in
humans. J Periodontal Res. 1988;23:127–33.
34. Tomakidi P, Breitkreuz D, Fusenig NE, Zöller J, Kohl
A, Komposch G.Establishment of oral mucosa phenotype invitro in correlation to epithelial anchorage.
Cell Tissue Res. 1998;292:355–66.
35. Lauer G, Schimming R, Frankenschmidt A.Intraoral
wound closure with tissue engineered mucosa—new

22 Oral Mucosa Tissue Engineering inCraniofacial Surgery
https://t.me/medicina_free
309
perspectives for urethra reconstruction with buccal
mucosa graft. Plast Reconstr Surg. 2001;107:25–33.
36. Lauer G, Schimming R, Gellrich NC, Schmelzeisen
R.Prelaminating the fascial radial forearm ap by tissue engineered mucosa—improvement of donor and
recipient site. Plast Reconstr Surg. 2001;108:1564–72.
37. Mitchell DL, Synnott SA, Van Dercreek JA.Tissue
reaction involving an intraoral skin graft and CP
titanium abutments: a clinical report. Int J Oral
Maxillofac Implants. 1990;5:79–84.
38. Schrott AR, Jimenez M, Hwang JW, Fiorellini J,
Weber HP. Five-year evaluation of the inuence of
keratinized mucosa on peri-implant soft-tissue health
and stability around implants supporting full-arch
mandibular xed prostheses. Clin Oral Implants Res.
2009;20:1170–7.
39. Clark HB.Deepening of the labial sulcus by mucosal
ap advancement. J Oral Surg. 1953;11:165–8.
40. Ewers R, Hoffmeister B. Reconstruction of the
mandibular denture bearing area and freeing of the
tongue after tumor surgery. J Oral Maxillofac Surg.
1988;46:272–5.
41. Hillerup S.Preprosthetic mandibular vestibuloplasty
with buccal mucosal graft—a 2-year follow-up study.
Int J Oral Surg. 1982;11:81–8.
42. Lauer G, Schimming R. Tissue-engineered mucosa
graft for reconstruction of the intraoral lining after
freeing of the tongue: a clinical and immunohistologic
study. J Oral Maxillofac Surg. 2001;59:167–9.
43. Yang G, Chen B, Gao Y.Forearm free skin ap transplantation. Natl Med J China. 1981;61:139.
44. Millesi W, Millesi-Schobel G, Glaser
C.Reconstruction of the oor of the mouth with fascial radial forearm ap prelaminated with autologous
mucosa. Int J Oral Maxillofac Surg. 1998;27:106–10.

Part XI
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Biological Procedures in Craniofacial
Reconstruction: Microsurgery

Microsurgical Jaw Reconstruction
https://t.me/medicina_free
MajeedRana andHenrietteMöllmann
23
Introduction: Mandibular Defects
The loss of continuity caused by trauma, defects
following tumor disease, or inammation (i.e.,
osteonecrosis or osteomyelitis) signicantly
impairs functions such as chewing, swallowing,
speaking, and breathing. Microsurgery allows
restoring mandibular continuity through free
bone grafting, microvascular grafts, or reconstruction with allogeneic and alloplastic materials. Technological advancements in
computer-assisted surgery (CAS) provide the
foundation for sustainable procedures. Depending
on the localization as well as the extent of mandibular defects, there are considerable functional
and aesthetic deteriorations.
Defects located in the lateral mandible or in
the area of the ascending mandibular branch
heavily impact the ability of chewing and swallowing. Due to a loss of continuity around the
chin, the tongue loses its support. Along with
issues of chewing and swallowing, patients are
endangered due to possible obstruction of the
upper respiratory tract. Furthermore, psychological as well as social consequences frequently
occur, which might negatively inuence social
M. Rana (*) · H. Möllmann
Department of Craniomaxillofacial Surgery,
University Hospital Düsseldorf, Heinrich Heine
University (HHU), Düsseldorf, Germany
e-mail: rana@med.uni-duesseldorf.de;
henriettelouise.moellmann@med.uni-duesseldorf.de
life and interactions. Thus, a functional and aesthetically appealing result using CAS represents
an indispensable component for mandibular
reconstruction.
the 1970s completely changed the therapeutic
concept. This technique allows different bone
grafts, also possible in combination with soft tissue, which might be harvested from areas distant
from the defect and transplanted into the head
and neck region. Here, primary or secondary
reconstruction is possible. Depending on the
underlying diagnosis, primary osseous reconstruction is preferred in the case of fractures or
chronic osteomyelitis as well as in the case of
resections due to benign lesions. In the case of
malignant underlying diseases, temporary xation by means of a reconstruction plate and secondary reconstruction is rarely performed.
