Controversies in Traditional Oral and Maxillofacial Reconstruction

This fuller impact of the use of hyperbaric oxygen therapy within dentistry is taking greater notice with newer research findings. There are new advancements in research regarding postradiotherapy cases, osteonecrosis of the jaw, osteomyelitis, periodontal disease, and dental implants. Hyperbaric oxygen therapy can even be used in conjunction with other procedures such as bone grafting. Although the research and clinical utility has come a long way, there are several complications to be mindful of during the application of hyperbaric oxygen therapy.

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“…The 10 subsequent treatments of HBOT and 3 months of healing are recommended. At this point, bone remodeling can be completed 29…”

Section: Uses In Dentistrymentioning

confidence: 99%

Clinical utility of hyperbaric oxygen therapy in dentistry

Patel

Gandhi

et al. 2019

Med Gas Res

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“…However, the diminished dimensions of the surgical field can require adjustments and bending of the malleable retractors, thus resulting in laceration or rupture of the DPA due to traction forces. 8 In addition, such instruments are often scratched by surgical burs from previous surgeries, which may offer sharp surface to the vessels during retraction.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Analog Preoperative Planning Versus Virtual Preoperative Planning for Mandibular Reconstruction With Fibula Free Flap

Cedillo

Córdova

Larralde

et al. 2022

Journal of Craniofacial Surgery

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: Mandibular reconstruction is a challenging procedure, especially in cancer patients with defects that are greater than 6 cm. Free vascularized fibular flap is the gold standard treatment in these cases since it allows three-dimensional restoration of the lost segments after ablative surgery in addition to providing the possibility of a subsequent implant-supported rehabilitation improving the functional and aesthetic outcomes of the surgery. To obtain accurate results, preoperative planning must be done with detail. Approaches for the preoperative planning include both the conventional analog planning and the virtual planning that are valid alternatives in meeting the trans-surgical requirements. This study makes a comparative analysis of 2 clinical cases with a diagnosis of squamous cell carcinoma that were reconstructed using a vascularized fibular free flap. The first case was planned using the conventional analog method whereas the second case was planned using the virtual planning approach. The impact of virtual planning and conventional analog planning on preoperative planning time, ischemia period, and total surgical time is analyzed according to the experience obtained in the cases presented. In addition, the authors described the technique used for each planning method along with a literature review in which the results are contrasted and discussed.

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“…Bone grafting procedures are carried out to reconstruct a bone defect [9]. In these surgical procedures, autografts are still considered the "gold standard" due to the essential combination of osteogenic, osteoinductive, and osteoconductive properties.…”

Section: Introductionmentioning

confidence: 99%

Bone Tissue Regeneration in the Oral and Maxillofacial Region: A Review on the Application of Stem Cells and New Strategies to Improve Vascularization

Helder

Bravenboer

et al. 2019

Stem Cells International

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Bone tissue engineering techniques are a promising alternative for the use of autologous bone grafts to reconstruct bone defects in the oral and maxillofacial region. However, for successful bone regeneration, adequate vascularization is a prerequisite. This review presents and discusses the application of stem cells and new strategies to improve vascularization, which may lead to feasible clinical applications. Multiple sources of stem cells have been investigated for bone tissue engineering. The stromal vascular fraction (SVF) of human adipose tissue is considered a promising single source for a heterogeneous population of essential cells with, amongst others, osteogenic and angiogenic potential. Enhanced vascularization of tissue-engineered grafts can be achieved by different mechanisms: vascular ingrowth directed from the surrounding host tissue to the implanted graft, vice versa, or concomitantly. Vascular ingrowth into the implanted graft can be enhanced by (i) optimizing the material properties of scaffolds and (ii) their bioactivation by incorporation of growth factors or cell seeding. Vascular ingrowth directed from the implanted graft towards the host tissue can be achieved by incorporating the graft with either (i) preformed microvascular networks or (ii) microvascular fragments (MF). The latter may have stimulating actions on both vascular ingrowth and outgrowth, since they contain angiogenic stem cells like SVF, as well as vascularized matrix fragments. Both adipose tissue-derived SVF and MF are cell sources with clinical feasibility due to their large quantities that can be harvested and applied in a one-step surgical procedure. During the past years, important advancements of stem cell application and vascularization in bone tissue regeneration have been made. The development of engineered in vitro 3D models mimicking the bone defect environment would facilitate new strategies in bone tissue engineering. Successful clinical application requires innovative future investigations enhancing vascularization.

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Controversies in Traditional Oral and Maxillofacial Reconstruction

Cited by 13 publications

References 46 publications

Clinical utility of hyperbaric oxygen therapy in dentistry

Clinical utility of hyperbaric oxygen therapy in dentistry

A Comparative Study of Analog Preoperative Planning Versus Virtual Preoperative Planning for Mandibular Reconstruction With Fibula Free Flap

Bone Tissue Regeneration in the Oral and Maxillofacial Region: A Review on the Application of Stem Cells and New Strategies to Improve Vascularization

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