[Reconstruction of mandibular defect by using Titanium mandibular prosthesis: a preliminary experimental study].
OBJECTIVE
The aim of this experiment was to investigate the possibility of application of mandibular reconstruction with titanium mandibular prosthesis.


METHODS
Two healthy adult goats were used in this study. Spiral CT of the mandibular region was performed. The data collected was related to the computer. Then a 5 cm mandibular body defect and a mandibular angle defect were designed accordingly. Titanium mandibular prostheses were manufactured according to the size of the above defect. Surgical operation was performed and the prosthesis were implanted into the aimed defects and internal fixation was used. Autogenic bone graft was introduced into the holes of the angle prosthesis. Radiographic examination was used to evaluate the healing of prostheses every month after operation. Three months later, the animal was sacrificed and the mandible specimens were sectioned for histological and biomechanical evaluation.


RESULTS
One of the body prosthesis was found to be exposed two weeks after operation. Four weeks later, fixation failed and the anterior part of the prosthesis separated from the mandible attached. The other body prosthesis also suffered from exposure,but the connection between the prosthesis and the mandible was still stable. Histological examination revealed that there was presence of osseointegration in the angle prosthesis as well as area that was not exposed in the body prosthesis model. Reattachment of the muscles to the bone graft area was found.


CONCLUSIONS
CAD/CAM generated Titanium mandibular prosthesis is applicable in human model. The vitality of this experiment revealed that a tight closure plays an important role in the healing by osseointegration. If there was any exposure, the osseointegration will be failed. Reattachment of the muscle to the prosthesis can be achieved by "muscle-bone-prosthesis"model.
Han
Zheng-Xue
ZX
Department of Oral Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Second Medical University, Shanghai 200011, China.
Ji
Tong
T
Zhang
Chen-Ping
CP
D000818:Animals; D006041:Goats; D008334:Mandible / Q000601:surgery*; D008338:Mandibular Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D008341:Mandibular Prosthesis; D019919:Prosthesis Implantation; D011859:Radiography; D014025:Titanium
D014025:Titanium