Dental Journal (Majalah Kedokteran Gigi)
Vol. 59 No. 3 (2026): September

Reconstruction of maxillopalatal defect in a syphilitic gumma patient with retrograde facial artery musculomucosal flap: A case report

Nissia Ananda (Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
Dental Department, Universitas Indonesia Hospital, Universitas Indonesia, Depok)

Viandra Tjokroadiredjo (Dental Intern, Dental Department, Dr. Suhardi Hardjolukito Air Force Central Hospital, Yogyakarta)
Ghina Humaira (Dental Department, Koja General Hospital, Jakarta)
Muhammad Kamil Hassan (Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur)
Firdaus Hariri (Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur)



Article Info

Publish Date
01 Sep 2026

Abstract

Background: The facial artery musculomucosal (FAMM) flap has been reported for the repair and reconstruction of various oral and craniofacial defects. However, reports describing its use for reconstruction of the anterior maxillary region remain limited. Purpose: This report describes the repair of an anterior maxillopalatal defect caused by tertiary syphilis (syphilitic gumma) using a retrograde-flow, superiorly based FAMM flap. Case: A 30-year-old man with a history of human immunodeficiency virus and syphilis infection presented with an anterior palatal perforation measuring 3.5 × 1 × 1 cm, accompanied by diffuse erythema, secondary to tertiary syphilis. Case Management: After confirmation that the patient no longer had active syphilis infection, peripheral ostectomy was performed, followed by closure of the defect using a tunneled FAMM flap. Conclusion: Modification of the FAMM flap with tunneling increases its versatility and facilitates closure of maxillopalatal bony defects caused by tertiary syphilis, potentially reducing the need for secondary revision surgery. The authors support the use of this flap for the management of oral defects of similar size and extent.

Copyrights © 2026






Journal Info

Abbrev

MKG

Publisher

Subject

Dentistry

Description

The Dental Journal (Majalah Kedokteran Gigi) (e-ISSN:2442-9740; p-ISSN:1978-3728) is published by the Faculty of Dental Medicine, Universitas Airlangga. Its diciplinary focus is dental science and dental hygiene. The Dental Journal (Majalah Kedokteran Gigi) is published in English on a quarterly ...