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

Reconstruction of segmental mandibular defects: Current procedures and perspectives.

Author information

1
Service de Chirurgie Maxillo Faciale Plastique et Brulés, Hôpital Trousseau, CHU de Tours Tours France.
2
Laboratoire Regenerative Medicine and Skeleton RMeS, France INSERM, U 1229 Nantes France.
3
UFR Médecine Université de Tours Tours France.
4
UFR Odontologie Université́ de Nantes Nantes France.
5
ONIRIS Nantes-Atlantic College of Veterinary Medicine Centre de Rechecherche et D'investigation Préclinique (CRIP) Nantes France.
6
Service de Chirurgie Maxillo-Faciale et Stomatologie CHU de Nantes Nantes France.

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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