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Clinical application of a custom-made bioresorbable raw particulate hydroxyapatite/poly-l-lactide mesh tray for mandibular reconstruction

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Abstract

Mandibular reconstruction using particulate cancellous bone and marrow (PCBM) allows functional oral reconstruction. Although ready-made titanium trays are the most common material used in this method, they have some disadvantages such as difficulty in making them form a suitable contour for the defect, and the need for removal. A forged composite of raw particulate hydroxyapatite (HA)/poly-l-lactide (PLLA) is a bioresorbable material that is stronger than pure PLLA and induces bone formation more rapidly. We present two cases successfully treated with custom-made bioresorbable HA/PLLA mesh trays for mandibular reconstruction. A 29-year-old woman with recurrent ameloblastoma and a 66-year-old man with a recurrent keratinized odontogenic tumor of the mandible gave informed consent for this reconstruction technique. Mesh sheets of HA/PLLA were customized by a rapid prototyping method based on computed tomography (CT) data. Marginal resection of the tumor was carried out, and PCBM was harvested from the bilateral posterior iliac crests. PCBM and platelet-rich plasma were transferred to the tray, and the tray was fixed rigidly with HA/PLLA screws. In the second case, dental implants were inserted. There has been no bone resorption for over 2 years since reconstruction in these two cases, and the inserted dental implants have been free from any complications 1 year after loading. The average CT value in Hounsfield units (HU) of the implant sites of two cases was 790. In conclusion, the customized HA/PLLA tray was easily adapted to the mandible, and fine bone quality was obtained. These cases show that this tray system contributed to functional oral rehabilitation with dental implants.

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References

  1. Carlson ER, Marx RE. Mandibular reconstruction using cancellous cellular bone grafts. J Oral Maxillofac Surg 1996;54:889–897.

    Article  PubMed  Google Scholar 

  2. Yamashita Y, Yamaguchi Y, Tsuji M, Shigematsu M, Goto M. Mandibular reconstruction using autologous iliac bone and titanium mesh reinforced by laser welding for implant placement. Int J Oral Maxillofac Implants 2008;23:1143–1146.

    PubMed  Google Scholar 

  3. Cheung LK, Samman N, Tong ACK, Tiedman AH. Mandibular reconstruction with the Dacron urethane tray. A radiological assessment of bone remodeling. J Oral Maxillofac Surg 1994;52:373–380.

    Article  PubMed  Google Scholar 

  4. Kinoshita Y, Kobayashi M, Hidaka T, Ikeda Y. reconstruction of mandibular continuity defects in dogs using poly (l-lactide) mesh and autogenic particulate cancellous bone and marrow: preliminary report. J Oral Maxillofac Surg 1997;55:718–723.

    Article  PubMed  Google Scholar 

  5. Louis P, Holmes J, Fernandes R. Resorbable mesh as a containment system in reconstruction of the atrophic mandible fracture. J Oral Maxillofac Surg 2004;62:719–723.

    Article  PubMed  Google Scholar 

  6. Bosker H, Powers MP. TMI reconstruction system. In: Fonseca RJ, Davis WH, editors. Reconstructive preprosthetic oral and maxillofacial surgery. 2nd ed. Philadelphia: Saunders; 1995.

    Google Scholar 

  7. Shikinami Y, Matsusue Y, Nakamura T. The complete process of bioresorption and bone replacement using devices made of forged composites of raw hydroxyapatite particles/polylactide (F-u-HA/PLLA). Biomaterials 2005;26:5542–5551.

    Article  PubMed  Google Scholar 

  8. Ito T, Kudo M, Yozu R. Usefulness of osteosynthesis device made of hydroxyapatite-poly-l-lactide composites in port-access cardiac surgery. Ann Thorac Surg 2008;86:1905–1908.

    Article  PubMed  Google Scholar 

  9. Metzger MC, Schon R, Schmelzeisen R. Preformed titanium meshes: a new standard? Skull Base 2007;17:269–272.

    Article  PubMed  Google Scholar 

  10. Iwamoto I, Matsuo A, Kato N, Takeuchi S, Takahashi H, Hojo S, Chiba H. Computed tomographic evaluation of bone quality of the mandible reconstructed by particular cellular bone and marrow combined with platelet rich plasma. Oral Sci Int 2009;6:63–72.

    Google Scholar 

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Akira Matsuo, Hiroshige Chiba, Hidetoshi Takahashi, Jun Toyoda & Harutsugi Abukawa

Authors
  1. Akira Matsuo
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  2. Hiroshige Chiba
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  3. Hidetoshi Takahashi
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  4. Jun Toyoda
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  5. Harutsugi Abukawa
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Correspondence to Akira Matsuo.

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Matsuo, A., Chiba, H., Takahashi, H. et al. Clinical application of a custom-made bioresorbable raw particulate hydroxyapatite/poly-l-lactide mesh tray for mandibular reconstruction. Odontology 98, 85–88 (2010). https://doi.org/10.1007/s10266-009-0111-x

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  • DOI: https://doi.org/10.1007/s10266-009-0111-x

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