Mandibular rehabilitation: From the Andy Gump deformity to jaw‐in‐a‐day

Abstract

The mandible is a critical structure of the lower facial skeleton which plays an important role in several vital functions. Segmental resection of the mandible is at times required in patients with advanced oral cavity malignancies, primary mandibular tumors, and radiation or medication induced osteonecrosis. Mandibulectomy can significantly decrease quality of life, and thus mandibular reconstruction is an important aspect of the operative plan. Mandibular reconstruction is challenging due to the complex three‐dimensional anatomy of the mandible, and the precision required to restore dental occlusion in dentate patients. Significant advances have been made over the past decade in the ability to reconstruct and rehabilitate patients after a segmental mandibulectomy. This review will highlight these advances and discuss the timing of dental implantation.

Osteocutaneous Radial Forearm Free Flap Fixed to a Prior Osteocutaneous Free Flap: Two Case Reports

“…Secondary mandibular defects can be managed with observation or with further reconstruction, which provides superior rehabilitation benefits for the patient in regards to nutrition by mouth and speech intelligibility 5 . Although a second free tissue transfer comes with surgical risks, the benefit for improved rehabilitation is valuable.…”

“…2,3 Secondary mandibular defects can be managed with observation or with further reconstruction, which provides superior rehabilitation benefits for the patient in regards to nutrition by mouth and speech intelligibility. 5 Although a second free tissue transfer comes with surgical risks, the benefit for improved rehabilitation is valuable. Reconstruction with a FFF is a commonly utilized option due to the length of bone available and tolerable donor site morbidity but is not always an option due to peripheral arterial disease.…”

Axolotl mandible regeneration occurs through mechanical gap closure and a shared regenerative program with the limb

“…Interestingly, even when these defects are small enough to elicit a regenerative response, the ends of the fragments are frequently misaligned, failing to integrate and heal adequately without external intervention (Chen et al, 2015;Polikarpova et al, 2022). This is similar to the human case, in which extensive jaw defects also show tight connective tissue scarring in the area of the missing mandibular segment (Lilly et al, 2021). One likely explanation for this proficiency to regenerate large defects in the lower jaw is the combination of gap minimization processes with formation of cartilage from both the proximal and distal mandibular stumps.…”

“…Before the development of surgical techniques for mandibular replacement, resection of the anterior mandibular body resulted in the so-called “Andy Gump deformity”. This condition, based on the depiction of a historical cartoon character missing their chin and lip, resulted in severe functional limitations in eating and speaking (Lilly et al, 2021). Indeed, the symphyseal (distal-most), and parasymphyseal (immediately adjacent lateral) areas of the mandible, in particular, are especially important from a medical point of view, given their propensity to be affected by trauma or invasion of malignant tumors (Atilgan et al, 2010; Eichberger et al, 2022).…”

Anaesthetic challenges in staged correction of Andy Gump deformity in a young girl with severe obstructive sleep apnoea

“…Patients with Andy Gump deformity have the appearance of absent chin due to an anterior mandibular defect with an extremely retrognathic mandible. [ 1 2 ] No report of congenital Andy Gump deformity is available to the best of our knowledge. Andy Gump is a famous cartoon character, in a popular comic strip, The Gumps, published in the American newspapers.…”