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Stomatological Hospital Successfully Completed Guizhou's First Ilium-repair Lower Jaw Simultaneous Implantation Surgery with Application of Digital Surgical Techniques
 

On June 22, the Stomatological Hospital Affiliated to Guizhou Medical University successfully completed the representative project of MDT cooperation mode "jaw tumor resection + simultaneous vascularized digital restoration and reconstruction + simultaneous multiple tooth-implant implantation and jaw reconstruction". The operation was carried out under the cooperation of oral and maxillofacial surgery, prosthodontics, anesthesiology department and operating room. The operation represented the world-class level, the first case of its kind in Guizhou Province. The whole process was live broadcast, and relevant medical and nursing staff watched the live video in the operating room.

Tumor resection, inflammation, trauma, or developmental deformity may cause bone tissue, muscle and skin defects. If the defect is not repaired, patients would find it difficult in their swallowing, language and chewing skills, and will be probably affected by infection and tissue contracture, which will in turn affect the later restoration of the prosthesis, cause great psychological barrier to patients and their family members. Therefore, it is necessary to repair and reconstruct. The repair and reconstruction of the defect has always been an important topic in oral and maxillofacial surgery. At present, vascularized bone flap transplantation is mainly used in mandibular defect reconstruction, which, however, is restricted by some disadvantages such as difficult molding, low precision, waste of time, tendency to have complications and large trauma. In order to achieve accurate surgery and restore the ideal shape, more precise preoperative design, accurate intraoperative control and reliable postoperative prediction are required. With the help of computer aided design/computer aided manufacturing (CAD/CAM) model, the reconstruction team of maxillofacial surgery in the hospital can basically achieve the ideal jaw reconstruction results. After restoring the patient's ideal appearance, the maxillofacial surgery team may restore the chewing function and jaw position relationship as soon as possible, further enhance the comprehensive strength of oral and maxillofacial surgery, and provide the nation-class and even world-class oral and maxillofacial repair treatment technical services for the majority of patients. The oral repair and reconstruction MDT team is comprised of the Oral and Maxillofacial Surgery Team, Prosthodontics Department Team, Operating Room and Anesthesiology Department.

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This operation was jointly operated by Liu Rui, Director of Oral and Maxillofacial Surgery and Dong Qiang, Director of Oral Prosthodontics Department. It took one whole day to successfully complete the first digital surgical technique guided "mandibular tumor extended resection + free vascularized iliac muscle flap transplantation + facial micro arteriovenous anastomosis + simultaneous implant implantation" in Guizhou Province.

The free vascularized iliac bone musculocutaneous flap was prepared in one stage, and the simultaneous functional repair and reconstruction of large area bone tissue and soft tissue defects were performed by microvascular digital surgery technology. On this basis, the simultaneous implant was realized by using the motor implant technology, so as to recover the function repair and jaw reconstruction time as early as possible, and restore the swallowing, chewing and language skills of the patients. In addition, it is to cover the wound surface to maximize the recovery of appearance and functionality, and create more favorable conditions for future denture repair.

The oral and maxillofacial surgery team is capable of independently completing the whole large-scale multiple operation areas, including extensive head, neck and maxillofacial radical surgery, microvascular surgery, functional repair and reconstruction surgery, and realize the collaborative cooperation with the oral prosthodontics surgical treatment team to independently carry out implant repair as one of the comprehensive complex operations. Up to date, the grafted iliac bone musculocutaneous flap performs well and the wound surface is recovered fine. It is reported that the operation was the first case in Guizhou Province (statistics from literature retrieval).

This operation was technically challenging and highly risky, so its success has brought the level of oral and maxillofacial surgery to a new level, which is a milestone for the hospital. In the meantime, the multidisciplinary cooperation among oral and maxillofacial surgery, prosthodontics, anesthesiology department and operating room also makes sure patients have the access to domestically advanced medical technology and medical services up to the high level and standards right in Guizhou, and benefits the general public.