[Historical development of maxillofacial surgery].
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In a survey, the three conventional methods of bridging a defect (immediate rib transplant, extraoral Becker splinting and intraoral metal plate bridging) are studied. The advantages and disadvantages of the pertinent method are described. Although metal plate bridging has risks and disadvantages, clinical experience has shown the great advantages of this temporary method in extensive mandibular resections with soft tissue covering the defect.
The authors believe that the AO mandibular reconstruction plate provides unique advantages for the reconstruction of mandibular defects. It provides for rigid fixation of the bones and the maintenance of occlusion and contour without the use of intermaxillary fixation or external fixation. The technique adds little time to the procedure, and the expertise needed to apply the technique can be quickly acquired by most surgeons. Although better techniques are being developed and perfected, the mandibular reconstruction plate should be considered for any patients for whom more complex techniques seem inappropriate and for whom reconstruction would otherwise not be considered.
The author describes three systems for (1) the treatment of mandibular fractures; (2) the treatment of midface fractures, for reconstructive surgery of the facial skeleton and the skull, and for orthognathic surgery; and (3) the reconstruction of mandibular defects including condyle replacement.
The authors described their experience using rigid internal fixation techniques in combination with free microvascular tissue transfer for the immediate reconstruction of mandibular defects following tumor ablation. The technique allows immediate return of jaw motion and limited function while assuring maintenance of occlusion and reasonable cosmesis.
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A retrospective study was conducted on 85 case-reports of patients with epithelioma of anterior and anterolateral region of floor of mouth operated upon in the Stomatology and Maxillofacial Surgery Clinic of Salpêtrière hospital, Paris. An update review of recent advances in surgery for reconstruction of floor of mouth is completed by results of study of the case-reports showing evolution of ideas related to functional results and to vital prognosis (as function of tumoral stage).
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