Skip to main content
SpringerLink
Log in

Functional Bone Replacement in Oral and Maxillofacial Surgery: Definition, Indications, and Manufacturing Considerations

  • Chapter
  • First Online:
Emerging Technologies in Oral and Maxillofacial Surgery

  • 230 Accesses

Abstract

Recent advancements in biomedical technologies have presented novel treatment options for the reconstruction of mandibular bone defects, caused by congenital syndromes, or following surgical tumor resections, one of the most challenging issues in oral and maxillofacial surgeries. Conventional approaches to reconstruct these defects use autogenous bone grafting harvested from the rib, fibula, and iliac. However, this method has several limitations, such as donor site morbidity, added time of operation for graft harvest, difficult molding, limited availability, and graft resorption. Novel approaches have been introduced with the aim of overcoming on these limitations. Patient-specific implants fabricated by computer-aided design and manufacturing (CAD/CAM) technology from virtual models successfully indicated functional mandibular bone replacement. Besides all that, a good knowledge about choosing favorable biomaterials and appropriate fabrication methods is required to reach better postoperative functional and esthetic outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Puricelli E. Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap. Head Face Med. 2021;1(17):1–9.

    Google Scholar 

  2. Ahmed W, Asim MA, Ehsan A, Abbas Q. Non-vascularized autogenous bone grafts for reconstruction of maxillofacial osseous defects. J Coll Physicians Surg Pak. 2018;28:17–21.

    Article  PubMed  Google Scholar 

  3. Subbiah R, Ruehle MA, Klosterhoff BS, Lin AS, Hettiaratchi MH, Willett NJ, et al. Triple growth factor delivery promotes functional bone regeneration following composite musculoskeletal trauma. Acta Biomater. 2021;127:180–92.

    Article  CAS  PubMed  Google Scholar 

  4. Omar O, Engstrand T, Kihlström Burenstam Linder L, Åberg J, Shah FA, Palmquist A, et al. In situ bone regeneration of large cranial defects using synthetic ceramic implants with a tailored composition and design. Proc Natl Acad Sci U S A. 2020;43(117):26660–71.

    Article  Google Scholar 

  5. Sakuraba M, Miyamoto S, Fujiki M, Higashino T, Oshima A, Hayashi R. Analysis of functional outcomes in patients with mandible reconstruction using vascularized fibular grafts. Microsurgery. 2017;2(37):101–4.

    Article  Google Scholar 

  6. Duda T, Raghavan LV. 3D metal printing technology. IFAC-PapersOnLine. 2016;29(49):103–10.

    Article  Google Scholar 

  7. Chernohorskyi DM, Chepurnyi YV, Kanyura OA, Kopchak AV. Total mandibular defect reconstruction by total titanium patient-specific implant: clinical efficacy and long term follow up. Clinical case. Wiad Lek. 2021;4(74):1037–41.

    Article  Google Scholar 

  8. Mascha F, Winter K, Pietzka S, Heufelder M, Schramm A, Wilde F. Accuracy of computer-assisted mandibular reconstructions using patient-specific implants in combination with CAD/CAM fabricated transfer keys. J Craniomaxillofac Surg. 2017;11(45):1884–97.

    Article  Google Scholar 

  9. Tideman H, Samman N, Cheung L. Functional reconstruction of the mandible: a modified titanium mesh system. Int J Oral Maxillofac Surg. 1998;5(27):339–45.

    Article  Google Scholar 

  10. Paganias CG, Tsakotos GA, Koutsostathis SD, Macheras GA. Osseous integration in porous tantalum implants. Indian J Orthop. 2012;5(46):505–13.

    Article  Google Scholar 

  11. Cachinho SC, Correia RN. Titanium scaffolds for osteointegration: mechanical, in vitro and corrosion behaviour. J Mater Sci Mater Med. 2008;1(19):451–7.