Through CAS, the size and extent of the tumor,
the safety distances, the resection margins, as
well as the reconstruction can be planned preoperatively, visualized, and further implemented
intraoperatively.
option of an obturator in the sense of a defect
prosthesis [1] is not possible. The continuity of
the mandible can be restored using microvascular
grafts from different donor regions. Besides the
quality, quantity, and shape of the bone, the variability and volume of the required soft tissue, the
length of the pellicle, and the morbidity of the
The introduction of microvascular surgery in
Unlike reconstruction in the maxilla, the
© Springer Nature Switzerland AG 2023
U. Meyer (ed.), Fundamentals of Craniofacial Malformations,
https://doi.org/10.1007/978-3-031-28069-6_23
313

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M. Rana and H. Möllmann
donor region are of particular relevance when
selecting the appropriate graft. For the reconstruction of the mandible, donor regions such as
the bula, the scapula, as well as the iliac crest
[2] are highly suitable for clinical and surgical
demands. Along with the restoration of continuity, masticatory rehabilitation following reconstruction is also of great importance.
Virtual Planning
Three-dimensional virtual surgical planning (3DVSP) uses three-dimensional imaging datasets
from computed tomography (CT) and magnetic
resonance imaging (MRI) of the defect site as
well as CT angiography of the graft harvest site.
Depending on the underlying disease, CT scans
provide high resolution of both hard and soft tissues in the case of bony defects or bone erosion.
In the case of soft tissue tumors and inammatory diseases such as osteomyelitis, MRI scans
can further enhance soft tissue imaging. For
improving the overall image quality, the strengths
of the imaging modalities can be exploited by
fusing and combining CT and MRI datasets using
new software programs. After merging the
desired datasets, the mandible and adjacent structures are initially segmented. Intelligent software
segments are semiautomatically based on algorithms, which simplies planning and shortens
the overall duration [3]. In the context of virtual
planning, the size and extent of the tumor, the
resection margins, and the desired reconstruction
can thus be planned preoperatively, visualized,
and then implemented intraoperatively. For the
planning of the intraoperative navigation, special
dental splints are manufactured and placed or
screws are inserted before the preoperative imaging. Intraoperatively, the digital planning and the
clinical situation are merged via a navigation tripod temporarily attached to the skull. During the
operation, navigation can be used to directly verify the targeted resection and the correct positioning of the patient-specic implants (PSI) and
graft [4]. In addition to intraoperative navigation,
preoperative planning can also serve as a basis
for postoperative performance monitoring. By
merging the pre- and postoperative CT scans, the
accuracy of t can be validated [5]. For a functional and aesthetically appealing reconstruction,
the opposite side can be used as reference or template for achieving a symmetrical result. Besides
the intersegmental cutting and visualization of
the microsurgical reconstruction, the dental and
prosthetic rehabilitation can also be considered,
simulated, and planned [6]. If the prosthetic rehabilitation is already addressed at an early stage,
the procedure is referred to functional or prosthetically oriented backward planning. Thereby,
the condylar position and intermaxillary relationship are reproduced, visualized preoperatively, or
planned. Thus, the entire functional and dental
rehabilitation is achievable. Virtual planning further allows visualization of different reconstruction possibilities enabling a completely
individualized treatment concept for the patient
without invasive procedures. However, not only
surgeons should benet from the possibility of
visualizing the surgical site in the future. The
development of virtual reality devices will also
provide access to the planned operation for
patients. Regarding patient education, the operation is presented in a more illustrative and tangible way, increasing the transparency of the
treatment concept [7].
