Dental implant treatment in vascularized bone flaps after jaw reconstruction / 华西口腔医学杂志

Jaw defects caused by various reasons often seriously affect appearance and function. The goal of the treatment of oral and maxillofacial tumors should include the cure of the tumor and the restoration of premorbid function. The development of microsurgery and digital surgery technology has promoted the development of jaw reconstruction with vascularized free bone flap. Good appearance and improved predictability could be obtained with the help of preope-rative visual design. How to rehabilitate occlusal function on the reconstructed jaw and improve the quality of life of patients has become an important research direction. This article discusses the challenge of jaw reconstruction, the selection of vascularized bone flap, the choice of implant timing, the treatment of peri-implant soft tissue, and the influence of radiotherapy on implants after jaw reconstruction.

Fournier's Gangrene: From Diagnosis to Reconstruction

Fournier gangrene (FG) is an acute and potentially fatal infection of the scrotum, perineum, and abdominal wall. It is characterized by necrotizing fasciitis with loss of subcutaneous tissue and skin. Althoughoriginally thought to be an idiopathic process, FG has been shown to have a predilection for patients with diabetes as well as long-term alcohol misuse; however, it can also affect patients with non‐obvious immune compromise. Twenty patients were admittedto our hospital with the diagnosis of Fournier gangrene, between 1 January 2011 to January 2013.The epidemiological characteristics, evolution and treatment modalities were reviewed. Early surgical debridement of necrotic tissues and antibiotics are fundamental in the treatment of FG. Scrotal reconstruction with skin grafts or flaps is fundamental to improve the quality of life and provides social reinsertion.Keywords: Fournier's gangrene; defect reconstruction; perineoscrotal defect; epidemiology.Original Research Article

Clinical effect of reconstruction of large anterior palatal fistulae by anteriorly based dorsal tongue flaps / 口腔疾病防治

Objective@#To evaluate the feasibility and outcomes of the reconstruction of large anterior palatal fistulae by anteriorly based dorsal tongue flaps to provide a rational reference of anteriorly based dorsal tongue flaps for clinicians.@*Methods @#Five patients with anterior hernia had a defect range of 1.0 cm × 1.0 cm to 1.5 cm × 2.0 cm, and the anterior tongue was 1.3 cm × 3.5 cm to 2.0 cm × 3.5 cm. The defects were all repaired with anteriorly based dorsal tongue flaps. The clinical efficacy was evaluated after operation, including whether the mucosal flap was infected, whether there was any shedding before the pedicle, and whether there was any perforation after operation. Thereafter, patients who were satisfied with their chewing, swallowing, speech function and appearance were followed up@*Results@#All patients underwent successful reconstruction of palatal defects by anteriorly based tongue flaps, and no case of spontaneous detachment of the tongue flap occurred. Patients with palatal fistulae were followed up for 16-28 months, and no recurrence was encountered. The operation had no effect on the speech, agitation and swallowing function of the tongue, and patients were satisfied with the appearance.@*Conclusion @#The dorsal lingual mucosal flap pedicled with the anterior tongue is a safe and reliable method for repairing large anterior palatal fistula.