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Khattak YR, Baig MA, Din SZU, Ahmad I. Autogenous, alloplastic, or hybrid for total mandibular reconstruction; is here an optimal path? Oral Maxillofac Surg 2024; 28:557-568. [PMID: 38366272 DOI: 10.1007/s10006-024-01224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024]
Abstract
For less fit patients, total reconstruction of the mandible (TRM) is an elucidated alternative for severe maxillofacial defects. This study aimed to comprehensively review and analyze the existing evidence, irrespective of the underlying pathologies, to provide a consolidated overview of the current state of TRM. An electronic search was performed on PubMed, Embase, Scopus, and Google Scholar to identify studies reporting TRM without restrictions on patient age, type of pathology underlying the mandibular defect, and study type. Electronic search identified 390 studies; only 21 met the inclusion criteria, documenting 7 (33.3%) autogenous, 6 (28.6%) alloplastic, and 8 (38.1%) hybrid TRMs. All studies reported one clinical case, except for two studies that reported two patients treated with TRM. The mean age of the patients was 39.0 ± 19.4 years, and the mean follow-up was 22.3 ± 14.7 months. Osteomyelitis was the most common pathology. Bilateral condyles were preserved in only two cases. The TRM has been reported in clinical cases only and no large cohort study is available. Functional and aesthetic parameters have either not been reported or have been reported in heterogeneous formats, thus hampering comparisons of autogenous, alloplastic, and hybrid TRMs. Overall, TRM in patients presenting with severe maxillofacial defects achieved promising clinical outcomes endowed with acceptable function and aesthetics. Large cohort studies are needed to validate these results.
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Affiliation(s)
| | - Mirza Albash Baig
- State Key Laboratory of Precision Measurement Technology and Instruments, Tianjin University, Tianjin, 300072, China
| | - Syed Zaheer Ud Din
- International School for Optoelectronic Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Iftikhar Ahmad
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan.
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Zheng J, Huo L, Jiao Z, Wei X, Bu L, Jiang W, Luo Y, Chen M, Yang C. 3D-printed temporomandibular joint-mandible combined prosthesis: A prospective study. Oral Dis 2024; 30:1360-1366. [PMID: 37246472 DOI: 10.1111/odi.14597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 04/10/2023] [Accepted: 04/15/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The study aimed to introduce and evaluate a new customized temporomandibular joint-mandible combined prosthesis with 3D printing fabrication. MATERIALS AND METHODS This was a prospective study including patients with temporomandibular joint-mandible combined lesions. A 3D-printed customized temporomandibular joint-mandible combined prosthesis was implanted to repair the joint and jaw defect. Clinical follow-up and radiographic examinations were taken to assess the clinical efficacy. The assessment indices were compared by the Wilcoxon signed rank test. RESULTS Eight patients were treated with the combined prosthesis and included in this study. All prostheses were accurately positioned and fixed without wound infection, prosthesis exposure, displacement, loosening, or fracture. All cases had no mass recurrence at the last follow-up point. Pain, diet, mandibular function, lateral mandibular movement to the diseased side, and maximal interincisal opening showed significant improvements at every follow-up point and went to a stable condition at 6 months after the operation. But the lateral movement to the non-operated side was still limited following surgery. CONCLUSION The 3D-printed combined prosthesis may be an alternative to other well-established reconstructions for temporomandibular joint and mandible defects.
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Affiliation(s)
- Jisi Zheng
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Liang Huo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Zixian Jiao
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Xiang Wei
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Lingtong Bu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Wenbo Jiang
- Center of 3D-printing translational medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Minjie Chen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
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Ângelo DF, Maffia F, Teschke M, Sanz D, Galrito M, Cardoso H, Marques R, Nabuco C. Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication. J Clin Med 2023; 12:6612. [PMID: 37892750 PMCID: PMC10607587 DOI: 10.3390/jcm12206612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Custom-made alloplastic temporomandibular joint replacement (ATMJR) is not validated in irradiated patients. However, in specific situations, after previous reconstructive surgical failures, the authors hypothesized the role of a customized ATMJR after radiotherapy. METHODS A 65-year-old male patient was referred to Instituto Português da Face-Lisbon, Portugal-after failed attempts of mandibular reconstruction secondary to oral carcinoma resection and partial hemi-mandibulectomy plus radiotherapy of 60 total Grays. Primary reconstruction was performed with fibula free flap. Due to failure, secondary reconstructions were performed with osteosynthesis plate without success. The patient was unable to have adequate mastication and deglutition due to a severe crossbite. The authors treated the patient with an extended customized alloplastic temporomandibular joint replacement (F0M2). RESULTS With 3 years of follow-up, the patient showed an improvement in masticatory function, mandibular motion, pain levels, and overall quality of life. No complications were observed related to ATMJR. CONCLUSIONS The presented case described how ATMJR, although not a validated option after radiotherapy, can be considered to restore functionality in complex cases with bone and soft tissues problems.
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Affiliation(s)
- David Faustino Ângelo
- Instituto Português da Face, 1050-227 Lisbon, Portugal; (D.S.); (M.G.); (H.C.); (R.M.); (C.N.)
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, 2430-028 Marinha Grande, Portugal
| | - Francesco Maffia
- Instituto Português da Face, 1050-227 Lisbon, Portugal; (D.S.); (M.G.); (H.C.); (R.M.); (C.N.)