Patient-Specic Implants (PSIs)
Advancements in CAS, particularly regarding
computer-aided design/computer-aided manufacturing (CAD/CAM) technology, are superior
to more traditional methods of mandibular reconstruction with hand-bent plates [8–15]. CAD/
CAM or selective laser melting (SLM) plates
achieve higher accuracy compared to manually
bent reconstruction plates. These plates provide
greater results in terms of strength and intraoperative positioning [16]. Decisive factors for this
procedure are anatomical and symmetrical bone
shaping, restoration of a stable dental occlusion,
and condylar repositioning into a centric relation
[9, 17–20].
In the conventional technique, in contrast to
CAS, the plates are bent intraoperatively or pre-

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operatively manually before their adaptation.
Depending on the complexity of the case and the
skills as well as experience of the surgeon, this
procedure might be very time consuming. The
standard plates offered by manufacturers do not
always possess the required size and number of
holes for the intraoperative situation. PSIs do not
need to be bent to t the patient’s mandible and
do not require predened bending points as with
conventional reconstruction [21, 22]. With
improvements of CAD/CAM, it is possible to
accurately plan the reconstruction of craniofacial
defects preoperatively, manufacture precise PSI,
and place them in less complex surgeries with
shorter operating times [12, 23–25]. The implant
can be designed and shaped by the surgeon
according to the defect size, shape, and morphology [26, 27]. By selecting the appropriate design
method, manufacturing process, and implant
material, it is possible to perform a precise surgical procedure and reduce complications [28–35].
The integration of this technology in the pre- and
intraoperative workow has simplied the production of cutting guides and has been shown to
shorten the operation time and the length of stay
and to improve osseous consolidation, symmetry,
and morphology [34, 36, 37]. Recent research
demonstrated additional advantages, for instance,
minimized interoperator variability caused by the
surgeon’s experience and improved teaching possibilities for younger colleagues involved in the
planning procedures/sessions with a senior consultant and/or biomedical engineer [38].
Computer-Assisted Reconstruction
oftheMandible Using
Microvascular Grafts
After continuity resections of the lower jaw in
case of carcinoma, osteonecrosis, osteomyelitis,
or trauma, a mandibular reconstruction is essential to restore function and aesthetics [6, 39]. The
size of the defect is determined by the preoperative extent, the entity of the pathology, and the
resulting radicality of the resection.
Defects of the mandible are reconstructible
using either a reconstruction plate without bony
reconstruction or immediately with a combina-
tion of reconstruction plate and primary bone
ap. Despite the considerable progress in microvascular surgery, complications such as tissue
necrosis, failure of the graft, infections (donor
site or recipient), prolonged hospital stay, and
long recovery process occur [40–42].
Fibula, scapula, or iliac crest grafts are suitable for the clinical requirements for reconstruction of the mandible, in the sense of a free tissue
transfer.
Fibula-Tx
The microvascular bula graft ingests a major
role in computer-assisted reconstruction of the
mandible and in dental rehabilitation. It provides
a similar cross section as an atrophied mandible,
shows good corticoid bone quality and special
vascularization, and can be harvested up to a
length of 20–25cm [43].
Nevertheless, not every patient can undergo
bular grafting as in 6% of cases a nonunion of
the anterior or posterior tibial artery is present
[22]. In more than 1% of cases, the peroneal or
bular artery is the only vessel supplying the
entire lower leg making microsurgical bular
transfer impossible. Angiography of the donor
region is used to check whether transplantation is
advisable, where the perforators are located, and
how the graft can be obtained in an individualized manner. During virtual planning, the harvesting templates including drill holes are
individually designed so that the number and
position of the perforators are considered along
with the planned osteotomy lines. This also facilitates the removal of a suitable skin transplant.
Due to the digital and visualized planning as well
as the facilitated handling, ischemia and operation time can be shortened, and an optimal aesthetic and functional result is achievable.
Scapula-Tx
The microvascular scapula graft is highly appropriate for reconstruction of the mandible [44],
especially if a bula graft is not possible due to
peripheral vascular arteriopathy [45]. The lateral

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scapula edge with the maximal length of 14cm
can be used for bony reconstruction [46]. The circumex scapular artery supplies the lateral scapula as the terminal branch of the subscapular
artery and equips the soft tissue above the scapula
via two other vascular branches. This special vascular anatomy allows two independent
fasciocutaneous aps, the scapular and the parascapular aps, to be harvested simultaneously for
soft tissue reconstruction with one pellicle [45].
