Practical Reconstructive Techniques Using the Transoral Approach to Segmental Mandibulectomy With Cosmofix: Technical...

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Oncology

Background:

• Medication-related osteonecrosis of the jaw (MRONJ) is a serious condition often requiring extensive surgical intervention.
• Advanced MRONJ can compromise mandibular structure, necessitating complex reconstruction.
• Traditional reconstructive methods may involve significant morbidity, including facial scarring and nerve damage.

Purpose of the Study:

• To introduce and evaluate a novel, minimally invasive transoral reconstructive technique for advanced MRONJ.
• To assess the aesthetic and functional outcomes of this new method.
• To compare the benefits of this approach against traditional reconstructive surgeries.

Main Methods:

• A custom-made Cosmofix fixation plate was transorally inserted for mandibular reconstruction.
• Segmental mandibulectomy was performed for stage 3 MRONJ involving the inferior mandibular margin.
• The transoral approach facilitated reconstruction without external facial incisions.

Main Results:

• Successful reconstruction was achieved in two cases of advanced MRONJ.
• Patients demonstrated satisfactory restoration of occlusal conditions and denture support.
• No aesthetic or functional issues were observed more than one year post-surgery.
• The transoral technique was associated with reduced operative time and avoidance of facial nerve palsy.

Conclusions:

• Transoral reconstruction with a Cosmofix plate is a safe and effective method for advanced MRONJ.
• This technique offers significant advantages over traditional methods, including improved aesthetics and reduced invasiveness.
• It is a viable option for elderly patients or those in poor general health.