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Pectoralis major myocutaneous flap /certified fixed orthodontic courses by Indian dental academy
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Pectoralis major myocutaneous flap /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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  • 1. PECTORALIS MAJOR MYOCUTANEOUS FLAP INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. INTRODUCTION • Development of myocutaneous flap- mid 70’s. • Floor of the mouth, lateral tongue- sternocleidomastoid, temporalis, nasolabial flaps. • Larger defects- free flaps, regional flaps. www.indiandentalacademy.com
  • 3. TEMPORALIS MUSCLE FLAP www.indiandentalacademy.com TEMPORALIS MUSCLE
  • 4. NASOLABIAL FLAP NASOLABIAL FLAP www.indiandentalacademy.com
  • 5. PECTORALIS MAJOR www.indiandentalacademy.com
  • 6. ANATOMY BLOOD SUPPLY  Thoracoacromial artery, Lateral thoracic, Superior thoracic artery, and Intercostal perforators from internal mammary artery NERVE SUPPLY  Lateral and medial pectoral nerves www.indiandentalacademy.com
  • 7. THORACOACROMIAL ARTERY www.indiandentalacademy.com
  • 8. www.indiandentalacademy.com
  • 9. • ORIGN:- 1) Clavicular head 2)Sternocostal head • INSERTION:- Lateral lip of intertubercular groove of humerus • ACTION:-Adducts and medially rotates humerus; draws scapula anteriorly and inferiorly Acting alone: clavicular head flexes humerus and sternocostal head extends it. www.indiandentalacademy.com
  • 10. Clavicular head Sternoclavicular head www.indiandentalacademy.com
  • 11. SURFACE MARKING www.indiandentalacademy.com
  • 12. INDICATIONS FOR PECTORALIS MAJOR • OROPHARYNX • MANDIBULAR RECONSTRUCTION • ORBITAL EXENTERATION • TEMPORAL BONE RESECTION www.indiandentalacademy.com
  • 13. CASES 1 2 3 4 www.indiandentalacademy.com
  • 14. 5 www.indiandentalacademy.com
  • 15. CASE DETAILS • CASE 1:- tumor-Lt gingivo buccal complex nodal involvement-node positive preop radiation-yes  CASE 2:- tumor -right gingivo buccal complex nodal involvement-node positive preop radiation-no  CASE 3:- tumor- left gingivo buccal complex nodal involvement-node positive preop radiation-no • CASE 4:- tumor size- Lt gingivo buccal complex nodal involvement- node positive preop radiation-no www.indiandentalacademy.com
  • 16. DISSECTION MARKING www.indiandentalacademy.com
  • 17. AFTER RESECTION www.indiandentalacademy.com
  • 18. DISSECTED SPECIMENS www.indiandentalacademy.com
  • 19. DEFECT www.indiandentalacademy.com
  • 20. INCISION MARKING www.indiandentalacademy.com
  • 21. DISSECTION www.indiandentalacademy.com
  • 22. PECTORALIS MAJOR MUSCLE www.indiandentalacademy.com
  • 23. PEDICLE MARKING www.indiandentalacademy.com
  • 24. FLAP ELEVATED Thoracoacromial vessels www.indiandentalacademy.com
  • 25. INSET OF FLAP www.indiandentalacademy.com
  • 26. TUNNELING SUPRACLAVICULARLY www.indiandentalacademy.com
  • 27. SUTURING THE FLAP TO THE DEFECT www.indiandentalacademy.com
  • 28. FLAPS IN POSITION www.indiandentalacademy.com
  • 29. DONOR SITE www.indiandentalacademy.com
  • 30. DONOR SITE CLOSED PRIMARILY www.indiandentalacademy.com
  • 31. HEALING www.indiandentalacademy.com
  • 32. CASE 5 www.indiandentalacademy.com
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  • 41. www.indiandentalacademy.com
  • 42. ADVANTAGES • • • • • • • Single stage repair Single dominant blood supply Provides inner and outer lining Protects carotid artery Sufficient skin and soft tissue bulk Good arc of rotation Donor site closed primarily www.indiandentalacademy.com
  • 43. DISADVANTAGES • • • • • Might be too bulky for oral cavity Arc of rotation limited for upper facial defects Shoulder function impaired Distal skin blood supply not reliable Distortion of symmetry in donor site SUPRACLAVICULAR BULGE DISTORTED BREAST www.indiandentalacademy.com
  • 44. THANK U www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com