Treatment of Mandibular Non-union Using Patient Specific Crib Cage Plates and Cellular Bone Allograft: A Case Report

Ryu, Brian K.; Abraham, Charles; Polido, Waldemar Daudt

doi:10.1177/24727512211005949

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…By providing all 3 essential bone remodeling properties, VF-CBA facilitated fusion at the defect site. Although VF-CBA has been used successfully to achieve fusion in spine and orthopedic applications, [13][14][15][16][17][18] its use in oral and maxillofacial surgery is an emerging application, [19][20][21] and in particular, to our knowledge, has not yet been shown in a pediatric patient. Therefore, this is the first known report of a successful immediate reconstruction of a large segmental mandibular defect using VF-CBA in a young child.…”

Section: Discussionmentioning

confidence: 99%

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Immediate Mandibular Reconstruction Using a Cellular Bone Allograft Following Tumor Resection in a Pediatric Patient

Alfi

Hassan

East

et al. 2021

FACE

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Reconstruction of large segmental mandibular defects presents a challenge for oral and maxillofacial surgeons, particularly in the skeletally immature pediatric patient. Autogenous bone graft is historically preferred; however, harvest of autograft requires a second surgical site, risking donor-site complications as well as the potential for long-term complications in the growing child. Here, we present the first known report of a pediatric patient who underwent immediate mandibular reconstruction of a 6.5-cm long segmental defect using a cellular bone allograft (VF-CBA) combined with custom-fabricated guides and plates following tumor resection. The use of VF-CBA, along with the custom guides and plates, eliminated the need for autograft harvest in a child, enabled an entirely intraoral approach, avoiding the creation of a cutaneous scar, and reduced the total operative time, resulting in a fast recovery and improved patient satisfaction. By 7 months postoperative, the patient’s mandible was fully healed with solid osseous consolidation. These results support VF-CBA combined with custom intraoral guides and plates as an effective treatment option for reconstruction of large segmental mandibular defects in a pediatric patient.

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Section: Discussionmentioning

confidence: 99%

“…While not readily generalizable, the results from this case support the continued research for VF-CBA use in oral and maxillofacial surgery, consistent with previously published results. [19][20][21]…”

Section: Discussionmentioning

confidence: 99%

Immediate Mandibular Reconstruction Using a Cellular Bone Allograft Following Tumor Resection in a Pediatric Patient

Alfi

Hassan

East

et al. 2021

FACE

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“…Vivigen (DePuy Synthes, Warsaw, IN), a cellular bone allograft, has been used in conjunction with patient-specific crib/cage plates to treat nonunion in gunshot wound trauma. 56 DBM has also been used successfully to fill skull base defects. 57 Demineralized perforated block bone, which is processed similarly to DBM but kept intact without morselization, has been utilized for cranial reconstruction safely without concern for immunogenic reaction.…”

Section: Bioactive Glassesmentioning

confidence: 99%

Bone Graft Substitutes and Enhancement in Craniomaxillofacial Surgery

Patel

Tatum

2023

Facial Plast Surg

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Critical-sized bone defects are a reconstructive challenge, particularly in the craniomaxillofacial (CMF) skeleton. The “gold standard” of autologous bone grafting has been the work horse of reconstruction in both congenital and acquired defects of CMF skeleton. Autologous bone has the proper balance of the protein (or organic) matrix and mineral components with no immune response. Organic and mineral adjuncts exist that offer varying degrees of osteogenic, osteoconductive, osteoinductive, and osteostimulative properties needed for treatment of critical-sized defects. In this review, we discuss the various mostly organic and mostly mineral bone graft substitutes available for autologous bone grafting. Primarily organic bone graft substitutes/enhancers, including bone morphogenic protein, platelet-rich plasma, and other growth factors, have been utilized to support de novo bone growth in setting of critical-sized bone defects. Primarily mineral options, including various calcium salt formulation (calcium sulfate/phosphate/apatite) and bioactive glasses have been long utilized for their similar composition to bone. Yet, a bone graft substitute that can supplant autologous bone grafting is still elusive. However, case-specific utilization of bone graft substitutes offers a wider array of reconstructive options.

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Characterization of an advanced viable bone allograft with preserved native bone-forming cells

et al. 2022

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Bone grafts are widely used to successfully restore structure and function to patients with a broad range of musculoskeletal ailments and bone defects. Autogenous bone grafts are historically preferred because they theoretically contain the three essential components of bone healing (ie, osteoconductivity, osteoinductivity, and osteogenicity), but they have inherent limitations. Allograft bone derived from deceased human donors is one alternative that is also capable of providing both an osteoconductive scaffold and osteoinductive potential but, until recently, lacked the osteogenic component of bone healing. Relatively new, cellular bone allografts (CBAs) were designed to address this need by preserving viable cells. Although most commercially-available CBAs feature mesenchymal stem cells (MSCs), osteogenic differentiation is time-consuming and complex. A more advanced graft, a viable bone allograft (VBA), was thus developed to preserve lineage-committed bone-forming cells, which may be more suitable than MSCs to promote bone fusion. The purpose of this paper was to present the results of preclinical research characterizing VBA. Through a comprehensive series of in vitro and in vivo assays, the present results demonstrate that VBA in its final form is capable of providing all three essential bone remodeling properties and contains viable lineage-committed bone-forming cells, which do not elicit an immune response. The results are discussed in the context of clinical evidence published to date that further supports VBA as a potential alternative to autograft without the associated drawbacks.

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Treatment of Mandibular Non-union Using Patient Specific Crib Cage Plates and Cellular Bone Allograft: A Case Report

Cited by 7 publications

References 29 publications

Immediate Mandibular Reconstruction Using a Cellular Bone Allograft Following Tumor Resection in a Pediatric Patient

Immediate Mandibular Reconstruction Using a Cellular Bone Allograft Following Tumor Resection in a Pediatric Patient

Bone Graft Substitutes and Enhancement in Craniomaxillofacial Surgery

Characterization of an advanced viable bone allograft with preserved native bone-forming cells

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