title: Mandibular reconstruction using a poly(L-lactide) mesh combined with autogenous particulate cancellous bone and marrow: a prospective clinical study.
abstract: The purpose of this study was to evaluate the stability and viability of mandibular bone regeneration using a poly(L-lactide) (PLLA) mesh and autogenous particulate cancellous bone and marrow (PCBM). Sixty-two procedures were undertaken at eight hospitals (22 malignant tumours, 30 benign tumours, five cysts, two osteomyelitis, two trauma, and one atrophy of the alveolar ridge); the success rate was 84%. The follow-up period was between 9 and 200 months (mean 88.2 months). Consequently, bone regeneration at 6 months postoperation was excellent in 35 cases (57%), good in 17 cases (27%), and poor in 10 cases (16%). In six of the 'poor' cases, the PLLA mesh was removed due to local infection early after surgery. Bone resorption>20% was observed in only one of 46 cases with a follow-up term of >1 year. There were no signs of any other adverse effects except in one case where a section of the tray broke off late in the follow-up period. It is concluded that this method is stable and effective due to favourable morphological and functional recovery and low invasiveness. It may thus be a useful alternative procedure for mandibular reconstruction.
authors.affiliation: Department of Oral Surgery, Saitama Cancer Center, Saitama, Japan. k-yagi@cancer-c.pref.saitama.jp
authors.forename: K
authors.initials: K
authors.lastname: Yagihara
authors.forename: S
authors.initials: S
authors.lastname: Okabe
authors.forename: J
authors.initials: J
authors.lastname: Ishii
authors.forename: T
authors.initials: T
authors.lastname: Amagasa
authors.forename: M
authors.initials: M
authors.lastname: Yamashiro
authors.forename: S
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: S
authors.initials: S
authors.lastname: Yokoya
authors.forename: T
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Y
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods; D064592:Autografts / Q000637:transplantation*; D016026:Bone Marrow Transplantation / Q000379:methods*; D001861:Bone Regeneration / Q000502:physiology; D001862:Bone Resorption / Q000209:etiology; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery; D008338:Mandibular Injuries / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery; D063175:Mandibular Reconstruction / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D009807:Odontogenic Cysts / Q000601:surgery; D010019:Osteomyelitis / Q000601:surgery; D011091:Polyesters / Q000737:chemistry*; D011183:Postoperative Complications; D011446:Prospective Studies; D013526:Surgical Mesh; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011091:Polyesters; C033616:poly(lactide)