Alloplastic reconstruction of the mandible after subtotal mandibulectomy for medication‐related osteonecrosis of the jaw: An update of the method

Abstract

BackgroundReconstruction of continuity defects following osteonecrosis in multimorbid patients is challenging. In all cases of the predescribed palliative treatment method for alloplastic mandible reconstruction, plate fractures were detected in follow‐up. We hypothesized that a modification could avoid these fractures, leading to stable long‐term results.MethodsThis retrospective study compares the original method with a modification using single, laser‐sintered CAD–CAM plates instead of manually bent miniplates. The predescribed shuttering technique was used to reconstruct the mandible in its original shape with bone cement.ResultsUneventful wound healing was observed in 86% of the cases after modification of the method. No implant or plate fracture occurred.ConclusionsThe presented method should be considered as a treatment option for mandible reconstruction in elderly, multimorbid patients in palliative situations. The results of this study suggest that the modification of the method leads to significantly improved long‐term stability. Donor site morbidity is avoided with this method of palliative surgery.

Axolotl mandible regeneration occurs through mechanical gap closure and a shared regenerative program with the limb

“…There are many procedures that can be used to help repair jaw injuries, such as preventing the ingrowth of unwanted soft tissue (membrane techniques), introducing missing cells or signals into the defect, and alloplastic replacement with metallic CAD/CAM-implants (Nauth et al, 2018; Reitemeier et al, 2016). In the latter case, new bone surrounding mandible replacement implants has been reported histomorphologically and radiologically in animals models and isolated cases of humans (Bräuer et al, 2023; Markwardt et al, 2014). Yet, the current gold standard for the treatment of critical-size segmental defects in the jaw is the grafting of suitable transplants from autologous donor regions (e.g., from the lower leg, hip, or shoulder blade) into the affected area (Disa and Cordeiro, 2000; Schemitsch, 2017).…”