title: Reconstruction of human mandibular continuity defects with allogenic scaffold and autologous marrow mesenchymal stem cells.
abstract: Mandibular continuity defects occur after tumor resection, maxillofacial injury, or osteomyelitis. In this clinical pilot study, we report a novel method for reconstruction of mandibular continuity defect by in vivo tissue engineering. In 3 patients with critical-size mandibular bone defects, the allogenic mandibular bone scaffold was customized, loaded by ex vivo expanded mesenchymal stem cells, and transplanted into the surgical defect site. According to the bone scintigraphy, vascularized bone was identified in 2 cases. In spiral computed tomography, normal bone healing without significant bone resorption was seen at the 2 viable grafts, but at the failed construction, there was a lack of osteointegration to the adjacent host bone and a higher density in the medullary bone. According to the serial panoramic imaging, the patients with viable bone grafts had normal bone healing, whereas the other patient had progressive overall bone resorption. Our results demonstrate the feasibility of allogenic bone scaffold loaded by mesenchymal stem cells in the reconstruction of mandibular continuity defects. Although long-term results are not yet available, it may be a novel method of reconstruction and a basis for further studies.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Dental Faculty, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Barbad
authors.initials: B
authors.lastname: Zamiri
authors.forename: Shoaleh
authors.initials: S
authors.lastname: Shahidi
authors.forename: Mohamadreza Baghaban
authors.initials: MB
authors.lastname: Eslaminejad
authors.forename: Ahad
authors.initials: A
authors.lastname: Khoshzaban
authors.forename: Mehdi
authors.initials: M
authors.lastname: Gholami
authors.forename: Emad
authors.initials: E
authors.lastname: Bahramnejad
authors.forename: Reza
authors.initials: R
authors.lastname: Moghadasali
authors.forename: Soura
authors.initials: S
authors.lastname: Mardpour
authors.forename: Nasser
authors.initials: N
authors.lastname: Aghdami
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts / Q000637:transplantation; D015519:Bone Density / Q000502:physiology; D001862:Bone Resorption / Q000209:etiology; D016025:Bone Transplantation / Q000379:methods*; D002469:Cell Separation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D016348:Osseointegration / Q000502:physiology; D010865:Pilot Projects; D011862:Radiography, Panoramic / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D036542:Tomography, Spiral Computed / Q000379:methods; D014945:Wound Healing / Q000502:physiology