title: Reconstruction of a Post-Traumatic Maxillary Ridge Using a Radial Forearm Free Flap and Immediate Tissue Engineering (Bone Morphogenetic Protein, Bone Marrow Aspirate Concentrate, and Cortical-Cancellous Bone): Case Report.
abstract: The purpose of this article is to describe reconstruction of the maxillary alveolar ridge by use of a microvascular free flap combined with an immediate tissue-engineered bone graft. This novel surgical technique involved the use of a radial forearm free flap and immediate allogeneic avascular bone graft augmented with bone morphogenetic protein and bone marrow aspirate concentrate. A poly-d,l-lactic acid mesh was used as a containment unit for the bone graft. The patient was successfully treated with a viable radial forearm free flap for soft tissue and regeneration of bone with adequate height and width, which allowed the placement of 3 dental implants with excellent arch coordination. We believe this is the first published case describing such a technique to reconstruct the maxillary alveolus.
authors.affiliation: Assistant Professor, Departments of Oral and Maxillofacial Surgery, Head and Neck Oncology, and Microvascular Surgery, School of Dentistry, University of Texas Health Sciences Center at Houston, Houston, TX. Electronic address: James.C.Melville@uth.tmc.edu.
authors.forename: James C
authors.initials: JC
authors.lastname: Melville
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL.
authors.forename: Ramzey
authors.initials: R
authors.lastname: Tursun
authors.affiliation: Staff Surgeon, Naval Medical Center Portsmouth, Portsmouth, VA; Assistant Professor of Surgery, Uniformed Services, University of the Health Sciences, Bethesda, MD.
authors.forename: J Marshall
authors.initials: JM
authors.lastname: Green
authors.affiliation: Professor and Chief, Department of Oral and Maxillofacial Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Marx
mesh_terms: D016026:Bone Marrow Transplantation / Q000379:methods*; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation; D054893:Cone-Beam Computed Tomography; D005260:Female; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps / Q000601:surgery*; D006801:Humans; D008437:Maxilla / Q000254:growth & development / Q000601:surgery; D008440:Maxillary Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011862:Radiography, Panoramic; D011884:Radius / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013526:Surgical Mesh; D023822:Tissue Engineering / Q000379:methods*
chemical_list: D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes