title: Prototyped grafting plate for reconstruction of mandibular defects.
abstract: To esthetically and functionally restore a 40-mm canine mandibular discontinuity defect using a custom-made titanium bone-grafting plate in combination with autologous iliac bone grafts. Individualized titanium bone-grafting plates were manufactured using a series of techniques, including reverse engineering, computer aided design, rapid prototyping and titanium casting. A 40-mm discontinuous defect in the right mandibular body was created in 9 hybrid dogs. The defect was restored immediately using the customized plate in combination with autologous cancellous iliac blocks. Sequential radionuclide bone imaging was performed to evaluate the bone metabolism and reconstitution of the grafts. The specimens were evaluated by biomechanical testing, 3-dimensional microcomputed tomographic scanning, and histological examination. The results revealed that the symmetry of the mandibles was reconstructed using the customized grafting plate, and the bony continuity of the mandibles was restored. By 12 weeks after the operation, the cancellous iliac grafts became a hard bone block, which was of comparable strength to native mandibles. A fibrous tissue intermediate was found between the remodelled bone graft and the titanium plate. The results indicate that the prototyped grafting plate can be used to restore mandibular discontinuous defects, and satisfactory aesthetical and functional reconstruction can be achieved.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China.
authors.forename: Libin
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China.
authors.forename: Peilin
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China.
authors.forename: Haolun
authors.initials: H
authors.lastname: Han
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China.
authors.forename: Baowei
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China.
authors.forename: Hongnan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, 145 Western Changle Road, Xi'an 710032, Shaanxi, PR China.
authors.forename: Jinlong
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, 145 Western Changle Road, Xi'an 710032, Shaanxi, PR China. Electronic address: liuyanpu@fmmu.edu.cn.
authors.forename: Yanpu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China. Electronic address: ent306ww@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
mesh_terms: D000497:Alloys / Q000737:chemistry; D000818:Animals; D064592:Autografts / Q000000981:diagnostic imaging / Q000637:transplantation; D001696:Biomechanical Phenomena; D015519:Bone Density / Q000502:physiology; D001860:Bone Plates; D016723:Bone Remodeling / Q000502:physiology; D016025:Bone Transplantation / Q000295:instrumentation*; D017076:Computer-Aided Design; D004285:Dogs; D004867:Equipment Design; D006085:Graft Survival; D021621:Imaging, Three-Dimensional / Q000379:methods; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000295:instrumentation*; D011877:Radionuclide Imaging; D013314:Stress, Mechanical; D013997:Time Factors; D014025:Titanium / Q000737:chemistry; D036542:Tomography, Spiral Computed / Q000379:methods; D014584:User-Computer Interface; D055114:X-Ray Microtomography / Q000379:methods
chemical_list: D000497:Alloys; C031462:titanium alloy (TiAl6V4); D014025:Titanium
keywords: Autologous bone grafting; Computer aided design; Mandible reconstruction; Rapid prototyping