Clinical Usefulness of Mandibular Reconstruction Using Custom-Made Titanium Mesh Tray and Autogenous Particulate Cancellous Bone and Marrow Harvested From Tibia and/or Ilia
| Autor: | Tomoko Ikawa, Noboru Kawamura, Tomoo Sonoyama, Takumi Ogawa, Hiroyuki Yamada, Yuko Shigeta, Kenichi Kumagai, Kazutoshi Nakaoka, Yoshiki Hamada, Naohiko Harada |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Adolescent Visual analogue scale Dentistry Mandible Ilium 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative infection medicine Humans Tibia Mandibular reconstruction 030223 otorhinolaryngology Child Aged Bone Marrow Transplantation Aged 80 and over Titanium Bone Transplantation business.industry 030206 dentistry General Medicine Prostheses and Implants Middle Aged Surgical Mesh Skull Mandibular Neoplasms medicine.anatomical_structure Surgical mesh Tray Otorhinolaryngology Cancellous Bone Printing Three-Dimensional Tissue and Organ Harvesting Surgery Female Oral Surgery Mandibular Reconstruction business Cancellous bone |
| Zdroj: | The Journal of craniofacial surgery. 27(3) |
| ISSN: | 1536-3732 |
| Popis: | The objective of this study was to evaluate usefulness of mandibular reconstructions using custom-made titanium mesh (Ti-mesh) tray and particulate cancellous bone and marrow (PCBM). Consecutive 21 patients who underwent mandibular reconstruction were enrolled in this study. They were 13 men and 8 women (mean age, 52.0 years). Virtual reality simulation was performed using computer software based on the preoperative computed tomography data. A 3-dimensional skull model was constructed using 3-dimensional printer. A tray was custom-made from Ti-mesh sheet bent to adapt to the model. After PCBM harvesting from posterior ilia and/or proximal tibia, the tray was fixed to the host bone. New bone formation and configuration of the reconstructed mandible were assessed radiologically. Complications were recorded in each patient during the follow-up period. Patients' satisfaction with postoperative facial contour was evaluated using visual analog scale (VAS score, range, 0-100). In 16 of 21 patients, excellent new bone formation was recognized and expected results were radiologically achieved. In 5 patients, new bone formation was insufficient. Causes of insufficient bone formation included postoperative infection in 2 patients, Ti-mesh tray fracture in 2 patients, and local recurrence of lower gingival cancer in 1 patient. To prevent a tray fracture, a double-layered Ti-mesh tray was useful. Mean VAS score on patients' satisfaction was 77.1. Our results comprehensively suggest that mandibular reconstruction using custom-made Ti-mesh tray and PCBM is clinically useful. |
| Databáze: | OpenAIRE |
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