Therefore, this transplant can be primarily used
for the reconstruction of combined defects where
intraoral and extraoral soft tissue reconstruction
is necessary as well as bony reconstruction.
Compared to the removal of the bula graft, a
change of position must be performed intraoperatively. When harvesting the scapula graft, it is not
possible to operate in two teams and save operating time.
Iliac Crest-Tx
The iliac crest transplant is further suitable for
microsurgical reconstruction of the mandible.
Supplied via the circumex ilium profunda
artery, the iliac crest graft is a valid graft because
of the good bone quality, the slightly curved contour, and the bone volume. The special bone
structure can facilitate the desired dental rehabilitation [47]. Nevertheless, the special vascular
supply (short pellicle) makes microsurgical anastomosis difcult. Thus, strict indication and concrete preoperative planning are advisable.
References
1. Phasuk K, Haug SP. Maxillofacial prosthetics. Oral
Maxillofac Surg Clin North Am. 2018;30(4):487–97.
https://doi.org/10.1016/j.coms.2018.06.009.
2. Mascha F, Winter K, Pietzka S, Heufelder M, Schramm
A, Wilde F.Accuracy of computer-assisted mandibular reconstructions using patient-specic implants
in combination with CAD/CAM fabricated transfer
keys. J Craniomaxillofac Surg. 2017;45(11):1884–97.
https://doi.org/10.1016/j.jcms.2017.08.028.
3. Rana M, Modrow D, Keuchel J, Chui C, Rana M,
Wagner M, Gellrich N-C.Development and evaluation
of an automatic tumor segmentation tool: a compari-
son between automatic, semi-automatic and manual
segmentation of mandibular odontogenic cysts and
tumors. J Craniomaxillofac Surg. 2015;43(3):355–9.
https://doi.org/10.1016/j.jcms.2014.12.005.
4. Schramm A, Suarez-Cunqueiro MM, Barth EL, Essig
H, Bormann K-H, Kokemueller H, etal. Computerassisted navigation in craniomaxillofacial tumors.
J Craniofac Surg. 2008;19(4):1067–74. https://doi.
org/10.1097/SCS.0b013e3181760fc0.
5. Scolozzi P, Schouman T. Unité interventionnelle
hybride multimodale: de la planication préopératoire
au contrôle postopératoire immédiat. Rev Stomatol
Chir Maxillofac. 2012;113(2):115–23. https://doi.
org/10.1016/j.stomax.2012.01.009.
6. Essig H, Rana M, Kokemueller H, von See C, Ruecker
M, Tavassol F, Gellrich N-C.Pre-operative planning
for mandibular reconstruction—a full digital planning
workow resulting in a patient specic reconstruction. Head Neck Oncol. 2011;3(1):45. https://doi.
org/10.1186/1758- 3284- 3- 45.
7. Pandrangi VC, Gaston B, Appelbaum NP,
Albuquerque FC, Levy MM, Larson RA.The application of virtual reality in patient education. Ann
Vasc Surg. 2019;59:184–9. https://doi.org/10.1016/j.
avsg.2019.01.015.
8. Antony AK, Chen WF, Kolokythas A, Weimer
KA, Cohen MN. Use of virtual surgery and
stereolithography- guided osteotomy for mandibular
reconstruction with the free bula. Plast Reconstr
Surg. 2011;128(5):1080–4. https://doi.org/10.1097/
PRS.0b013e31822b6723.
9. Eckardt A, Swennen GRJ.Virtual planning of composite mandibular reconstruction with free bula bone
graft. J Craniofac Surg. 2005;16(6):1137–40. https://
doi.org/10.1097/01.scs.0000186306.32042.96.
10. Gil RS, Roig AM, Obispo CA, Morla A, Pagès
CM, Perez JL. Surgical planning and microvascular reconstruction of the mandible with a bular
ap using computer-aided design, rapid prototype
modelling, and precontoured titanium reconstruction plates: a prospective study. Br J Oral Maxillofac
Surg. 2015;53(1):49–53. https://doi.org/10.1016/j.
bjoms.2014.09.015.
