Clinical Usefulness of Mandibular Reconstruction Using Custom-Made Titanium Mesh Tray and Autogenous Particulate Cancellous Bone and Marrow Harvested From Tibia and/or Ilia.
The objective of this study was to evaluate usefulness of mandibular reconstructions using custom-made titanium mesh (Ti-mesh) tray and particulate cancellous bone and marrow (PCBM). Consecutive 21 patients who underwent mandibular reconstruction were enrolled in this study. They were 13 men and 8 women (mean age, 52.0 years). Virtual reality simulation was performed using computer software based on the preoperative computed tomography data. A 3-dimensional skull model was constructed using 3-dimensional printer. A tray was custom-made from Ti-mesh sheet bent to adapt to the model. After PCBM harvesting from posterior ilia and/or proximal tibia, 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 postoperative facial contour was evaluated using visual analog scale (VAS score, range, 0-100). In 16 of 21 patients, excellent new bone formation was recognized and expected results were radiologically achieved. In 5 patients, new bone formation was insufficient. Causes of insufficient bone formation included postoperative infection in 2 patients, Ti-mesh tray fracture in 2 patients, and local recurrence of lower gingival cancer in 1 patient. To prevent a tray fracture, a double-layered Ti-mesh tray was useful. Mean VAS score on patients' satisfaction was 77.1. Our results comprehensively suggest that mandibular reconstruction using custom-made Ti-mesh tray and PCBM is clinically useful.
*Department of Oral and Maxillofacial Surgery†Department of Fixed Prosthodontics‡Department of Dental Laboratory Technology, Tsurumi University School of Dental Medicine, Yokohama, Japan.
Hiroyuki
H
Yamada
Kazutoshi
K
Nakaoka
Tomoo
T
Sonoyama
Kenichi
K
Kumagai
Tomoko
T
Ikawa
Yuko
Y
Shigeta
Naohiko
N
Harada
Noboru
N
Kawamura
Takumi
T
Ogawa
Yoshiki
Y
Hamada
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016026:Bone Marrow Transplantation / Q000379:methods; D016025:Bone Transplantation / Q000379:methods*; D000071556:Cancellous Bone / Q000637:transplantation*; D002648:Child; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008297:Male; D008334:Mandible / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D066330:Printing, Three-Dimensional; D019736:Prostheses and Implants; D013526:Surgical Mesh; D013977:Tibia / Q000637:transplantation*; D020858:Tissue and Organ Harvesting; D014025:Titanium; D055815:Young Adult
D014025:Titanium