title: Four-dimensional computed tomography evaluation of jaw movement following mandibular reconstruction: A pilot study.
abstract: OBJECTIVE
  The purpose of this study was to analyze jaw movement during mastication in patients who underwent mandibular reconstruction following segmental mandibulectomy, including mouth opening and mastication time, based on four-dimensional computed tomography (4D CT) images.
  
  
  METHODS
  This study included six surgical patients, who underwent segmental mandibulectomy and simultaneous reconstruction with a free fibula osteocutaneous flap, and four controls. 4D CT was performed during mastication of a cookie to evaluate the movement of the jaw during natural function. The maximum mouth opening, mastication time, and movement of the mandibular angle during mastication were evaluated from the 4D CT images.
  
  
  RESULTS
  4D CT images enabled visualization of jaw movement during mastication. When compared with the controls, the maximum mouth opening during mastication and excursion of the mandibular angle, especially on the diseased side, tended to decrease in surgical patients; however, this did not occur with mastication time. The numerical differences between the diseased and nondiseased side in surgical patients tended to be higher than the crosswise differences in controls.
  
  
  CONCLUSIONS
  4D CT images revealed differences in jaw function between patients who underwent mandibular reconstruction and controls. 4D CT could be used to evaluate postoperative outcomes following mandibular reconstruction.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: akashim@med.kobe-u.ac.jp.
authors.forename: Masaya
authors.initials: M
authors.lastname: Akashi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. Electronic address: shibuya@med.nagoya-cu.ac.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shibuya
authors.affiliation: Department of Radiology, Kobe University Hospital, Kobe, Japan. Electronic address: staka@med.kobe-u.ac.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: kazunobu@med.kobe-u.ac.jp.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Hashikawa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: hasetaku@med.kobe-u.ac.jpm.
authors.forename: Takumi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: ykakei@med.kobe-u.ac.jp.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kakei
authors.affiliation: Department of Radiology, Kobe University Hospital, Kobe, Japan. Electronic address: noriyuki@med.kobe-u.ac.jp.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Negi
authors.affiliation: Department of Radiology, Kobe University Hospital, Kobe, Japan. Electronic address: atieinks-toshi@nifty.com.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sekitani
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: komori@med.kobe-u.ac.jp.
authors.forename: Takahide
authors.initials: T
authors.lastname: Komori
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005360:Fibula / Q000637:transplantation; D056973:Four-Dimensional Computed Tomography; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction; D008409:Mastication; D008875:Middle Aged; D010865:Pilot Projects; D013524:Surgical Flaps
keywords: Four-dimensional computed tomography; Free fibula osteocutaneous flap; Mastication; Segmental mandibulectomy