title: Enhancing mandibular bone regeneration and perfusion via axial vascularization of scaffolds.
abstract: OBJECTIVE
  Reconstruction of large and complex bone segments is a challenging problem facing maxillofacial surgery. The majority of current regenerative approaches rely on extrinsic vascularization, which is deficient after cancer ablation and irradiation. The aim of the study was to investigate the efficacy of intrinsic axial vascularization of synthetic bone scaffolds in the management of critical-size mandibular defects.
  
  
  METHODS
  Scaffold-guided mandibular regeneration in two groups of adult male goats was compared. Only the scaffolds of the second group were axially vascularized via in situ embedding of an arteriovenous loop through microsurgical anastomosis of facial vessels. After 6 months of follow up, both groups were compared through radiological, biomechanical, histological and histomorphometric analysis.
  
  
  RESULTS
  The axially vascularized constructs have showed significantly more central vascularization (p = 0.021) and markedly enhanced central bone formation (p = 0.08). The biomechanical characteristics were enhanced, but the difference between both groups was not statistically significant (p = 0.98).
  
  
  CONCLUSIONS
  Axially vascularized synthetic mandibular grafts show better vascularization at their central regions, permitting more efficient bone regeneration.
  
  
  CONCLUSIONS
  The encouraging results of the proposed technique could be of benefit in optimizing the reconstruction of large critical-size bone defects.
authors.affiliation: Head and Neck and Endocrine Surgery, Faculty of Medicine, University of Alexandria, Elkhartoum Square, Alexandria, 21131, Egypt, ahmad.eweida@alexmed.edu.eg.
authors.forename: Ahmad Mahmoud
authors.initials: AM
authors.lastname: Eweida
authors.forename: Ayman Sameh
authors.initials: AS
authors.lastname: Nabawi
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abouarab
authors.forename: Mohamed
authors.initials: M
authors.lastname: Kayed
authors.forename: Habashi
authors.initials: H
authors.lastname: Elhammady
authors.forename: Ashraf
authors.initials: A
authors.lastname: Etaby
authors.forename: Mohamed Rafik
authors.initials: MR
authors.lastname: Khalil
authors.forename: Michael Samir
authors.initials: MS
authors.lastname: Shawky
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kneser
authors.forename: Raymund E
authors.initials: RE
authors.lastname: Horch
authors.forename: Naglaa
authors.initials: N
authors.lastname: Nagy
authors.forename: Mona Kamal
authors.initials: MK
authors.lastname: Marei
mesh_terms: D000818:Animals; D001861:Bone Regeneration; D006041:Goats; D008297:Male; D008334:Mandible / Q000502:physiology*; D054457:Tissue Scaffolds