Application of transport distraction osteogenesis in reconstruction of mandibular segmental defects

doi:10.12307/2021.288

Abstract

Abstract: BACKGROUND: In recent years, distraction osteogenesis has become an important alternative option to the reconstruction of mandibular segmental bone defects.
OBJECTIVE: To explore the clinical feasibility and efficiency of transport distraction osteogenesis for reconstruction of segmental mandibular bone defect and later dental implantation.
METHODS: Six patients with ameloblastoma or keratocystic odontogenic tumor were included in this study. Computed tomography and panoramic film were performed for preoperative evaluation and surgical planning. Transport distraction osteogenesis was used to reconstruct the defect after tumor resection. The fixation period after distraction varied from 16 to 25 weeks, depending on the degree of ossification in the distraction space after operation. The second operation was performed to remove the traction device and restore the gap between the delivery disc and the residual bone defect with bone graft and rigid internal fixation. Finally, the occlusal relationship was restored by dental implantation on the new bone in the distraction space.
RESULTS AND CONCLUSION: All patients successfully completed the whole treatment period without traction failure or tumor recurrence. The stretch length ranged from 45 to 57 mm. Satisfactory new bone formation and high calcification in the distraction space were confirmed by imaging examination and intraoperative observation. Of the six patients, one developed infection, and the symptoms were controlled by surgical dressing change; two had salivary leakage, and were cured by pressure bandaging and atropine. All patients eventually achieved satisfactory facial appearance and occlusal function. The findings of this study indicate that transport distraction osteogenesis can be used to reconstruct segmental mandibular bone defect and further used in clinical dental implant treatment, and moreover, the therapeutic effect is satisfactory.

Key words: mandibular defect, distraction osteogenesis, transport distraction osteogenesis, dental implant, occlusal relationship

CLC Number:

Su Chengli, Zhu Songsong, Li Yunfeng. Application of transport distraction osteogenesis in reconstruction of mandibular segmental defects[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(35): 5604-5609.

Figures/Tables 16

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