title: Simple maxillary reconstruction following total maxillectomy using artificial bone wrapped with vascularized tissue: five key points to ensure success.
abstract: CONCLUSIONS
  Our new method for hard tissue maxillary reconstructions using artificial bone implants provides stable results during long-term follow-up.
  
  
  OBJECTIVE
  To date, vascularized bone/cartilage grafting has been the most popular method for hard tissue reconstruction after total maxillectomy; however, such three-dimensional reconstruction requires complex and lengthy invasive surgery. We have developed a simple maxillary reconstruction procedure using artificial bone.
  
  
  METHODS
  This study included six patients who had undergone hard tissue reconstructions using artificial bone (Ceratite(TM)) implants after total maxillectomies between October 2002 and October 2010. We considered the following five key points to ensure success: (1) the procedure was conducted in two stages without communicating with the nasal cavity and sinuses; (2) when constructing the artificial bone, the curvature was reduced; (3) the space for the implant was kept to a minimum; (4) the artificial bone implant was closely and accurately fixed to the stump of the zygomatic arch; and (5) the artificial bone implant was wrapped with a vascularized tissue flap.
  
  
  RESULTS
  The follow-up period ranged from 12 to 94 months. The postoperative zygomatic contour was maintained satisfactorily in all patients with no signs of late complications.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Osaka City University Graduate School of Medicine, Japan. motomura@med.osaka-cu.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Motomura
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Iguchi
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008441:Maxillary Neoplasms / Q000601:surgery*; D063166:Maxillary Osteotomy / Q000379:methods*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D015050:Zygoma / Q000601:surgery*