Comparison of Free Fibular Flaps With Reamer-Irrigator-Aspirator Bone Grafts for the Reconstruction of Critical-Sized Mandibular Defects

Dorafshar, Amir H.; Mundinger, Gerhard S.; Mohan, Raja; Brown, Emile N.; Kelamis, Joseph A.; Bojovic, Branko; Christy, Michael R.; Rodriguez, Eduardo D.

doi:10.1097/scs.0000000000000974

Cited by 2 publications

(1 citation statement)

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“…Full‐text copies of 54 manuscripts were retrieved. Data was not retrieved from 37 of the 54 full‐text papers for meeting the following exclusion criteria; not using free flaps ( n = 2), not reporting a failure rate ( n = 7), using only 1 free flap harvest site ( n = 6), using an uncommon combination of free flaps ( n = 1), studying cadavers ( n = 1), studying animals ( n = 1), not reporting at least 1 failure ( n = 18), or containing data from another larger study ( n = 1) . Seventeen studies underwent data extraction and are reported in Table …”

Section: Resultsmentioning

confidence: 99%

Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta‐analysis

et al. 2015

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Section: Resultsmentioning

confidence: 99%

Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta‐analysis

et al. 2015

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Experimental Model of Zygomatic and Mandibular Defects to Support the Development of Custom Three-Dimensional--Printed Bone Scaffolds

Mulloy

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Sharma

et al. 2020

Journal of Craniofacial Surgery

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Introduction: Autologous reconstruction of segmental craniomaxillofacial bone defects is limited by insufficient graft material, donor site morbidity, and need for microsurgery. Reconstruction is challenging due to the complex three-dimensional (3D) structure of craniofacial skeleton. Customized 3D-printed patient-specific biologic scaffolds hold promise for reconstruction of the craniofacial skeleton without donor site morbidity. The authors report a porcine craniofacial defect model suitable for further evaluation of custom 3D-printed engineered bone scaffolds. Methods: The authors created a 6 cm critical load-bearing defect in the left mandibular angle and a 1.5 cm noncritical, nonload bearing defect in the contralateral right zygomatic arch in 4 Yucatan minipigs. Defects were plated with patient-specific titanium hardware based on preoperative CT scans. Serial CT imaging was done immediately postoperatively, and at 3 and 6 months. Animals were clinically assessed for masticatory function, ambulation, and growth. At the 6-month study endpoint, animals were euthanized, and bony regeneration was evaluated through histological staining and micro-CT scanning compared to contralateral controls. Results: All 4 animals reached study endpoint. Two mandibular plates fractured, but did not preclude study completion due to loss of masticatory function. One zygoma plate loosened while the site of another underwent heterotopic ossification. Gross examination of site defects revealed heterotopic ossification, confirmed by histological and micro-CT evaluation. Biomechanical testing was unavailable due to insufficient bony repair. Conclusions: The presented porcine zygoma and mandibular defect models are incapable of repair in the absence of bone scaffolds. Based on the authors’ results, this model is appropriate for further study of custom 3D-printed engineered bone scaffolds.

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Comparison of Free Fibular Flaps With Reamer-Irrigator-Aspirator Bone Grafts for the Reconstruction of Critical-Sized Mandibular Defects

Abstract: The RIA technique significantly reduces operative time and provides bone of equal strength and histologic quality to FF flap reconstruction in a large animal model. The RIA method may represent an efficient technique for the reconstruction of craniomaxillofacial defects.

Cited by 2 publications

References 31 publications

Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta‐analysis

Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta‐analysis

Experimental Model of Zygomatic and Mandibular Defects to Support the Development of Custom Three-Dimensional--Printed Bone Scaffolds

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