    Article  Google Scholar 

  12. Pellizzari M, Jam A, Tschon M, Fini M, Lora C, Benedetti M. A 3D-printed ultra-low young’s modulus β-Ti alloy for biomedical applications. Materials. 2020;12(13):2792.

    Article  Google Scholar 

  13. Farajpour H, Bastami F, Bohlouli M, Khojasteh A. Reconstruction of bilateral ramus-condyle unit defect using custom titanium prosthesis with preservation of both condyles. J Mech Behav Biomed Mater. 2021;124:104765.

    Article  CAS  PubMed  Google Scholar 

  14. Qin Y, Wen P, Guo H, Xia D, Zheng Y, Jauer L, et al. Additive manufacturing of biodegradable metals: current research status and future perspectives. Acta Biomater. 2019;98:3–22.

    Article  CAS  PubMed  Google Scholar 

  15. Riviș M, Roi C, Roi A, Nica D, Văleanu A, Rusu L-C. The implications of titanium alloys applied in maxillofacial osteosynthesis. Appl Sci. 2020;9(10):3203.

    Article  Google Scholar 

  16. Gaviria L, Pearson JJ, Montelongo SA, Guda T, Ong JL. Three-dimensional printing for craniomaxillofacial regeneration. J Korean Assoc Oral Maxillofac Surg. 2017;5(43):288–98.

    Article  Google Scholar 

  17. Oh J-h. Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing. Plast Reconstr Surg. 2018;1(40):2.

    Google Scholar 

  18. Rotaru H, Schumacher R, Kim S-G, Dinu C. Selective laser melted titanium implants: a new technique for the reconstruction of extensive zygomatic complex defects. Maxillofac Plast Reconstr Surg. 2015;1(37):1.

    Article  Google Scholar 

  19. Ma J, Ma L, Wang Z, Zhu X, Wang W. The use of 3D-printed titanium mesh tray in treating complex comminuted mandibular fractures: a case report. Medicine. 2017;96(27):e7250.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Shan X-F, Chen H-M, Liang J, Huang J-W, Cai ZG. Surgical reconstruction of maxillary and mandibular defects using a printed titanium mesh. J Oral Maxillofac Surg. 2015;73(7):1437.e1–9.

    Article  PubMed  Google Scholar 

  21. Grecchi F, Zecca PA, Macchi A, Mangano A, Riva F, Grecchi E, et al. Full-digital workflow for fabricating a custom-made direct metal laser sintering (DMLS) mandibular implant: a case report. Int J Environ Res Public Health. 2020;8(17):2693.

    Article  Google Scholar 

  22. Popescu D, Zapciu A, Amza C, Baciu F, Marinescu R. FDM process parameters influence over the mechanical properties of polymer specimens: a review. Polym Test. 2018;69:157–66.

    Article  CAS  Google Scholar 

  23. Dub V, Medvedev P, Kudrin K, Delov A, Stepanov S, Sviatoslavov D et al. The effect of thermal treatment on the properties of SLM samples with a bionic design. International Conference “Energy Efficiency and Energy Saving in Technical Systems” (EEESTS-2019). 2019;104:01010.

    Google Scholar 

  24. Perrott DH, Umeda H, Kaban LB. Costochondral graft construction/reconstruction of the ramus/condyle unit: long-term follow-up. Int J Oral Maxillofac Surg. 1994;6(23):321–8.

    Article  Google Scholar 

  25. Cole P, Crawford MH, Hollier LH, Taylor TJ. The composite costochondral-iliac crest bone graft: a novel technique for temporomandibular joint reconstruction. J Oral Maxillofac Surg. 2008;6(66):1299–301.

    Article  Google Scholar 

  26. Kaur K, Roychoudhury A, Bhutia O, Bhalla AS, Yadav R, Pandey RMJ, et al. Evaluation of success of transport disc distraction osteogenesis and costochondral graft for ramus condyle unit reconstruction in pediatric temporomandibular joint ankylosis. J Oral Maxillofac Surg. 2020;78(6):1018.e1–1018.e16.

