title: Evaluation of three-dimensional mandibular movements after reconstruction with free fibula flap.
abstract: Seven patients who underwent mandibular reconstruction with a fibula free flap (one on the midline, six on either right or left side) and were rehabilitated with implant supported prostheses, performed free mandibular border movements (maximal mouth opening and closing, right and left lateral excursions, protrusion) that were recorded by a non-invasive motion analyser. Temporomandibular joint (TMJ) kinematic parameters were compared to those calculated in healthy control subjects using z-scores. Maximum mouth opening was reduced in all patients, with z-scores ranging from -2.742 to -0.106, and performed with a reduced sagittal plane mandibular rotation. Interincisal point forward movement during protrusion was reduced in all but one patient. Lateral mandibular movements (displacement of the interincisal point) and bilateral condylar movements during mouth opening were very variable and sometimes asymmetrical. Mandibular rotation was also variable, with z-scores ranging from -1.265 to 1.388. Together with mandibular range of motion, we investigated biomechanical characteristics of TMJ motion that can provide further information about the joint without submitting the patient to harmful procedures, and that can be followed-up during healing. The investigation indicates those areas that need to be given special attention in preoperative planning, patient information and rehabilitation.
authors.affiliation: Maxillofacial and Odontostomatology Unit, IRCSS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Italy;
authors.forename: A
authors.initials: A
authors.lastname: Bolzoni
authors.affiliation: Functional Anatomy Research Center (FARC), Department of Biomedical Sciences for Health, Università degli Studi di Milano, Italy;; Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, Ribeirão Preto, University of São Paulo, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: Mapelli
authors.affiliation: Maxillofacial and Odontostomatology Unit, IRCSS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Italy;
authors.forename: A
authors.initials: A
authors.lastname: Baj
authors.affiliation: Functional Anatomy Research Center (FARC), Department of Biomedical Sciences for Health, Università degli Studi di Milano, Italy;; Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, Ribeirão Preto, University of São Paulo, Brazil.
authors.forename: F V
authors.initials: FV
authors.lastname: Sidequersky
authors.affiliation: Maxillofacial and Odontostomatology Unit, IRCSS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Italy;
authors.forename: A B
authors.initials: AB
authors.lastname: Giannì
authors.affiliation: Functional Anatomy Research Center (FARC), Department of Biomedical Sciences for Health, Università degli Studi di Milano, Italy;
authors.forename: C
authors.initials: C
authors.lastname: Sforza
mesh_terms: D005360:Fibula; D058752:Free Tissue Flaps; D006801:Humans; D008334:Mandible / Q000601:surgery*; D013704:Temporomandibular Joint
keywords: Border movements; Fibula free flap; Motion analysis; Temporomandibular joint