title: Mandibular reconstruction using custom-made titanium mesh tray and particulate cancellous bone and marrow harvested from bilateral posterior ilia.
abstract: The objective of this study is to evaluate usefulness of mandibular reconstructions using a custom-made titanium mesh (Ti-mesh) tray and particulate cancellous bone and marrow (PCBM). A consecutive nine patients who underwent mandibular reconstruction were enrolled in this study. They were five men and four women (mean age: 53.9 years). Virtual reality simulation was performed using computer software based on the pre-operative computed tomography data. A 3-dimensional (3-D) skull model was constructed using a 3-D printer. A tray was custom-made from a Ti-mesh sheet bent to adapt to the model. After PCBM harvesting from bilateral posterior ilia, the tray was fixed to the host bone. New bone formation and configuration of the reconstructed mandible were assessed radiologically. Complications were recorded in each patient during the follow-up period. Patients, satisfaction with post-operative facial contour was evaluated using a visual analogue scale (VAS score, range = 0-100). In six of nine patients, excellent new bone formation was recognised and expected results were radiologically achieved. Complications occurred in four patients. These complications included Ti-mesh fracture, Ti-mesh exposure in the oral cavity, and delayed infection. Mean VAS score on patient satisfaction was 77.6. Although the data are preliminary, the results suggest that this method is clinically useful.
authors.affiliation: Department of Oral and Maxillofacial Surgery.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Nakaoka
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kumagai
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ikawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shigeta
authors.forename: Eisaku
authors.initials: E
authors.lastname: Imamura
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Iino
authors.forename: Takumi
authors.initials: T
authors.lastname: Ogawa
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hamada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D016026:Bone Marrow Transplantation; D016025:Bone Transplantation; D002648:Child; D005260:Female; D005887:Gingival Neoplasms / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation; D021621:Imaging, Three-Dimensional; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D066330:Printing, Three-Dimensional; D025321:Surgery, Computer-Assisted; D013526:Surgical Mesh; D014025:Titanium; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D014025:Titanium
keywords: Reconstruction; mandible; titanium mesh tray