Implant Survival in Tissue-Engineered Mandibular Reconstruction-Early Experiences

Abstract

Study design: This article is to evaluate the early outcomes of dental implants placed in bone generated with tissueengineering techniques, specifically recombinant human bone morphogenic protein-2 (rhBMP-2), allogeneicbone particulate, and bone marrow aspirate concentrate (BMAC) in patients with resection of benignpathology.

Objective: To evaluate the long-term prognosis of dental implants placed in tissue engineered mandibular reconstruction.

Methods: We retrospectively evaluated 12 patient records, all of whom underwent segmental mandibular resection of benign pathology and reconstruction with a combination of BMAC, rhBMP-2, and allogeneic bone. Collecteddata points included the patient's age, gender, medical and social histories, implant site and placement date, resection/reconstruction date, final prosthesis, pathology resected, and follow-up dates (average 25 monthsof follow-up). Implant success was defined as clinical osseointegration (immobility), absence of peri-implantradiolucency, and absence of infection.

Results: Twelve patients met inclusion criteria with a total of 46 implants. The overall implant survival rate was 91.3%. There were 4 implant failures occurring in two patients: 1 failure in Patient 3 and 3 failures in Patient 8. Neitherpatient had any existing medical comorbidities or social history known to increase the risk for implant failure. The average implant placement occurred 11.6 months after mandibular reconstruction.

Conclusions: Preliminary findings of implant placement in bone generated with tissue engineering techniques have shown to be another predictable alternative for orofacial rehabilitation. Practical Implications: Dental rehabilitationusing dental implants is a predictable treatment option for patients that have required reconstruction of largebony defects status post resection of benign pathology using novel tissue engineering techniques.

Keywords: dental rehabilitation; implants; tissue engineering.

Figure 1.

Patient 2 is restored with 4 mandibular implants status post resection and reconstruction using tissue engineering techniques. These implants are without radiolucency or other signs of pathology 8 months post-operatively.

Figure 2.

Patient 12 is restored with 4 mandibular implants that support the dental prosthesis. The implants remain stable and without pathology after 12 months.

Figure 3.

(A) Patient 12 is restored with an implant supported prostheses after reconstruction and rehabilitation with tissue engineering and dental implants. (B) Intraoral view of Patient 12; implant supported prostheses after reconstruction and rehabilitation with tissue engineering and dental implants.