Non-Autogenous Innovative Reconstruction Method Following Mandibulectomy

Medicina (Kaunas). 2020 Jun 30;56(7):326. doi: 10.3390/medicina56070326.

Abstract

Background: Plexiform ameloblastoma is a locally aggressive odontogenic tumor, rare in the anterior mandible. The treatment of choice is resection with 1-3 cm free margins. In most of reported cases, the affected mandible is reconstructed by autogenic bone graft or osseocutaneous microvascular free flap in order to return function and esthetics.

Case description: A 2 cm diameter exophytic ameloblastoma, located in the anterior mandible of a 50-year-old male was resected and reconstructed in a unique manner-allogenic bone block, recombinant human bone morphogenetic protein (rhBMP) and xenograft particles via transcutaneous submental approach. After bone maturation, dental implants were placed and restored by fixed prosthetics.

Practical implications: Mandible reconstruction modalities have a crucial influence on patient quality of life, function and esthetics. Allogenic bone block combined with rhBMP and xenograft particles can replace the traditional autogenous bone in certain circumstances. A submental transcutaneous "tent pole" approach can improve the success rate of the reconstruction procedure.

Keywords: allogenic; ameloblastoma; autogenic; bone block; mandible; rhBMP.

Publication types

  • Case Reports

MeSH terms

  • Bone Transplantation / methods
  • Humans
  • Male
  • Mandible / abnormalities
  • Mandible / pathology
  • Mandibular Osteotomy / adverse effects
  • Mandibular Osteotomy / methods
  • Mandibular Osteotomy / standards*
  • Middle Aged
  • Neurofibroma, Plexiform / complications
  • Neurofibroma, Plexiform / physiopathology
  • Neurofibroma, Plexiform / surgery*
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods
  • Plastic Surgery Procedures / standards