IADR Abstract Archives
Efficacy of Stem-Cell Biotechnology for Reconstruction of Mandibular Continuity Defects
Objectives: Reconstruction of hard tissue continuity defects caused by ablative tumor surgery has been traditionally reconstructed with autogenous cancellous marrow grafts, microvascular free flaps or hardware. Although results have been predictable from these methods of reconstruction, the morbidity associated with bone harvest is quite significant for the patient. With the advances made in tissue engineering, it is our opinion that successful and predictable results can be obtained using a combination of 100% cadaver bone, Bone Marrow Aspirate Concentrate (BMAC) and rhBMP or solely BMAC in the immediate reconstruction for maxillofacial continuity defects.
Methods: The aim of this retrospective study is to share our experience with the use of 100% allogeneic bone in combination with BMP and BMAC for immediate reconstruction of continuity defects resulting from ablative tumor surgery or trauma in a 3 year span (2014 - 2017) at the UTHealth OMS department. The present study reviewed 21 patients at the UTHealth OMFS during a 3-year period between 2014 and 2017. We identified (11 men and 10 women) with a mean age (33.9) of ranging from 11 to 65yo. All patients were ASA I or II with no history of chemotherapy, radiation treatment or prior ablative surgery. We defined criteria for success as follows: 1) Unity of bony defect, 2) >3.0cm bone height and >1.0cm bone width, 3) Arch coordination, 4) Implantable bone, 5) Maintenance of osseous content for longer than 18 months, and 6) Restoration of Acceptable facial form
Results: We report a 91% success rate (19/21 pts) related to reconstruction with our rigid criteria. 19 patients demonstrated excellent bone quality both clinically and radiographically. 2 patients developed bone but did not meet our criteria as a successful reconstruction.
Conclusions: The combination of 100% Allogenic bone, Bone Marrow concentrate and Bone Morphogenetic protein is an effective and predictable technique for reconstruction of continuity defects from ablative benign tumor surgery. Patient selection is critical in using this method. All patients were ASA I or II with no history of chemotherapy, radiation or previous ablative surgery. Overall we had less than patient morbidity, less time operating time, less inpatient hospital stay and overall reduction in total costs.
Methods: The aim of this retrospective study is to share our experience with the use of 100% allogeneic bone in combination with BMP and BMAC for immediate reconstruction of continuity defects resulting from ablative tumor surgery or trauma in a 3 year span (2014 - 2017) at the UTHealth OMS department. The present study reviewed 21 patients at the UTHealth OMFS during a 3-year period between 2014 and 2017. We identified (11 men and 10 women) with a mean age (33.9) of ranging from 11 to 65yo. All patients were ASA I or II with no history of chemotherapy, radiation treatment or prior ablative surgery. We defined criteria for success as follows: 1) Unity of bony defect, 2) >3.0cm bone height and >1.0cm bone width, 3) Arch coordination, 4) Implantable bone, 5) Maintenance of osseous content for longer than 18 months, and 6) Restoration of Acceptable facial form
Results: We report a 91% success rate (19/21 pts) related to reconstruction with our rigid criteria. 19 patients demonstrated excellent bone quality both clinically and radiographically. 2 patients developed bone but did not meet our criteria as a successful reconstruction.
Conclusions: The combination of 100% Allogenic bone, Bone Marrow concentrate and Bone Morphogenetic protein is an effective and predictable technique for reconstruction of continuity defects from ablative benign tumor surgery. Patient selection is critical in using this method. All patients were ASA I or II with no history of chemotherapy, radiation or previous ablative surgery. Overall we had less than patient morbidity, less time operating time, less inpatient hospital stay and overall reduction in total costs.