Mandibular reconstruction using custom-made titanium mesh tray and particulate cancellous bone and marrow harvested from bilateral posterior ilia

Abstract

The objective of this study is to evaluate usefulness of mandibular reconstructions using a custom-made titanium mesh (Ti-mesh) tray and particulate cancellous bone and marrow (PCBM). A consecutive nine patients who underwent mandibular reconstruction were enrolled in this study. They were five men and four women (mean age: 53.9 years). Virtual reality simulation was performed using computer software based on the pre-operative computed tomography data. A 3-dimensional (3-D) skull model was constructed using a 3-D printer. A tray was custom-made from a Ti-mesh sheet bent to adapt to the model. After PCBM harvesting from bilateral posterior ilia, the tray was fixed to the host bone. New bone formation and configuration of the reconstructed mandible were assessed radiologically. Complications were recorded in each patient during the follow-up period. Patients, satisfaction with post-operative facial contour was evaluated using a visual analogue scale (VAS score, range = 0–100). In six of nine patients, excellent new bone formation was recognised and expected results were radiologically achieved. Complications occurred in four patients. These complications included Ti-mesh fracture, Ti-mesh exposure in the oral cavity, and delayed infection. Mean VAS score on patient satisfaction was 77.6. Although the data are preliminary, the results suggest that this method is clinically useful.

Key Words::

• Reconstruction
• mandible
• titanium mesh tray

Acknowledgements

We thank Yukihiro Mizuno, Naohiko Harada, Noboru Kawamura, and Masayuki Ichikawa of the Department of Dental Laboratory Technology, Tsurumi University School of Dental Medicine for manufacturing the custom-made Ti-mesh trays used in this study.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.