Management considerations in reconstruction of postablative defects of the mandible: vertical distraction of a scapular bone flap and removable lip support: a case report

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Dec;106(6):e6-9. doi: 10.1016/j.tripleo.2008.05.048.

Abstract

Objective: To describe vertical distraction osteogenesis of a scapular flap and removable lip support for oral rehabilitation after surgical creation of an ablative defect of the mandible.

Case report: A 70-year-old man who was diagnosed with squamous cell carcinoma of the left lower gingiva underwent segmental mandibulectomy for tumor ablation and reconstruction with a scapular bone flap. To augment bone height of this flap, vertical distraction osteogenesis was performed. After denture fabrication, a removable lip support was placed between the implant-supported denture and the lower lip.

Results: The bone height of the scapular bone flap increased by 9 mm. Implants with adequate length could be placed in the distracted bone. The lip support was effective. Two years after masticatory loading, the implants remained stable.

Conclusion: Vertical distraction osteogenesis of the scapular bone flap was suitable to facilitate postoperative functional and esthetic restoration after tumor resection. A removable lip support was also useful as a supplementary tool for oral rehabilitation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Alveolar Ridge Augmentation / methods*
  • Bone Transplantation / methods*
  • Bone Transplantation / physiology
  • Carcinoma, Squamous Cell / rehabilitation
  • Carcinoma, Squamous Cell / surgery
  • Dental Implantation, Endosseous
  • Gingival Neoplasms / rehabilitation
  • Gingival Neoplasms / surgery
  • Humans
  • Lip / physiology
  • Male
  • Mandible / surgery*
  • Mandibular Prosthesis*
  • Oral Surgical Procedures / rehabilitation*
  • Osteogenesis, Distraction / methods*
  • Plastic Surgery Procedures / methods*
  • Scapula / surgery
  • Surgical Flaps* / blood supply