Mandibular reconstruction using nonvascularized autogenous bone grafting

Morrison, Archie; Brady, James

doi:10.1097/moo.0b013e32833a46ed

Cited by 13 publications

(5 citation statements)

References 32 publications

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“…[1234] Today, this traditional technique for the reconstruction of the mandible is indicated mainly to bridge segmental defects of the mandible where adjuvant radiotherapy is not indicated after ablative surgery as well as the reconstruction of the condyle, wide palatal clefts and in preprosthetic surgery. [567]…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

Ndukwe¹,

Aregbesola²,

Ikem³

et al. 2014

Niger J Surg

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Objectives:The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria.Patients and Methods:A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients’ records. This information include patients’ demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications.Result:There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded.Conclusion:The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome.

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Section: Introductionmentioning

confidence: 99%

Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

Ndukwe¹,

Aregbesola²,

Ikem³

et al. 2014

Niger J Surg

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“…One of the most affected tissues, which functioning must be regained in such situations for normal limb performance is the bone. One possibility is an autogenous bone grafting when a bone fragments are translocated within the body of a patient 1, 2. However, this is not always possible and a degree of complication can reach up to 30% 3.…”

Section: Introductionmentioning

confidence: 99%

Biocompatibility evaluation of glycolide‐containing polyesters in contact with osteoblasts and fibroblasts

Ścisłowska-Czarnecka

Pamuła

Kołaczkowska

2012

J of Applied Polymer Sci

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Biodegradable aliphatic polyesters have numerous biomedical applications and their capacity to degrade in biological fluids provides the significant advantage of their removal. Three glycolide-containing aliphatic polyesters: a copolymer of glycolide and L-lactide (PGLA), a terpolymer of glycolide, L-lactide and e-caprolactone (PGLCap) and a copolymer of glycolide, and e-caprolactone (PGCap) were tested to evaluate their biocompatibility towards osteoblasts and fibroblasts. Each of the polymer units was previously reported to have acceptable biological properties and good biodegradability, and PGLA is already used for biomedical applications. Here we report that both PGLCap and PGCap affected cell adherence, and compromised cell viability as estimated by flow cytometric analyses of apoptotic and necrotic cells. The two polymers enhanced also production of numerous inflammation-related factors: nitric oxide, matrix metalloproteinases (MMP-2 and MMP-9), and cytokines, including proinflammatory TNF-a, IL-1b, IL-6, and chemokines (IL-8 or MCP-1) attracting leukocytes. The effects of PGLCap and PGCap were similar despite the fact that they possess different characteristics: amorphous/smooth surface and semicristalline/rough surface, respectively. However, their common feature, distinctive from PGLA, is a presence of e-caprolactone units in their structure. This compound is considered to be acceptably biocompatible but our data suggest that its copolymerization with glycolide and L-lactide does not provide satisfactory biocompatibility towards osteoblasts and fibroblasts.

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“…In cases involving large defects and requiring a greater amount of graft, removal of grafts from extra buccal sites, such as calvarium, iliac crest, rib and tibia, are recommended. 24 We can still indicate the removal of the extra buccal graft in cases that involve access to multiple intraoral donor areas or that these areas are very close to the noble structures, such as the inferior alveolar nerve, the mental foramen and the dental roots; when the graft is removed, there may be no adequate margin of safety to withdraw the graft with the appropriate amount without causing permanent damage to the patient. 9 Among the extrabuccal donor areas, the calvarial region has been shown to be a viable, predictable and safe option to be used as a donor site bed for grafting, prior to the dental implant's placement.…”

Section: Discussionmentioning

confidence: 99%

Previous reconstruction of severely atrophic maxilla with calvarial bone graft and implant supported fixed partial prosthesis - Case report

Filho¹

2019

JSPIR

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Purposes: Autogenous bone graft is still considered the “gold standard” for bone augmentation of the jaws prior to dental implants placement. In cases of major bone defects, we can relinquish reconstructive techniques using grafts from extra buccal donor areas, such as the calvarial bone graft. Although this technique is well established in the literature, many professionals feel insecure in indicating this type of treatment to their patients, due to the high degree of complexity for the execution of the procedure and not acceptance by the patient. Case report: A female patient, 42-year-old, had undergone reconstructive surgery by means of a calvarial bone graft for pre-maxilla reconstruction prior to dental implants placement in regions of 14 to 24. The graft collection procedure was performed in a hospital setting and under general anesthesia. The grafts were transplanted from the calvarial bone to reconstruct the anterior maxilla. After 7 months, 4 dental implants were placed, allowing a future prosthetic rehabilitation. After the period of osseointegration, screw-retained partial fixed prosthesis was made, returning function and aesthetics to the patient. Conclusions: In view of the clinical case and literature presented, it is concluded that patients with severe maxillary bone atrophy can undergo a successful reconstruction process with calvarial bone grafts and dental implants.

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Mandibular reconstruction using nonvascularized autogenous bone grafting

Abstract: Although vascularized free flap reconstruction of mandibular defects has become the more common method of treating the postablative cancer surgery patient, there remain indications for nonvascularized reconstruction of mandibular defects as well as other techniques.

Cited by 13 publications

References 32 publications

Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

Biocompatibility evaluation of glycolide‐containing polyesters in contact with osteoblasts and fibroblasts

Previous reconstruction of severely atrophic maxilla with calvarial bone graft and implant supported fixed partial prosthesis - Case report

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