    Article  PubMed  Google Scholar 

  27. Mercuri LG. The role of custom-made prosthesis for temporomandibular joint replacement. Rev Esp Cir Oral Maxilofac. 2013;1(35):1–10.

    Google Scholar 

  28. Machoň V, Levorová J, Hirjak D, Drahoš M, Brizman E, Beňo M, et al. Evaluation of complications following stock replacement of the temporomandibular joint performed between the years 2006 and 2015: a retrospective study. Oral Maxillofac Surg. 2020;24(3):373.

    Article  PubMed  Google Scholar 

  29. Aagaard E, Thygesen TJ. A prospective, single-centre study on patient outcomes following temporomandibular joint replacement using a custom-made Biomet TMJ prosthesis. Int J Oral Maxillofac Surg. 2014;10(43):1229–35.

    Article  Google Scholar 

  30. Öhman D, Schaefer C, Nannmark U, Kjeller G, Malmström J. Mandible reconstruction with patient-specific implants: case report of five consecutive patients. Int J Oral Maxillofac Implants. 2019;1(34):e7.

    Article  Google Scholar 

  31. Park J-H, Jo E, Cho H, Kim HJ. Temporomandibular joint reconstruction with alloplastic prosthesis: the outcomes of four cases. Maxillofac Plast Reconstr Surg. 2017;39(1):6.

    Article  PubMed  PubMed Central  Google Scholar 

  32. de Souza NT, Cavalcante RCL, de Albuquerque Cavalcante MA, Hespanhol W, de Oliveira MR, de Carvalho FD, et al. An unusual osteoma in the mandibular condyle and the successful replacement of the temporomandibular joint with a custom-made prosthesis: a case report. BMC Res Notes. 2017;1(10):727.

    Article  Google Scholar 

  33. Mercuri LG. Costochondral graft versus total alloplastic joint for temporomandibular joint reconstruction. Oral Maxillofac Surg Clin North Am. 2018;3(30):335–42.

    Article  Google Scholar 

  34. Ow A, Tan W, Pienkowski L. Mandibular reconstruction using a custom-made titanium prosthesis: a case report on the use of virtual surgical planning and computer-aided design/computer-aided manufacturing. Craniomaxillofac Trauma Reconstr. 2016;03(9):246–50.

    Article  Google Scholar 

  35. Vignesh U, Mehrotra D, Howlader D, Singh PK, Gupta S. Patient specific three-dimensional implant for reconstruction of complex mandibular defect. J Craniofac Surg. 2019;4(30):e308–e11.

    Google Scholar 

  36. Touré G, Gouet E. Use of a 3-dimensional custom-made porous titanium prosthesis for mandibular body reconstruction with prosthetic dental rehabilitation and Lipofilling. J Oral Maxillofac Surg. 2019;6(77):1305–13.

    Article  Google Scholar 

  37. Jeremic JV, Nikolic ZS, Boricic IV, Tacevic ZD, Tomanovic NR, Drcic LJ, et al. Total mandibular reconstruction after resection of rare “honeycomb-like” ameloblastic carcinoma–a case report. J Craniomaxillofac Surg. 2010;6(38):465–8.

    Article  Google Scholar 

  38. Sato J, Yamazaki Y, Satoh A, Onodera-Kyan M, Abe T, Satoh T, et al. Pain may predict poor prognosis in patients with oral squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;5(111):587–92.

    Article  Google Scholar 

  39. Van Cann EM, Dom M, Koole R, Merkx MA, Stoelinga PJ. Health related quality of life after mandibular resection for oral and oropharyngeal squamous cell carcinoma. Oral Oncol. 2005;7(41):687–93.

    Article  Google Scholar 

  40. Sannomiya EK, Silva JVL, Brito AA, Saez DM, Angelieri F, da Silva DG. Surgical planning for resection of an ameloblastoma and reconstruction of the mandible using a selective laser sintering 3D biomodel. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;1(106):e36–40.

