Mandibular reconstruction with fibula free flap: case series

Lima, Marcel Fernando Miranda Batista; Maricevich, Juan Pablo Borges Rodrigues; Sá, Jairo Zacchê de; Kawamura, Kelson; Anlicoara, Rafael

doi:10.5935/2177-1235.2020rbcp0005

Cited by 1 publication

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“…Depending on the patient’s clinical conditions, there are several reconstructive options for mandibular defects, including 3D-printed PEEK implants [ 5 ], fibula bone–cutaneous flap [ 6 , 7 ], three-dimensional modeling of part of the scapula [ 8 ], titanium implant [ 9 ], non-vascularized autogenous bone graft [ 10 ], osteogenic distraction [ 11 ], microvascular tissue transfer [ 3 ], transfer using sternum and rib bone [ 12 ], free rib flap associated with muscles in the thoracic region [ 13 ], guided regeneration with non-resorbable membranes [ 14 ], gene therapies for bone reconstruction [ 15 ], and autologous grafts [ 16 ], which are considered the gold standard in bone reconstruction [ 17 ]. However, one of the problems with the use of autologous bone grafts is their early resorption [ 18 ], and this can jeopardize the long-term effectiveness of osseointegrated dental implants [ 19 ].…”

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confidence: 99%

Use of Plant Extracts in Polymeric Scaffolds in the Regeneration of Mandibular Injuries

de Oliveira,

Maia,

Massimino

et al. 2024

Pharmaceutics

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Severe loss of bone mass may require grafting, and, among the alternatives available, there are natural biomaterials that can act as scaffolds for the cell growth necessary for tissue regeneration. Collagen and elastin polymers are a good alternative due to their biomimetic properties of bone tissue, and their characteristics can be improved with the addition of polysaccharides such as chitosan and bioactive compounds such as jatoba resin and pomegranate extract due to their antigenic actions. The aim of this experimental protocol was to evaluate bone neoformation in experimentally made defects in the mandible of rats using polymeric scaffolds with plant extracts added. Thirty rats were divided into group 1, with a mandibular defect filled with a clot from the lesion and no graft implant (G1-C, n = 10); group 2, filled with collagen/chitosan/jatoba resin scaffolds (G2-CCJ, n = 10); and group 3, with collagen/nanohydroxyapatite/elastin/pomegranate extract scaffolds (G3-CHER, n = 10). Six weeks after surgery, the animals were euthanized and samples from the surgical areas were submitted to macroscopic, radiological, histological, and morphometric analysis of the mandibular lesion repair process. The results showed no inflammatory infiltrates in the surgical area, indicating good acceptance of the scaffolds in the microenvironment of the host area. In the control group (G1), there was a predominance of reactive connective tissue, while in the grafted groups (G2 and G3), there was bone formation from the margins of the lesion, but it was still insufficient for total bone repair of the defect within the experimental period standardized in this study. The histomorphometric analysis showed that the mean percentage of bone volume formed in the surgical area of groups G1, G2, and G3 was 17.17 ± 2.68, 27.45 ± 1.65, and 34.07 ± 0.64 (mean ± standard deviation), respectively. It can be concluded that these scaffolds with plant extracts added can be a viable alternative for bone repair, as they are easily manipulated, have a low production cost, and stimulate the formation of new bone by osteoconduction.

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