Dental tissues and their replacements/ oral surgery courses
Reconstruction of ca defects (nx power lite)
1. RECONSTRUCTION OF ORAL
MALIGNANCY EXCISION DEFECTS
- AN ANALYSIS OF 50 CASES
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
2. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
6th
leading
malignancy
Accounts for 40% of
all malignancies in
India
Commonest site is
buccal mucosa
80 % of patients
report in advanced
stage of the disease
www.indiandentalacademy.com
3. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Excision of these
tumors leaves large
defects with significant
functional and esthetic
morbidity
Reconstructionintegral part of
multidisciplinary
management of oral
cancer patients
www.indiandentalacademy.com
4. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
To
analyze the patients who underwent oral
malignancy resection and reconstruction
To
evaluate the need for free tissue transfer
in head and neck reconstruction
To
illustrate our experience in
reconstructing complex oro-facial excision
defects
www.indiandentalacademy.com
5. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
50 patients treated between
2000 JAN-2003 AUG
Age Range – 31- 70 years
Majority in the 5th & 6th decade
17
33
Sex ratio
www.indiandentalacademy.com
Male
Female
S.D.M.
DHARWAD
6. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Tongue
24%
Lower Alveolus
14%
Buccal Mucosa
54%
Retromolar
area
8%
www.indiandentalacademy.com
S.D.M.
DHARWAD
11. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Pectoralis Major
- Has remained a work
horse for head and neck
reconstruction
- Reliable long pedicle
- Multiple skin perforators
enabling multiple paddles
www.indiandentalacademy.com
S.D.M.
DHARWAD
13. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Limitations :
Skin size limited
Distal most part of the flapVascularity limited
Mobility of the flap restricted
by pedicle
Can be bulky
Early Lymph node detection
can be hampered
www.indiandentalacademy.com
S.D.M.
DHARWAD
14. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Free Tissue Transfer
Greater variety of donor
sites
Superior vascularity
Technically
more
demanding
Mobility not affected by
vascular pedicle
Long
procedures
Potential for sensate flaps
Composite tissue can be
harvested
www.indiandentalacademy.com
S.D.M.
DHARWAD
15. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Radial Forearm :
Based on the ascending
septo-cutaneous
branches of RA
Thin pliable skin with a
long pedicle
Very useful for
reconstructing mucosal
defects
Potential for sensate flap
www.indiandentalacademy.com
S.D.M.
DHARWAD
17. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Free Fibula
Based on the Peroneal
artery
Long length of the bone
can be harvested
Good peri & endosteal
supply allowing multiple
osteotomies for shaping
Skin and muscle paddles
possible
www.indiandentalacademy.com
S.D.M.
DHARWAD
20. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Antero-Lateral Thigh
Based on perforators of
descending branch of Lat
circumflex Femoral artery
Large tissue stock
Long large pedicle
Tissue can be folded for
through and through
defects
www.indiandentalacademy.com
S.D.M.
DHARWAD
24. RECONSTRUCTION OF ORAL
MALIGNANCY DEFECTS
Conclusion
-Recent developments in
Reconstructive procedures has made
large resections possible
-Although pedicled flaps have
limitations they still play a significant
role
-Free flaps have helped significantly
in rehabilitating patients with large
defects
-Team approach is essential for
successful reconstruction
www.indiandentalacademy.com
