[Reconstruction of maxillary defect by prefabricated titanium mesh combined with pedicled buccal fat pad flap and bone autograft].
OBJECTIVE
To introduce individualized 3-dimensional (3-D) reconstruction of maxillary defect by prefabricated titanium mesh combined with pedicled buccal fat pad flap (PBFPF) and bone autograft.


METHODS
Since May, 2001, 16 patients with maxillary defect resulted from tumor or trauma were treated. The 3-D models were created through 3-D CT and rapid prototype technique. The maxilla on the unaffected side was copied to the affected side by CAD/CAM. Then the titanium mesh was prefabricated accurately on the 3-D model. The PBFPF served as lining of the titanium mesh and the autogenous bone graft was used to reconstruct the shape and function of maxilla.


RESULTS
The duration of follow-up was 6 to 36 months. All the wounds healed primarily with good facial symmetry. No food reflux to nasal cavity was observed. The dentitions in 8 of 16 cases were restored with good function by removable partial denture. They could have normal diet and were articulate. Nasopharyngoscopy showed normal tissue lining of the titanium mesh 5-12 months after operation in 3 cases.


CONCLUSIONS
Satisfactory aesthetic and functional result can be achieved with this 3-D reconstruction method for maxilla defect. The PBFPF was insert better titanium mesh and mucous of maxilla sinus to avoid exposure of titanium mesh. The fat pad flap with blood supply promotes wound healing and helps partially restoring the function of the maxillary sinus.
Yan
Jun-lie
JL
Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou 310009, China.
Chen
Guan-fu
GF
Liu
Yan-ming
YM
Zhang
Wei-min
WM
Zhao
Song
S
Jiang
Chen
C
Chen
Le
L
D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D002610:Cheek; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery; D008875:Middle Aged; D013524:Surgical Flaps; D014025:Titanium / Q000627:therapeutic use; D014182:Transplantation, Autologous; D055815:Young Adult
D014025:Titanium