COMPLICATIONS OF RECONSTRUCTION PLATE INSTALLATION IN MANDIBULAR

Leni Ruslaini, A. Arumsari, A. Tasman, K. Rizki
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Abstract

Background: Mandibular resection will cause mandibular stability disturbance due to loss of some part of the bone. Instability of the mandible can cause aesthetic, physiological, and psychological malfunction. Installment of mandibular reconstruction plat on the remaining mandibular using screws were suggested to restore its stability. However, it is not uncommon that plat exposure occurs following mandibular reconstruction, caused by inaccurate adaptation of the plats to the mandibular bone. The aims of this report are to describe the various complications and managements after jaw resection and reconstruction with plates. Case Report: A 44 years old male patient complained the small defect in the chin, painless, and no fluid emited, accompanied by dermatitis. Intra oral examination showed no abnormalities. About 1 year ago the patient performed segmental resection of the mandible on the indication of ameloblastoma. The radiological x-ray showed all screw detached from the plat and radiolucent images appeared around the plat that attached to the mandible. The diagnosis was fistula at regio mentale, post resection and reconstruction surgery, suspected caused by titanium plate allergies. The provided therapies were fistulectomy, screw removal, and plate reconstruction. Post therapy conditions showed improvement and no patients complaints of pain. Conclusion: Plate exposure is a complication that can occur after the installation of the reconstruction plate, but besides that it can also cause an allergic reaction from the material used. Keywords: Complication, Mandibular Resection, Plate Reconstruction, Titanium Plate Allergies
下颌骨重建钢板安装的并发症
背景:下颌切除术会造成部分骨丢失,导致下颌稳定性紊乱。下颌骨的不稳定会引起审美、生理和心理上的障碍。建议使用螺钉将下颌骨重建板安装在剩余的下颌骨上以恢复其稳定性。然而,由于钢板与下颌骨的不准确适应,在下颌重建后钢板暴露的情况并不罕见。本报告的目的是描述颌骨切除和钢板重建后的各种并发症和处理。病例报告:男性,44岁,主诉颏部小缺损,无痛,无分泌液排出,伴有皮炎。口腔内检查未见异常。大约一年前,患者因成釉细胞瘤的适应症行下颌骨节段性切除术。x线片显示螺钉全部脱离钢板,并在附着于下颌骨的钢板周围出现透光图像。诊断为颏区瘘,术后切除重建手术,怀疑钛板过敏所致。提供的治疗方法包括瘘管切除术、螺钉取出和钢板重建。治疗后情况有所改善,无患者抱怨疼痛。结论:钢板暴露是重建钢板安装后可能发生的并发症,除此之外还可能引起所用材料的过敏反应。关键词:并发症,下颌骨切除术,钢板重建,钛板过敏
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