口腔颌面外科学绪论.ppt

90 * 91 * 92 * 123 * Stage 1: mandibular reconstruction with fibula flap Computer assisted virtual surgery Model surgery Resin template: guide the shape of fibula flap Bite plate: guide the location of fibula flap A large paddle of 20*6cm Virtual surgery Reposition the ramus according to TMJ Design the shape and position of fibula flap according to “new” ramus and teeth bar of maxilla Virtual surgery Model surgery Real surgery courseguidance of the fibula flap Expose defect and replace the ramus Remain the muscle attachment of temporal muscle, medial and lateral pterygoid muscle Guiding the flap by resin template and bite-plate Real surgery course Fixed the flap，sutured the muscle of oral floor to the inferior border of fibula flap Shaped the flap according to template Real surgery course Soft tissue reconstruction by skin paddle Intra-oral appearance Six months after surgery X ray Results of stage 1 Facial appearance is improved Movement of mandible is reliable Good attachment of oral floor muscle makes the air way improved a lot Swallow function is improved Stage 2 Correct maxillmal occlusion by orthognathic surgery Virtual surgery Original model projected model Intraoral testing Fix on the occlusion model and marked the fibula part Simulate the teeth bar on the model Surgical design Model surgery Guiding splint after surgery Guiding splint during surgery Surgery course Pre-operation Post-operation Corrected maxilla occlusion Stage 3 Soft tissue reconstruction Latissimus dorsi muscular flap Scar resection Postoperative appearance Stage 4 Oral implantation and soft tissue plastic surgery Design the location of the implant on 3D model and gesso model Z plasty of the soft tissue around neck. Model surgery Pre-operation Post-operation Postoperative appearance Front view Lateral vie