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Condylar reconstruction by oblique sliding vertical-ramus osteotomy
Juan L Martinez-Lage1, Joaquín Gonzalez, Alberto Pineda
1Department of Cranio-Maxillofacial Surgery, Hospital Ramón y Cajal, Madrid, Spain. jlmlage@hotmail.com
Summary
Reconstructing the mandibular condyle using the posterior ramus border offers excellent functional and cosmetic outcomes. This technique provides stable occlusion and improved mouth opening, avoiding temporomandibular joint pain.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
- Anatomic Reconstruction
Background:
- The posterior border of the mandibular ramus serves as a viable pedicled graft for condylar reconstruction.
- This technique presents an advantageous alternative to other autogenous grafts and alloplastic materials in specific clinical scenarios.
Observation:
- Three adult patients underwent condylectomy and reconstruction using a pedicled posterior mandibular border graft.
- Procedures involved oblique osteotomy and lateral pterygoid muscle reinsertion.
Findings:
- All patients achieved immediate mouth opening and stable occlusion post-surgery.
- Interincisal opening exceeded 40 mm within 3 weeks, with minimal deviation (≤4mm).
- Full range of excursive movements, corrected facial asymmetry, and absence of temporomandibular joint pain were noted over a 56-month average follow-up.
Implications:
- Sliding vertical-oblique ramus osteotomy is effective for condylar reconstruction in cases of tumors.
- The technique yields superior functional and cosmetic results, with good neocondyle remodeling and stable occlusion.