11. Hallermann W, Olsen S, Bardyn T, Taghizadeh F,
Banic A, Iizuka T.A new method for computer-aided
operation planning for extensive mandibular reconstruction. Plast Reconstr Surg. 2006;117(7):2431–7.
https://doi.org/10.1097/01.prs.0000219076.83890.e8.
12. Nilsson J, Hindocha N, Thor A.Time matters—differences between computer-assisted surgery and
conventional planning in cranio-maxillofacial surgery: a systematic review and meta-analysis. J
Craniomaxillofac Surg. 2020;48(2):132–40. https://
doi.org/10.1016/j.jcms.2019.11.024.
13. Powcharoen W, Yang W-F, Yan Li K, Zhu W, Su
Y-X. Computer-assisted versus conventional freehand mandibular reconstruction with bula free ap:
a systematic review and meta-analysis. Plast Reconstr
Surg. 2019;144(6):1417–28. https://doi.org/10.1097/
PRS.0000000000006261.

23 Microsurgical Jaw Reconstruction
https://t.me/medicina_free
317
14. Rodby KA, Turin S, Jacobs RJ, Cruz JF, Hassid VJ,
Kolokythas A, Antony AK. Advances in oncologic
head and neck reconstruction: systematic review and
future considerations of virtual surgical planning and
computer aided design/computer aided modeling. J
Plast Reconstr Aesthet Surg. 2014;67(9):1171–85.
https://doi.org/10.1016/j.bjps.2014.04.038.
15. Wilde, et al. Computer-assisted mandibular reconstruction using a patient-specic reconstruction plate fabricated with computer-aided design
and manufacturing techniques. Craniomaxillofac
Trauma Reconstr. 2014;7(2):158–66. https://doi.
org/10.1055/s- 0034- 1371356.
16. Rana M, Chin S-J, Muecke T, Kesting M, Groebe A,
Riecke B, etal. Increasing the accuracy of mandibular
reconstruction with free bula aps using functionalized selective laser-melted patient-specic implants: a
retrospective multicenter analysis. J Craniomaxillofac
Surg. 2017;45(8):1212–9. https://doi.org/10.1016/j.
jcms.2017.04.003.
17. Bak M, Jacobson AS, Buchbinder D, Urken
ML. Contemporary reconstruction of the mandible. Oral Oncol. 2010;46(2):71–6. https://doi.
org/10.1016/j.oraloncology.2009.11.006.
18. Hidalgo DA, Pusic AL. Free-ap mandibular
reconstruction: a 10-year follow-up study. Plast
Reconstr Surg. 2002;110(2):438–49. https://doi.
org/10.1097/00006534- 200208000- 00010.
19. Sonmez N, Gultekin P, Turp V, Akgungor G, Sen D,
Mijiritsky E. Evaluation of ve CAD/CAM materials by microstructural characterization and mechanical tests: a comparative in vitro study. BMC Oral
Health. 2018;18(1):5. https://doi.org/10.1186/
s12903- 017- 0458- 2.
20. Wagner M, Gander T, Blumer M, Valdec S,
Schumann P, Essig H, Rücker M. Die CAD/CAMrevolution in der kraniofazialen Rekonstruktion.
Praxis. 2019;108(5):321–8. https://doi.
org/10.1024/1661- 8157/a003185.
21. Rendenbach C, Sellenschloh K, Gerbig L, Morlock
MM, Beck-Broichsitter B, Smeets R, et al. CADCAM plates versus conventional xation plates
for primary mandibular reconstruction: a biomechanical in vitro analysis. J Craniomaxillofac Surg.
2017;45(11):1878–83. https://doi.org/10.1016/j.
jcms.2017.08.024.
22. Telschow T, Wilde F, Pietzka S, Schramm A,
Mascha F. Unbreakable? Frakturen patientenspezischer Implantate nach alloplastischer
Unterkieferrekonstruktion. MKG-Chirurg.
2019;12(4):263–7. https://doi.org/10.1007/
s12285- 019- 00220- x.
23. Bartier S, Mazzaschi O, Benichou L, Sauvaget
E.Computer-assisted versus traditional technique in
bular free-ap mandibular reconstruction: a CT symmetry study. Eur Ann Otorhinolaryngol Head Neck
Dis. 2021;138(1):23–7. https://doi.org/10.1016/j.
anorl.2020.06.011.