    Article  Google Scholar 

  41. Smith A, Petersen D, Samant S, Ver Halen JP. Pediatric mandibular reconstruction following resection of oral squamous cell carcinoma: a case report. Am J Otolaryngol. 2014;6(35):826–8.

    Article  Google Scholar 

  42. Ash CS, Nason RW, Abdoh AA, Cohen MA. Prognostic implications of mandibular invasion in oral cancer. Head Neck. 2000;8(22):794–8.

    Article  Google Scholar 

  43. Lai HC, Zhuang LF, Zhang ZY, Wieland M, Liu X. Bone apposition around two different sandblasted, large-grit and acid-etched implant surfaces at sites with coronal circumferential defects: an experimental study in dogs. Clin Oral Implants Res. 2009;3(20):247.

    Article  Google Scholar 

  44. Persson LG, Berglundh T, Lindhe J, Sennerby L. Re-osseointegration after treatment of peri-implantitis at different implant surfaces: an experimental study in the dog. Clin Oral Implants Res. 2001;6(12):595–603.

    Article  Google Scholar 

  45. Namgoong H, Kim M, Ku Y, Rhyu IC, Lee YM, Seol YJ, et al. Bone reconstruction after surgical treatment of experimental peri-implantitis defects at a sandblasted/acid-etched hydroxyapatite-coated implant: an experimental study in the dog. J Clin Periodontol. 2015;42(10):960–6.

    Article  CAS  PubMed  Google Scholar 

  46. Dolgolev A, Reshetov I, Svyatoslavov D, Sinelnikov M, Kudrin K, Dub V, et al. Experimental biointegration of a titanium implant in delayed mandibular reconstruction. J Pers Med. 2020;1(10):6.

    Article  Google Scholar 

  47. Wei FC, Celik N, Yang WG, Chen IH, Chang YM, Chen HC. Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap. Plast Reconstr Surg. 2003;112(1):37.

    Article  PubMed  Google Scholar 

  48. Akhlaghi F, Hesami N, Rad MR, Nazeman P, Fahimipour F, Khojasteh A. Improved bone regeneration through amniotic membrane loaded with buccal fat pad-derived MSCs as an adjuvant in maxillomandibular reconstruction. J Craniomaxillofac Surg. 2019;8(47):1266–73.

    Article  Google Scholar 

  49. Khojasteh A, Hosseinpour S, Rezai Rad M, Alikhasi M, HHJ Z. Buccal fat pad-derived stem cells with anorganic bovine bone mineral scaffold for augmentation of atrophic posterior mandible: an exploratory prospective clinical study. Clin Implant Dent Relat Res. 2019;2(21):292–300.

    Article  Google Scholar 

  50. Bohlouli M, Bastami F, Nokhbatolfoghahei H, Khojasteh A. Tissue buccal fat pad- stromal vascular fraction as a safe source in maxillofacial bone regeneration: a clinical pilot study. J Plast Reconstr Aesthet Surg. 2023;79:111.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Farshid Bastami & Arash Khojasteh

Authors
  1. Farshid Bastami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arash Khojasteh
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sc, Tehran, Iran

    Arash Khojasteh

  2. School of Medicine, University of Glasgow, Glasgow, UK

    Ashraf F. Ayoub

  3. Department of Maxillofacial Surgery, University of Antwerp, Antwerp, Belgium

    Nasser Nadjmi

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bastami, F., Khojasteh, A. (2023). Functional Bone Replacement in Oral and Maxillofacial Surgery: Definition, Indications, and Manufacturing Considerations. In: Khojasteh, A., Ayoub, A.F., Nadjmi, N. (eds) Emerging Technologies in Oral and Maxillofacial Surgery . Springer, Singapore. https://doi.org/10.1007/978-981-19-8602-4_7

Download citation

  • DOI: https://doi.org/10.1007/978-981-19-8602-4_7

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-8601-7

  • Online ISBN: 978-981-19-8602-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation