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

J Oral Maxillofac Surg. 2017 Feb;75(2):438.e1-438.e6. doi: 10.1016/j.joms.2016.11.001. Epub 2016 Nov 9.

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.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow Transplantation / methods*
  • Bone Morphogenetic Proteins / therapeutic use*
  • Bone Substitutes / therapeutic use*
  • Bone Transplantation
  • Cone-Beam Computed Tomography
  • Female
  • Forearm / surgery
  • Free Tissue Flaps / surgery*
  • Humans
  • Maxilla / growth & development
  • Maxilla / surgery
  • Maxillary Fractures / diagnostic imaging
  • Maxillary Fractures / surgery*
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Radiography, Panoramic
  • Radius / transplantation*
  • Surgical Mesh
  • Tissue Engineering / methods*

Substances

  • Bone Morphogenetic Proteins
  • Bone Substitutes