Reconstruction of the mandible using preshaped 2.3-mm titanium plates, autogenous cortical bone plates, particulate cancellous bone, and platelet-rich plasma: a retrospective analysis of 20 patients.
OBJECTIVE
The purpose of this retrospective study was to evaluate a group of 20 patients who underwent a reconstruction of the mandible by use of free bone grafts and platelet-rich plasma (PRP).


METHODS
In a period of 8 years, 20 patients underwent a reconstruction of the mandible, by use of preshaped 2.3-mm titanium plates, autogenous cortical bone plates, autogenous particulate bone, PRP, and a special fixation technique. The patients were divided into 3 groups. Group 1 consisted of 10 patients who underwent secondary reconstruction after ablative surgery for malignant tumors. Of these, 4 had preoperative or postoperative radiotherapy. Group 2 comprised 7 patients who underwent primary reconstruction after resections for benign but aggressive odontogenic tumors. Group 3 consisted of 3 patients with severe atrophy and malunion. The defects ranged in size from 8 to 12 cm in groups 1 and 2 and from 2 to 4 cm in group 3, and the follow-up ranged from 1 to 8 years.


RESULTS
The initial healing was uneventful in all but 3 patients. In these 3 patients additional bone grafts had to be placed to allow for optimal implant placement. At the time of implant insertion, some areas of granulation tissue were found, possibly because of the rather high dose of PRP used. Continuity in all cases was achieved, and the patients considered the results good in 10 cases and satisfactory in 9 cases. One patient could not be approached for the last assessment.


CONCLUSIONS
The grafting and fixation technique used proved to be rather reliable. The antimicrobial effect and the proliferation of osteoblasts are likely to be responsible for the results achieved.
Mooren
Robert E C M
RE
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. r.mooren@chello.nl
Merkx
Matthias A W
MA
Kessler
Peter A W H
PA
Jansen
John A
JA
Stoelinga
Paul J W
PJ
D000540:Alveolar Ridge Augmentation / Q000379:methods; D019072:Antibiotic Prophylaxis; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D049109:Cell Proliferation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008337:Mandibular Fractures / Q000150:complications; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D009808:Odontogenic Tumors / Q000534:rehabilitation / Q000601:surgery; D019647:Oral Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D010006:Osteoblasts / Q000166:cytology; D053657:Platelet-Rich Plasma; D011542:Pseudarthrosis / Q000209:etiology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium