Soft Tissue Defect

Soft Tissue Defect

Proper preparation of the soft tissue bed that is to receive the bone. graft is just as important to the success of bone grafting as the bone graft mntcrihl itself. The transplanted bone cells must survive initially by diffusion of nutrients from the surrounding soft tissues, Revascularization of the
bone ‘graft through the development of new blood vessels from the soft tissue bed must then occur. Thus an essential factor for the success of any bone-grafting procedure is the availability of an adequately vascularized soft tissue bed. Fortunately this essential factor is usually obtainable in the lush vascular tissue of the head and neck region. However, occasionally the soft tissue’ bed is not as desirable as it could be, such as ‘after. radiotherapy or excessive scarring from trauma or infection. Therefore a thorough assessment of the quantity and quality of the surrounding soft tissues is necessary before undertaking bone graft procedures. The reason forthe osseous void often provides important  information on the amount and quality of soft tissuesremaining. For example, if the patient lost a large portion of the mandible from a composite resection for a malignancy,
the chances are that the patient will haw deficiencies both in quantity and quality of soft tissues. During the initial surgery, mahy. vital structures were probably removed, and denervation of the platysma muscle will
result in atrophy of the muscular fibers .. An intraoral examination helps the clinician determine how much oral mucosa was removed with the mandibular fragment. Frequently the tongue or floor of the mouth appears to be sutured to the buccal mucosa, with no intervening alveolar ridge or buccal sulcus, because the gingiva is sacrificed with the osseous specimen. If the patient received cancericidal doses of radiation  10 till’ area of the osseous defect, the clinician can assume

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