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Is Reconstruction of Large Mandibular Defects Using Bioengineering Materials Effective?

James C Melville1, Huy Q Tran2, Arsalan K Bhatti3

  • 1Associate Professor, Department of Oral, Head and Neck Oncology and Microvascular Reconstructive Surgery, and Internship Director, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, Houston, TX.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|December 29, 2019
PubMed
Summary

Tissue-engineered bone grafts effectively reconstruct mandibular defects, offering an alternative to traditional autogenous grafts with reduced patient morbidity. This method shows promising results for complex head and neck reconstructions.

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Area of Science:

  • Biomaterials Science
  • Regenerative Medicine
  • Surgical Innovation

Background:

  • Clinical tissue engineering advances surgical procedures, enhancing efficiency and safety compared to traditional bone grafting.
  • Composite tissue-engineered grafts offer osteoconduction, osteoinduction, and osteogenesis, providing sufficient bone volume for maxillofacial reconstruction with reduced morbidity.

Purpose of the Study:

  • To evaluate the effectiveness of composite tissue-engineered bone grafts in reconstructing mandibular defects.
  • To assess graft success based on bone union and adequate bone volume for implant placement.

Main Methods:

  • Retrospective case series of patients undergoing mandibular reconstruction using allogeneic bone, recombinant human bone morphogenic protein-2, and bone marrow aspirate concentrate.
  • Success criteria included bone union (radiographic evidence, no mobility) and adequate graft volume (≥1.0 cm height, ≥0.8 cm width).
  • Clinical examinations and CT scans were performed at 6 months postoperatively.

Main Results:

  • 34 patients received tissue-engineered grafts between 2014-2019, with a median follow-up of 6 months.
  • Of 30 patients with continuity defects, 27 (90%) achieved successful bone union and adequate volume.
  • Average gained height was 2.12 cm and width was 1.53 cm.

Conclusions:

  • Clinical tissue engineering provides an effective treatment for complex head and neck defects.
  • This approach offers reduced morbidity and comparable graft material to autogenous bone, establishing it as a viable alternative.
  • While autogenous grafts remain a standard, tissue engineering represents an evolving and effective therapeutic option.