The objects of jaw reconstruction after tumor resection were to recover the continuity of bone, to improve the esthetic problem, which was mainly facial contour, and to achieve the functional occlusion with dental prosthesis. Although there were various methods for jaw reconstruction, free vascularized bone graft has been first choice so far. Particulate cancellous bone and marrow (PCBM) and custom-made titanium mesh tray, ULTRA FLEX MESH CUSTOM^® (UFMC^®), have been reported as the other methods for jaw reconstruction with good outcome. The special feature of this system was to fabricate titanium-mesh tray using reconstructed 3D model by mirroring residual side of the mandible. In this way, an adequate alveolar ridge could be reconstructed with custom-made UFMC^® and PCBM for the dental prosthesis with implant or denture. Besides, symmetric facial contour could be obtained. For these reasons, we have applied this system as the secondary reconstruction in malignancy and for the immediate reconstruction in benign tumor respectively.

　In the present review, the clinical utilities and issues of this system were described.

In this report, we describe a case of oncocytoma of the buccal region which derived from the accessory parotid gland in a 69-year-old woman. The patient had a history of right-sided lung cancer, right-sided supraclavicular lymph node metastasis, and metastatic brain tumor.

　In July 2018, positron emission tomography– computed tomography showed fluorodeoxyglucose accumulation at the left anterior border of the masseter muscle, and the patient was referred to our department in August. At the initial examination, we found a movable 13 mm elastic-hard mass at the left anterior border of the masseter muscle. The mass had clear borders and was painless. A left buccal tumor was diagnosed, and the patient underwent surgery under general anesthesia in early September of the same year. Pathological examination revealed oncocytoma, and salivary gland tissue was found at the margin of the excised specimen. A diagnosis of oncocytoma derived from the accessory parotid gland was made based on the imaging and histopathological examination. It has been three years and five months since the surgery, and the patient has been doing well with no evidence of recurrence.

Pyoderma gangrenosum (PG) is a rare, non-infectious inflammatory skin disease where painful pustules or nodules become ulcers that progressively grow. It can affect any part of the skin however rarely involves the oral region.

　We report a case of revision surgery performed on the oral commissure in a 14-year-old girl to improve the narrowed mouth fissure caused by scarring of the lips due to PG at the age of 8.

　On the right side, skin scars were removed first while maintaining the current mucosal corner of the mouth, which was not present before the onset of PG. Subsequently the corner of the mouth was relocated outward while pulling the buccal mucosa out toward the lips. On the left side, there were few scars on the corner of the mouth and it was almost symmetrical to the new position of the right side. Therefore, the mucosal corner of the mouth was moved slightly outward using Y-V advancement on the oral mucosa side.

　One year and 4 months after surgery, her mouth fissure had elongated and the mouth-opening limitation was improved. This surgical method preserves the continuity of the current oral commissure, is less invasive, and seems to be advantageous in preventing postoperative contracture.

We report a case of a copper-deficiency hematological disorder caused by the administration of zinc preparations, which manifested during the treatment of a left mandibular gingival carcinoma. A 69-year-old woman was referred to our hospital seeking treatment of a left mandibular gingival carcinoma. She had a medical history of liver cirrhosis type C and had been taking zinc acetate hydrate (Nobelzin^®) for six years to control hepatic encephalopathy, without any clinical signs of leucopenia. She underwent a radical cancer resection (left radical neck dissection and left segmental resection of the mandible) and reconstructive surgery (titanium reconstruction plate and pectoralis major myocutaneous flap). Postoperative radiotherapy was also performed. Seven months after the surgery, an infection of the reconstruction plate was observed, and antimicrobial therapy was administered. The patient was scheduled for plate replacement surgery, but pancytopenia was observed in the preoperative blood tests. The patient was referred to the hematology department, where a bone marrow puncture was performed resulting in a negative finding for myelodysplastic syndrome. At this time we found a high serum zinc level of 135 μg/dL and a low serum copper level of 12 μg/dL. The patient was diagnosed with copper deficiency due to zinc overload which manifested due to myelosuppression caused by cancer therapy, and was treated via copper supplementation and cessation of zinc preparations. Approximately two months after that, the leucopenia showed improvement and the serum copper level recovered to the reference level.