PMC4093637_01
Facial asymmetry and a firm swelling in the area of the left mandibular ramus region extending to the base of the mandible
ijcpd-05-078-g001.jpg
PMC4093637_01_ijcpd-05-078-g001.jpg
F1
Extraoral clinical examination of the patient was notable for facial asymmetry and a firm swelling in the area of the left mandibular ramus region extending to the base of the mandible (Figs 1 and 2).
A firm swelling in the area of the left mandibular ramus region extending to the base of the mandible
ijcpd-05-078-g002.jpg
PMC4093637_01_ijcpd-05-078-g002.jpg
F2
Extraoral clinical examination of the patient was notable for facial asymmetry and a firm swelling in the area of the left mandibular ramus region extending to the base of the mandible (Figs 1 and 2).
Radiograph showing radiolucency extending till the base of mandible surrounding the crown of the unerupted third molar resembling the dentigerous cyst
ijcpd-05-078-g003.jpg
PMC4093637_01_ijcpd-05-078-g003.jpg
F3
The lesion extending till the base of mandible surrounding the crown of the unerupted third molar resembling the dentigerous cyst (Fig. 3).
Histological slide confirmed the diagnosis of a plexiform ameloblastoma
ijcpd-05-078-g004.jpg
PMC4093637_01_ijcpd-05-078-g004.jpg
F4
The pathology report confirmed the diagnosis of a plexiform ameloblastoma (Fig. 4) and the patient was scheduled for surgical resection of the involved mandible followed by placement of the costochondral graft.
Extraoral incision and retraction of the left mandibular ramus region
ijcpd-05-078-g005.jpg
PMC4093637_01_ijcpd-05-078-g005.jpg
F5
Premolars were extracted and mandible was sectioned maintaining a safe margin of 1.5 mm of uninvolved bone (Figs 5 to 7).
Sectioning of the mandible
ijcpd-05-078-g006.jpg
PMC4093637_01_ijcpd-05-078-g006.jpg
F6
Premolars were extracted and mandible was sectioned maintaining a safe margin of 1.5 mm of uninvolved bone (Figs 5 to 7).
Sectioned mandible maintaining a safe margin of 1.5 mm of uninvolved bone
ijcpd-05-078-g007.jpg
PMC4093637_01_ijcpd-05-078-g007.jpg
F7
Premolars were extracted and mandible was sectioned maintaining a safe margin of 1.5 mm of uninvolved bone (Figs 5 to 7).
Contralateral sixth rib was harvested as a costochondral graft through inframammary incision
ijcpd-05-078-g008.jpg
PMC4093637_01_ijcpd-05-078-g008.jpg
F8
Contralateral sixth rib was harvested as a costochondral graft through inframammary incision and secured into place by means of reconstruction plate (Figs 8 to 10).
Costochondral graft secured into place in continuation with the distal end of resected mandible
ijcpd-05-078-g009.jpg
PMC4093637_01_ijcpd-05-078-g009.jpg
F9
Contralateral sixth rib was harvested as a costochondral graft through inframammary incision and secured into place by means of reconstruction plate (Figs 8 to 10).
Costochondral graft secured into place by means of reconstruction plate
ijcpd-05-078-g010.jpg
PMC4093637_01_ijcpd-05-078-g010.jpg
F10
Contralateral sixth rib was harvested as a costochondral graft through inframammary incision and secured into place by means of reconstruction plate (Figs 8 to 10).
After a week, patient was recalled for the check-up
ijcpd-05-078-g011.jpg
PMC4093637_01_ijcpd-05-078-g011.jpg
F11
Radiograph to ensure the stability of the graft
ijcpd-05-078-g012.jpg
PMC4093637_01_ijcpd-05-078-g012.jpg
F12