Mandibular defect reconstruction utilizing preoperative 3D modeling, plate pre-bending and a novel triad graft: a case report

Abstract

The reconstruction of boney defects of the mandible are a challenge in surgical therapy despite advances in bone grafting. This case study details a 30-year-old female who sustained a gunshot wound to the mandible leaving a 5 cm boney defect. This defect was reconstructed utilizing preoperative three-dimensional (3D) planning, an accurately pre-bent reconstruction plate, and a novel "triad" construct of autogenous bone graft, demineralized bone matrix, and an osteoprotective membrane. This reconstruction workflow allowed maintenance of the contour of the mandible and bone regeneration while also acting as a barrier to other tissues. This new technique reduced operative donor site morbidity and decreased surgical time dramatically, allowing the patient to be discharged the same day. The patient has a 5-year follow-up with panorex film and a biopsy of the graft area showing normal cortical bone. This case report illustrates the combination of advanced technology and novel products which can decrease operating time, decrease anesthesia time, increase precision, and most importantly decrease patient morbidity. Key words:3-dimensional prototyping, osteoprotective membrane, acellular dermal matrix, demineralized bone matrix putty, bone morphogenetic proteins, osteopromotion, pre-bending, reconstruction plate ABSTRACTArticle history:

The comparison between various methods of mandibular reconstruction based on finite element analysis

“…Surgical reconstruction of mandible is done to improve the performance of mandible and to improve the cosmesis of the lower face. 1 It has been done due to various reasons including traumatic injuries, benign jaw tumors and malignant oral cavity neoplasms. Moreover, mandibular reconstruction may be done due to chronic infections and pathologic fractures resulting from osteonecrosis.…”