Mandibular Reconstruction Surgery

 

679. <Mandibular Reconstruction Surgery>
Jaw reconstruction surgery restores the structure and function of the lower jaw damaged by trauma, tumors, congenital defects, infection, or osteonecrosis.

Depending on the type of tissue lost, reconstruction may involve skin, soft tissue, bone, or a combination.
In early life, conditions like Treacher Collins syndrome or hemifacial microsomia may require correction. In adulthood, jaw injuries from trauma, tumors like oral or mandibular cancer, or complications from radiation or medications can lead to jaw defects needing reconstruction.

Skin loss is treated with primary closure, local or distant flaps, or free flap techniques. For soft tissue atrophy, fat grafting is commonly used, but severe cases may need flap surgery.
When bone (hard tissue) is lost, the most reliable method is the fibular free flap, which transplants leg bone and soft tissue with microvascular anastomosis. If autologous bone is not an option, custom 3D-printed implants made of titanium or PEEK can be designed using mirrored imaging and virtual surgery planning.

These 3D-guided methods reduce surgery time and improve symmetry. If jawbone loss results in missing teeth, dental implants restore chewing function. In cases of tongue defects, free flaps are used followed by speech therapy for functional recovery.

Milder reconstructions often involve fat grafting, especially when only volume correction is needed. In asymmetry cases where one side underdevelops, instead of enlarging the smaller side, the healthy side can be reduced with jaw contouring to balance the face with less surgical burden.

Similarly, underdeveloped upper jaws or cheekbones may not need augmentation if the larger side can be reduced or softened with contouring and fat grafts. Every plan is tailored to the patient's anatomy, symmetry, and needs.

Jaw reconstruction aims to restore function, improve aesthetics, and support full rehabilitation. Each treatment plan is carefully designed with respect to the patient’s medical needs, financial resources, and surgical timeline.

[Mandibular reconstruction is a complex surgery combining aesthetics, function, and rehabilitation.]
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