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Cysts and tumors of the jaws are amongst the most common jaw pathologies. Treatment of these conditions includes jaw resection and reconstruction. The most common cysts of the jaws include dentigerous cysts and odontogenic keratocysts. Dentigerous cysts are always associated with an impacted tooth.
The importance of the jaws towards maintaining optimal physical and mental health cannot be understated. Proper mastication of food is very important in obtaining the nutrition that the body needs to maintain good health. Jaws also play an important role facilitating overall human health.
The effects of jaw pathology on speech and facial esthetics can result in a compromise in the overall quality of life. Speech therapy is often required after radical resection of jaws and jaw reconstruction surgery. Maxillofacial surgeons receive specialized training for jaw cyst surgery.
Patients who have undergone resection of extensive jaw pathologies are often left with residual facial deformities. Patients thus affected require jaw reconstruction surgery for returning to normal life.
Cystic conditions like dentigerous cysts and odontogenic keratocysts often cause the destruction of the jawbone. Mastery over jaw reconstruction surgery takes many years to attain and is technique sensitive.
Bone grafts for jaw reconstruction surgery are harvested from three preferred sites. The preferred sites for harvesting bone grafts among different surgeons include the long bones of the legs, hips and ribs.
Harvesting sufficient bone from the hips leads to a deformity in the region. An unsightly scar is usually the result of harvesting sufficient quantities of bone from the tibia.
The ideal site for harvesting bone for jaw reconstruction surgery is from the rib region. There is complete regeneration of the bone when the periosteal continuity is not compromised following surgery. Scarring is also minimal as multiple grafts can be harvested through a single incision.
Our hospital is a leading center for jaw reconstruction surgery following resection of jaw pathologies. Results from facial plastic surgery have won us many international accolades. We have over 30 years of experience in successfully reconstructing a wide variety of jaw defects.
Types of jaw surgery performed here include orthognathic surgery and surgery for receded lower jaws. Other procedures performed include removal of odontogenic cysts and mandibular osteotomy. Corrective jaw surgery is performed through intraoral small incisions.
We also address radicular cysts, nevoid basal cell carcinoma syndrome, giant cell lesions and fibrous dysplasia.
The patient is an 18-year-old female from Cuttack in Odisha, India. She had developed pain and swelling in the right side of her mandible approximately one year ago. The swelling was gradually progressive and greatly alarmed them.
They presented at a local hospital where imaging studies demonstrated a radiolucent lesion enclosing an impacted third molar. The lesion extended from the body into the ramus of the mandible. A diagnosis of dentigerous cyst was made.
She had subsequently undergone enucleation of the cyst. The teeth associated with the cyst were also extracted. Jaw reconstruction had however not been performed. The patient and her parents were very unsatisfied with the treatment.
Unfortunately, the swelling and pain returned approximately four months ago. They had visited another local hospital where imaging studies had been obtained. Diagnosed with a recurrent dentigerous cyst, they were referred to our hospital for management of her recurrent dentigerous cyst.
The patient and her parents made their initial presentation at our hospital for her redo dentigerous cyst surgery. Our hospital exclusively uses bone grafts harvested from the ribs. We have successfully performed redo dentigerous cyst surgery for many patients with failed iliac and femoral grafts.
Treatment planning was explained to the patient and her parents. They consented to the redo dentigerous cyst surgery. She first underwent the redo dentigerous cyst surgery. This was followed by jaw reconstruction surgery using titanium reconstruction plate and rib grafts.
A second procedure was performed four months later. This was dental implant surgery in the reconstructed jaw bone. The time period was to allow for consolidation of the bone grafts with surrounding alveolar bone. The patient and her parents were very happy with the results of the surgery.
The patient and her parents were instructed to return in four months for ceramic crowns. This interim period would allow for complete osseointegration of the dental implants to the surrounding bone.
The patient and her patents expressed understanding of the instructions. They were very happy with the level of care given to them at our hospital.
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