title: Management considerations in reconstruction of postablative defects of the mandible: vertical distraction of a scapular bone flap and removable lip support: a case report.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oral And Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. mhirota@med.yokohama-cu.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirota
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsui
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Mizuki
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Saito
authors.forename: Kei
authors.initials: K
authors.lastname: Watanuki
authors.forename: Toshinori
authors.initials: T
authors.lastname: Iwai
authors.forename: Iwai
authors.initials: I
authors.lastname: Tohnai
mesh_terms: D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods* / Q000502:physiology; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D003758:Dental Implantation, Endosseous; D005887:Gingival Neoplasms / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008046:Lip / Q000502:physiology; D008297:Male; D008334:Mandible / Q000601:surgery*; D008341:Mandibular Prosthesis; D019647:Oral Surgical Procedures / Q000534:rehabilitation*; D019857:Osteogenesis, Distraction / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012540:Scapula / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply