Distraction osteogenesis of the mandible in the previously irradiated patient

Treatment of primary malignant bone tumours of the distal tibia

“…In one case, the bone transport became infected and was later followed by an amputation. The resected limb had been irradiated post-operatively, and bone transport in irradiated bones is a controversial issue [7,10]; our experience does not support this procedure. Bone transport is a demanding procedure in which many problems may occur.…”

Biomechanical Configurations of Mandibular Transport Distraction Osteogenesis Devices

“…This method is often incorrectly referred to as an MBT process. 37,82,83,86 In contrast, reconstruction of segmental bone defects of the mandibular body has been mainly accomplished by using unidirectional MBT devices, 19,42 whereas few devices have been designed to reconstruct the slightly curved lateral aspect of the mandibular body. 1,16 Examination of the literature reveals that no internal devices have been reported for the reconstruction of the mandibular symphysis, although several external MBT devices provide either bidirectional 26,31 or multidirectional reconstruction of this anatomical part.…”

“…Inspite of the proven success of the MBT technique, problems still persist, such as soft tissue dehiscence, occurrence of occlusal disturbances, bone transport segment losing orientation, premature consolidation, regenerate deficiency, docking site nonunion, and failing devices. 34 Although several mandibular distraction devices have failed, 13,32,[35][36][37] paradoxically, no studies have examined both device design and biomechanical characteristics.…”

The effect of irradiation and hyperbaric oxygenation (HBO) on extracellular matrix of the condylar cartilage after mandibular distraction osteogenesis in the rabbit

“…In addition to delayed bone regeneration 6,19 , it has been shown that pressure created by the distraction force causes severe damage to the mandibular condylar cartilage if the temporomandibular joint (TMJ) region has received even low doses of irradiation. Hyperbaric oxygenation (HBO) does not seem to prevent the cartilagionous damage 19 .…”