The cheesecake technique: A layered autologous soft-tissue adjunct to extended TMJ prosthetic reconstruction after mandibular ameloblastoma resection - 10/10/26
, Rita Vitagliano a, Daniele Ordano a, Vincenzo Santoro a, Vincenzo Farina a, Stefania Perrotta b, Pasquale Piombino aSummary |
Introduction |
Extensive ameloblastoma involving the mandibular condylar region may create a combined skeletal, articular, and soft-tissue reconstructive challenge.
Technical Note |
A 35-year-old woman with multicystic ameloblastoma underwent en bloc right mandibular resection and immediate patient-specific extended total TMJ replacement. The prosthesis formed the structural “base”; an autologous dermal-fat graft was adapted around it as the volumetric “cream layer”; and a calcium-activated autologous PRP-derived fibrin membrane was applied superficially as the “frosting layer.” The dermal-fat graft was intended to obliterate dead space and provide peri‑prosthetic soft-tissue volume. The fibrin membrane was used as a conformable autologous provisional matrix with two proposed adjunctive functions: to support healing of the intraoral mucosal incision and to create a local pro-reparative and pro-angiogenic interface over the dermal-fat graft that might favour its early revascularisation and survival. These biological effects are mechanistically plausible but cannot be demonstrated from a single case. Healing was uneventful, without infection, dehiscence, facial nerve impairment, or prosthetic exposure. Maximal mouth opening was 35 mm at 1 month and 40 mm at 6 months.
Discussion |
The Cheesecake Technique provided a feasible multilayer strategy for simultaneous skeletal reconstruction and peri‑prosthetic soft-tissue management. The specific contribution of the PRP-derived membrane requires confirmation in comparative studies.
Le texte complet de cet article est disponible en PDF.Keywords : Ameloblastoma, Temporomandibular joint, Joint Prosthesis
Plan
Vol 127 - N° 6
Article 103024- décembre 2026 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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