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When performing mandibular reconstruction following mandibular segmentectomy, the surgical method that we have been using involves creating a surgical guide plate using a three dimensions model for bending the mandible reconstruction plate. It has been reported that the current method results in an excellent suitability of the graft into the mandible, which allows for a highly esthetic recovery. The purpose of the present study was to evaluate how well the current surgical method enables the grafted bone to suitability within the mandibular defect in terms of esthetics and functionality by measuring masticatory performance using a gummy score method. We enrolled 11 patients who had undergone mandibular reconstruction using the current method following mandibular tumorectomy at Osaka Medical College Hospital. Among them, 6 evaluable patients were examined using the gummy score method and occlusal force measurement two months after the operation. Gummy score evaluations were performed while masticating on a whole and then a half-portion gummy jelly, taking into account the decline in occlusal force. The results revealed a declining tendency in masticatory performance and occlusal force; however, adequate masticatory performance was obtained with the half-portion gummy jelly. We believe that the gummy score method using a test gummy jelly is a useful tool in evaluating whether a functionally good suitability between the grafted bone and the mandible has been achieved after mandibular reconstruction using the current method.

Platelet-rich fibrin (PRF) is the focus of research on the efficacy of regeneration of soft tissue and hard tissue in the dental field. PRF includes vascular endothelium growth factor (VEGF), platelet-derived growth factor (PDGF), insulin-like growth factor (IGF) and transforming growth factor-beta1 (TGF-beta 1). It is essential to quantitate the growth factors in PRF to evaluate its efficacy. In the present preliminary study, we quantitate TGF-beta1, VEGF and IGF-1 in PRF. Blood was collected from 10 healthy volunteers ranging in age from 25 to 51 years. The 10 ml blood samples were collected from the peripheral vein. After immediate centrifugation at 2,750 rpm for 10 minutes with 1000G, the platelet-poor plasma (PPP), which accumulated at the top, was collected. PRF was collected approximately 2 mm below its connection to the red corpuscle. The PPP and PRF were stored in tubes, and the quantity of TGF-beta1, VEGF and IGF-1 were quantified by ELISA. There were no significant differences in the level of IGF-1 in the PPP and PRF. However, the levels of TGF-beta1 and VEGF in PRF were significantly higher than in PPP. These results suggest that PRF has some ability to stimulate soft tissue healing and bone regeneration.