24. Ren W, Gao L, Li S, Chen C, Li F, Wang Q, et al.
Virtual planning and 3D printing modeling for man-
dibular reconstruction with bula free ap. Med Oral
Patol Oral Cir Bucal. 2018;23(3):e359–66. https://doi.
org/10.4317/medoral.22295.
25. Serrano C, van den Brink H, Pineau J, Prognon
P, Martelli N. Benefits of 3D printing applications in jaw reconstruction: a systematic review
and meta- analysis. J Craniomaxillofac Surg.
2019;47(9):1387–97. https://doi.org/10.1016/j.
jcms.2019.06.008.
26. Shan X-F, Chen H-M, Liang J, Huang J-W, Cai
Z-G. Surgical reconstruction of maxillary and mandibular defects using a printed titanium mesh. J Oral
Maxillofac Surg. 2015;73(7):1437.e1–9. https://doi.
org/10.1016/j.joms.2015.02.025.
27. Wilde F, Winter K, Kletsch K, Lorenz K, Schramm
A.Mandible reconstruction using patient-specic prebent reconstruction plates: comparison of standard
and transfer key methods. Int J Comput Assist Radiol
Surg. 2015;10(2):129–40. https://doi.org/10.1007/
s11548- 014- 1065- 1.
28. Farfalli GL, Albergo JI, Ritacco LE, Ayerza MA,
Milano FE, Aponte-Tinao LA. What is the expected
learning curve in computer-assisted navigation
for bone tumor resection? Clin Orthop Relat Res.
2017;475(3):668–75. https://doi.org/10.1007/
s11999- 016- 4761- z.
29. Hanasono MM, Skoracki RJ. Computer-assisted
design and rapid prototype modeling in microvascular mandible reconstruction. Laryngoscope.
2013;123(3):597–604. https://doi.org/10.1002/
lary.23717.
30. Hsu SS-P, Gateno J, Bell RB, Hirsch DL, Markiewicz
MR, Teichgraeber JF, etal. Accuracy of a computeraided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. J Oral
Maxillofac Surg. 2013;71(1):128–42. https://doi.
org/10.1016/j.joms.2012.03.027.
31. Ritschl LM, Mücke T, Hart D, Unterhuber T, Kehl
V, Wolff K-D, Fichter AM.Retrospective analysis of
complications in 190 mandibular resections and simultaneous reconstructions with free bula ap, iliac
crest ap or reconstruction plate: a comparative single
Centre study. Clin Oral Invest. 2021;25(5):2905–14.
https://doi.org/10.1007/s00784- 020- 03607- 8.
32. Roser SM, Ramachandra S, Blair H, Grist W, Carlson
GW, Christensen AM, et al. The accuracy of virtual
surgical planning in free bula mandibular reconstruction: comparison of planned and nal results. J
Oral Maxillofac Surg. 2010;68(11):2824–32. https://
doi.org/10.1016/j.joms.2010.06.177.
33. Stirling Craig E, Yuhasz M, Shah A, Blumberg J,
Salomon J, Lowlicht R, etal. Simulated surgery and
cutting guides enhance spatial positioning in free
bular mandibular reconstruction. Microsurgery.
2015;35(1):29–33. https://doi.org/10.1002/
micr.22229.
34. Weitz J, Bauer F, Hapfelmeier A, Rohleder NH, Wolff
K-D, Kesting MR. Accuracy of mandibular reconstruction by three-dimensional guided vascularised
bular free ap after segmental mandibulectomy. Br J

318
https://t.me/medicina_free
M. Rana and H. Möllmann
Oral Maxillofac Surg. 2016;54(5):506–10. https://doi.
org/10.1016/j.bjoms.2016.01.029.
35. Zeller AN, Neuhaus MT, Weissbach LVM, Rana
M, Dhawan A, Eckstein FM, et al. Patient-specic
mandibular reconstruction plates increase accuracy
and long-term stability in immediate alloplastic
reconstruction of segmental mandibular defects. J
Maxillofac Oral Surg. 2020;19(4):609–15. https://doi.
org/10.1007/s12663- 019- 01323- 9.
