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Review
. 2019 Nov 22;4(6):587-596.
doi: 10.1002/lio2.325. eCollection 2019 Dec.

Reconstruction of segmental mandibular defects: Current procedures and perspectives

Arnaud Paré  1   2   3   4 , Adeline Bossard  5 , Boris Laure  1 , Pierre Weiss  2   4 , Olivier Gauthier  2   5 , Pierre Corre  2   4   6
Affiliations
Review

Reconstruction of segmental mandibular defects: Current procedures and perspectives

Arnaud Paré et al. Laryngoscope Investig Otolaryngol. .

Abstract

Background: The reconstruction of segmental mandibular defects remains a challenge for the reconstructive surgeon, from both a functional and an esthetic point of view.

Methods: This clinical review examines the different techniques currently in use for mandibular reconstruction as related to a range of etiologies, including the different bone donor sites, the alternatives to free flaps (FFs), as well as the contribution of computer-assisted surgery. Recent progress and the perspectives in bone tissue engineering (BTE) are also discussed.

Results: Osseous FF allows reliable and satisfying outcomes. However, locoregional flap, distraction osteogenesis, or even induced membrane techniques are other potential options in less favorable cases. Obtaining an engineered bone with satisfactory mechanical properties and sufficient vascular supply requires further investigations.

Conclusions: Osseous FF procedure remains the gold standard for segmental mandible reconstruction. BTE strategies offer promising alternatives.

Keywords: CAD/CAM; bone tissue engineering; free flap; mandible reconstruction; microvascular.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

Figure 1
Figure 1
Input of computer‐assisted surgery for the shaping of osseous free flap. A, Images from a surgical planning showing the cutting guide for the shaping of the fibula (Materialise, Louvain, and Belgium). B, The preoperative results. C, The postoperative results Source: Giannoudis et al.48
Figure 2
Figure 2
Virtual surgical planning for alternative techniques to osseous free flap. Surgical planning for, A, a distraction osteogenesis, B, a chondrocostal graft and, C, a custom made rigid fixation plate (Materialise, Louvain, and Belgium)
Figure 3
Figure 3
Diamond concept describing the required characteristics for bone tissue engineering. Desirables features of a bone construct including the bone matrix (scaffold) able to guide the bone ingrowth, osteogenic cells, cell modulators as well as the oxygen and nutrient supply
See this image and copyright information in PMC

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