Reconstruction of the mandible with a poly(D,L-lactide) scaffold, autogenous corticocancellous bone graft, and autogenous platelet-rich plasma: an animal experiment.
An animal study is presented, evaluating a method of mandibular reconstruction using a poly(D,Llactide) (PDLLA) scaffold. Six goats underwent a continuity resection of the mandibular angle. The defect was bridged with a preshaped PDLLA scaffold, filled with an autogenous particulate bone graft from the anterior iliac crest, and fixed with two preshaped titanium plates. To accelerate bone healing, autogenous platelet-rich plasma was mixed with the particulate bone graft. All goats had an uneventful healing. The osteosynthesis system withstood immediate loading for a period of 6 weeks until sacrifice. The particulate bone grafts within the PDLLA scaffold, which appeared to be narrowed, showed considerable resorption and replacement by fibrous tissue. In all goats, however, callus formation along the reconstructed segment was seen, providing bony continuity and maintaining the original contour of the reconstructed segment. Thus, the technique used may provide an alternative for reconstruction with revascularized composite flaps with less associated donor site morbidity.
Fennis
Jeroen P M
JP
Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem, The Netherlands. j.fennis@chello.nl
Stoelinga
Paul J W
PJ
Merkx
Matthias A W
MA
Jansen
John A
JA
D000818:Animals; D001705:Bioprosthesis; D001804:Blood Transfusion, Autologous / Q000379:methods; D001861:Bone Regeneration / Q000502:physiology; D016025:Bone Transplantation / Q000295:instrumentation*; D015921:Dental Implants; D017102:Fracture Healing / Q000502:physiology; D006041:Goats; D048091:Guided Tissue Regeneration / Q000295:instrumentation* / Q000379:methods; D008337:Mandibular Fractures / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D017713:Platelet Transfusion / Q000379:methods*; D011091:Polyesters / Q000737:chemistry; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D014182:Transplantation, Autologous / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
D015921:Dental Implants; D011091:Polyesters; C033616:poly(lactide)