36. Sieira Gil R, Roig AM, Obispo CA, Morla A, Pagès
CM, Perez JL. Surgical planning and microvascular reconstruction of the mandible with a bular
ap using computer-aided design, rapid prototype
modelling, and precontoured titanium reconstruction plates: a prospective study. Br J Oral Maxillofac
Surg. 2015;53(1):49–53. https://doi.org/10.1016/j.
bjoms.2014.09.015.
37. Tarsitano A, Ciocca L, Scotti R, Marchetti
C.Morphological results of customized microvascular mandibular reconstruction: a comparative study. J
Craniomaxillofac Surg. 2016;44(6):697–702. https://
doi.org/10.1016/j.jcms.2016.03.007.
38. Avraham T, Franco P, Brecht LE, Ceradini DJ,
Saadeh PB, Hirsch DL, Levine JP. Functional outcomes of virtually planned free bula ap reconstruction of the mandible. Plast Reconstr Surg.
2014;134(4):628e–34e. https://doi.org/10.1097/
PRS.0000000000000513.
39. Zhou L, Shang H, He L, Bo B, Liu G, Liu Y, Zhao
J.Accurate reconstruction of discontinuous mandible
using a reverse engineering/computer-aided design/
rapid prototyping technique: a preliminary clinical
study. J Oral Maxillofac Surg. 2010;68(9):2115–21.
https://doi.org/10.1016/j.joms.2009.09.033.
40. Chaine A, Pitak-Arnnop P, Hivelin M, Dhanuthai K,
Bertrand J-C, Bertolus C.Postoperative complications
of bular free aps in mandibular reconstruction: an
analysis of 25 consecutive cases. Oral Surg Oral Med
Oral Pathol Oral Radiol Endod. 2009;108(4):488–95.
https://doi.org/10.1016/j.tripleo.2009.05.043.
41. Vignesh U, Mehrotra D, Howlader D, Singh PK,
Gupta S. Patient specic three-dimensional implant
for reconstruction of complex mandibular defect.
J Craniofac Surg. 2019;30(4):e308–11. https://doi.
org/10.1097/SCS.0000000000005228.
42. Wilkman T, Husso A, Lassus P. Clinical comparison of scapular, bular, and iliac crest osseal
free aps in maxillofacial reconstructions.
Scand J Surg. 2019;108(1):76–82. https://doi.
org/10.1177/1457496918772365.
43. Patel A, Harrison P, Cheng A, Bray B, Bell RB.Fibular
reconstruction of the maxilla and mandible with
immediate implant-supported prosthetic rehabilitation: jaw in a day. Oral Maxillofac Surg Clin North
Am. 2019;31(3):369–86. https://doi.org/10.1016/j.
coms.2019.03.002.
44. Harada H, Shimamoto H, Oikawa Y, Kuroshima
T, Tomioka H, Hirai H, et al. Mandibular reconstruction with scapular systems: a single-center
case series involving 208 aps. Plast Reconstr
Surg. 2021;148(3):625–34. https://doi.org/10.1097/
PRS.0000000000008301.
45. Dowthwaite SA, Theurer J, Belzile M, Fung K,
Franklin J, Nichols A, Yoo J. Comparison of bular and scapular osseous free aps for oromandibular reconstruction: a patient-centered approach
to ap selection. JAMA Otolaryngol Head Neck
Surg. 2013;139(3):285–92. https://doi.org/10.1001/
jamaoto.2013.1802.
46. Shnayder Y, Lin D, Desai SC, Nussenbaum B, Sand
JP, Wax MK.Reconstruction of the lateral mandibular defect: a review and treatment algorithm. JAMA
Facial Plast Surg. 2015;17(5):367–73. https://doi.
org/10.1001/jamafacial.2015.0825.
47. Osborn TM, Helal D, Mehra P.Iliac crest bone grafting for mandibular reconstruction: 10-year experience
outcomes. J Oral Biol Craniofac Res. 2018;8(1):25–9.
https://doi.org/10.1016/j.jobcr.2017.12.001.

Part XII
https://t.me/medicina_free
Planning of Craniofacial Malformation
Surgery: Surgical Planning Principles
Соседние файлы в папке Библиотека им академика М.И. Перельмана
