Resorption of left posterior mandibular bone is part of a complex biological process that results in shrinkage or loss of bone.
In some cases, hemimandiblectomy and free fibula bone microvascular reconstruction is recommended.
A 28 year old female reported with discomfort and tenderness associated with a complaint of swelling in the left posterior mandible for the past 2 months. She had visited a dentist for a tooth ache 3 months before and was given analgesics and since pain did not subside, she was advised x-ray OPG which revealed resorption of left posterior mandibular bone. She was referred to Dr. A.Mathan Mohan and team for specialist consultation.
The overlying mucosa seemed normal without any signs of inflammation, but palpation revealed buccal expansion on the posterior left mandible. Inflammatory lesions like infected dental cyst, osteosarcoma and intraosseous squamous cell carcinoma are usually the cause of tender swellings of the mandible.
Treatment and prognosis
Radiological investigation revealed a lobular radio-opaque mass near the angle of the mandible diagnosed as a benign cystic tumour. Dr. Mathan Mohan recommended hemimandiblectomy and free fibula bone microvascular reconstruction harvested from her left leg.
Hemimandibulectomy is a complex operation, performed on malignant growths involving either the alveolar ridge and the mandible, or adjacent structures. It is usually approached transcervically, with incisions to the face and neck to gain adequate exposure and access to the mass. The procedure involves the resection of a substantial segment of the mandible which usually requires a reconstructive procedure to maintain the function of the jaw. In this case free fibula bone microvascular reconstruction harvested from her left leg.
After performing hemimandibulectomy and reconstructive procedure, the patient was actively mobilised on the third post-operative day and after satisfactory healing of the donor and recipient site she was discharged home.