Mandibular reconstruction using a poly(L-lactide) mesh combined with autogenous particulate cancellous bone and marrow: a prospective clinical study

Int J Oral Maxillofac Surg. 2013 Aug;42(8):962-9. doi: 10.1016/j.ijom.2013.03.010. Epub 2013 Apr 18.

Abstract

The purpose of this study was to evaluate the stability and viability of mandibular bone regeneration using a poly(L-lactide) (PLLA) mesh and autogenous particulate cancellous bone and marrow (PCBM). Sixty-two procedures were undertaken at eight hospitals (22 malignant tumours, 30 benign tumours, five cysts, two osteomyelitis, two trauma, and one atrophy of the alveolar ridge); the success rate was 84%. The follow-up period was between 9 and 200 months (mean 88.2 months). Consequently, bone regeneration at 6 months postoperation was excellent in 35 cases (57%), good in 17 cases (27%), and poor in 10 cases (16%). In six of the 'poor' cases, the PLLA mesh was removed due to local infection early after surgery. Bone resorption>20% was observed in only one of 46 cases with a follow-up term of >1 year. There were no signs of any other adverse effects except in one case where a section of the tray broke off late in the follow-up period. It is concluded that this method is stable and effective due to favourable morphological and functional recovery and low invasiveness. It may thus be a useful alternative procedure for mandibular reconstruction.

Publication types

  • Case Reports
  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorbable Implants*
  • Adolescent
  • Adult
  • Aged
  • Alveolar Ridge Augmentation / methods
  • Autografts / transplantation*
  • Bone Marrow Transplantation / methods*
  • Bone Regeneration / physiology
  • Bone Resorption / etiology
  • Bone Transplantation / methods*
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mandibular Diseases / surgery
  • Mandibular Injuries / surgery
  • Mandibular Neoplasms / surgery
  • Mandibular Reconstruction / instrumentation
  • Mandibular Reconstruction / methods*
  • Middle Aged
  • Odontogenic Cysts / surgery
  • Osteomyelitis / surgery
  • Polyesters / chemistry*
  • Postoperative Complications
  • Prospective Studies
  • Surgical Mesh*
  • Tissue Scaffolds
  • Treatment Outcome
  • Young Adult

Substances

  • Polyesters
  • poly(lactide)