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• W3128714183 abstract "Intraosseous vascular malformations (IVM) of the jaw are rare in the adolescent. Skeleto-facial development of children is known, but facial asymmetry after hemimandibulectomy may occur in adolescence because of growth. A 12-year-old girl was performed anterior hemimandibulectomy with immediate mandibular reconstruction by fibula free flap (FFF) because of an IVM. We present an interdisciplinary treatment concept with orthodontic treatment, dental implantation, and customized high-density porous polyethylene chin augmentation on free musculocutaneous fibula reconstruction in an adolescent as a ten-year follow-up. The presented case describes the complex interdisciplinary treatment of an adolescent suffering from the destruction of the anterior mandible caused by low-flow intraosseous venous malformation. The case report's task is to examine whether the use of customized chin implants on FFF can be a useful addition to a growth-adapted dentofacial restoration of faces in young adulthood. Facial growth in adolescents after tumor resection and reconstruction seems to be unpredictable. The use of customized chin-implants in children is controversial. The anticipation of the presumed adult dimensions is necessary for the correct extension. For observation of facial development, lateral-views, and CBCT, are suitable. Orienting the reconstructed mandible to correctly adjusted maxilla by orthodontic advice and early loaded implants, the development of mandible deficits can be compensated, and an average face height ratio and a mesiofacial profile anticipated. Clinical relevance/Purpose: In line with other publications, this case shows that accompanying orthodontic treatment of the opposing maxilla after free fibula graft in the mandible is decisive for masticatory function. Immediate dental rehabilitation by fixed prosthetics on dental implants and insertion of HDPE-chin implants for facial harmonization during puberty demonstrates average growth and could be a possible concept to avoid secondary orthognathic interventions. The investigators hypothesized that mandibular growth-curves after sagittal hemimandibulectomy are mainly in the superior and posterior ramus (20%) compared to horizontal ramus (5%) mandibular angulation so that customized HDPE-chin reconstruction in adolescent should be progenic oversized to correct the horizontal deficit. The authors have reported a unique concept of orthodontic treatment, immediate loading of dental implants of the vascularized fibula, and customized chin-augmentation by evaluating angle, length, and facial profile by images of CBCT and lateral view 5 and 10 years after single step surgery. The skeleto-facial development of growing children after hemimandibulectomy is unpredictable. The presented case describes the complex interdisciplinary treatment of an adolescent suffering from the destruction of the anterior mandible caused by intraosseous venous malformation and consecutive hemimandibulectomy. A functional oral restoration with Fibula Free Flap (FFF), orthodontic treatment, immediate loading of dental implants, and fixed bridges a juvenile facial rehabilitation demand an age-appropriate treatment plan. The case report's task is to examine whether the use of customized chin implants can be a useful addition to a growth-adapted dentofacial restoration of faces in young adulthood." @default.
• W3128714183 created "2021-02-15" @default.
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• W3128714183 date "2021-03-01" @default.
• W3128714183 modified "2023-09-23" @default.
• W3128714183 title "Intraosseous venous malformation in an adolescent: Interdisciplinary concept for facial reconstruction after hemimandibulectomy, fibula free flap, and HDPE-chin reconstruction - 10 years follow up" @default.
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• W3128714183 doi "https://doi.org/10.1016/j.omsc.2021.100209" @default.
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