Spontaneous Regeneration of Bone in Segmental Mandibular Defect

Abstract

Aim To highlight the spontaneous regeneration of mandibular segmental defects in young and pediatric cases and to review the literature of this unusual and rare phenomenon. Methodology Two case reports of a 17-year old male and a 8-month-old infant has been presented who underwent resection of mandible for benign tumors. These two cases have been compared with the existing literature of 61 cases published till date. Inference Spontaneous regeneration of mandible as a viable reconstructive option is not practically feasible. The consistency and predictability of the phenomenon is questionable. Bone grafting should probably be done immediately in all cases, even in young patients if a delay would interfere with quality of life. In infants and small children though, we propose that immediate reconstruction may be avoided to allow some regeneration at the defect site. If it does not occur, secondary reconstruction may then be considered.

Self‐regeneration of an extensive bony defect following mandibular resection

“…Spontaneous bone regeneration (SBR) is a rapid, uncommon, and unexpected formation of new bone in a previous bone defect. 7 The mechanism of spontaneous regeneration of the bone is not fully understood 8 ; however, several factors have been suggested to influence this phenomenon. Most cases of this phenomenon reported in the literature are in younger individuals.…”

“…Most cases of this phenomenon reported in the literature are in younger individuals. [7][8][9] Better bone regeneration in young patients is associated with higher cellular activity including bone absorption and regeneration. Higher cellular content and abundant mesenchymal cells differentiating into osteogenic cells are another potential theory in younger patients (Ref.…”

“…Higher cellular content and abundant mesenchymal cells differentiating into osteogenic cells are another potential theory in younger patients (Ref. [7] [p227], [9] [275]).…”

“…The mechanism of spontaneous regeneration of the bone is not fully understood 8 ; however, several factors have been suggested to influence this phenomenon. Most cases of this phenomenon reported in the literature are in younger individuals 7‐9 . Better bone regeneration in young patients is associated with higher cellular activity including bone absorption and regeneration.…”

Pediatric Mandible Reconstruction: Controversies and Considerations

“… 30 The process, however, is not predictable, with <65 cases of spontaneous bone regeneration reported in literature. 31 In patients with benign condition, it may therefore be prudent to preserve as much of the periosteum and soft tissue as possible; if spontaneous bone regeneration does occur, it will increase bone volume and form difficult-to-reconstruct structures like the condyle. 32…”