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | | | - David Sanz
- Instituto Português da Face, 1050-227 Lisbon, Portugal; (D.S.); (M.G.); (H.C.); (R.M.); (C.N.)
| | - Marta Galrito
- Instituto Português da Face, 1050-227 Lisbon, Portugal; (D.S.); (M.G.); (H.C.); (R.M.); (C.N.)
| | - Henrique Cardoso
- Instituto Português da Face, 1050-227 Lisbon, Portugal; (D.S.); (M.G.); (H.C.); (R.M.); (C.N.)
| | - Rute Marques
- Instituto Português da Face, 1050-227 Lisbon, Portugal; (D.S.); (M.G.); (H.C.); (R.M.); (C.N.)
| | - Carlos Nabuco
- Instituto Português da Face, 1050-227 Lisbon, Portugal; (D.S.); (M.G.); (H.C.); (R.M.); (C.N.)
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Rex J, Banfer FA, Sukumar M, Zurca AD, Rodgers DL. Using Simulation to Develop and Test a Modified Cardiopulmonary Resuscitation Technique for a Child With Severe Scoliosis: A System-Based Approach From Theory, to Simulation, to Practice. Simul Healthc 2023; 18:341-347. [PMID: 36326755 DOI: 10.1097/sih.0000000000000695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jenny Rex
- From the Nursing Education and Professional Development (J.R.), Penn State Health Milton S. Hershey Medical Center, Hershey, PA; Advis (F.A.B.), Trinley Park, IL; Center for Education, Simulation, and Innovation (M.S.), Hartford Healthcare, Hartford, CN; Department of Pediatrics (A.D.Z.), Penn State Hershey Children's Hospital, Hershey, PA; Interprofessional Simulation Center (D.L.R.), Indiana University, Bloomington, IN; and Department of Medicine (D.L.R.), Indiana University School of Medicine, Bloomington, IN
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Zheng K, Yu X, Xu M, Cui H, Wu J, Hou Z, Tian D. Using 3D Printing Technology to Manufacture Personalized Bone Cement Placeholder Mold for Bone Defect Repair and Reconstruction with Infection: A Case Report. Orthop Surg 2023; 15:2724-2729. [PMID: 37382443 PMCID: PMC10549869 DOI: 10.1111/os.13779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Limb salvage surgery is the preferred treatment for most malignant bone tumors, but postoperative infection treatment is very challenging. Simultaneously controlling infection and solving bone defects are clinical treatment challenges. CASE PRESENTATION Here we describe a new technique for treating bone defect infection after bone tumor surgery. An 8-year-old patient suffered an incision infection after osteosarcoma resection and bone defect reconstruction. In response, we designed her a personalized, anatomically matched, antibiotic-loaded, bone cement spacer mold using 3D printing technology. The patient's infection was cured, and limb salvage was successful. In follow-up, the patient had returned to normal postoperative chemotherapy and was able to walk with the help of a cane. There was no obvious pain in the knee joint. At 3 months after operation, the range of motion of the knee joint was 0°-60°. CONCLUSION The 3D printing spacer mold is an effective solution for treating the infection with large bone defect.
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Affiliation(s)
- Kai Zheng
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Xiu‐chun Yu
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Ming Xu
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Haocheng Cui
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Junyi Wu
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Zhiwei Hou
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Dongmu Tian
- ShanDong Weigao Haixing Medical Device Co., LTDShanDongChina
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Charbe NB, Tambuwala M, Palakurthi SS, Warokar A, Hromić‐Jahjefendić A, Bakshi H, Zacconi F, Mishra V, Khadse S, Aljabali AA, El‐Tanani M, Serrano‐Aroca Ã, Palakurthi S. Biomedical applications of three-dimensional bioprinted craniofacial tissue engineering. Bioeng Transl Med 2023; 8:e10333. [PMID: 36684092 PMCID: PMC9842068 DOI: 10.1002/btm2.10333] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023] Open
Abstract
Anatomical complications of the craniofacial regions often present considerable challenges to the surgical repair or replacement of the damaged tissues. Surgical repair has its own set of limitations, including scarcity of the donor tissues, immune rejection, use of immune suppressors followed by the surgery, and restriction in restoring the natural aesthetic appeal. Rapid advancement in the field of biomaterials, cell biology, and engineering has helped scientists to create cellularized skeletal muscle-like structures. However, the existing method still has limitations in building large, highly vascular tissue with clinical application. With the advance in the three-dimensional (3D) bioprinting technique, scientists and clinicians now can produce the functional implants of skeletal muscles and bones that are more patient-specific with the perfect match to the architecture of their craniofacial defects. Craniofacial tissue regeneration using 3D bioprinting can manage and eliminate the restrictions of the surgical transplant from the donor site. The concept of creating the new functional tissue, exactly mimicking the anatomical and physiological function of the damaged tissue, looks highly attractive. This is crucial to reduce the donor site morbidity and retain the esthetics. 3D bioprinting can integrate all three essential components of tissue engineering, that is, rehabilitation, reconstruction, and regeneration of the lost craniofacial tissues. Such integration essentially helps to develop the patient-specific treatment plans and damage site-driven creation of the functional implants for the craniofacial defects. This article is the bird's eye view on the latest development and application of 3D bioprinting in the regeneration of the skeletal muscle tissues and their application in restoring the functional abilities of the damaged craniofacial tissue. We also discussed current challenges in craniofacial bone vascularization and gave our view on the future direction, including establishing the interactions between tissue-engineered skeletal muscle and the peripheral nervous system.
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Affiliation(s)
- Nitin Bharat Charbe
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
| | - Murtaza Tambuwala
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | | | - Amol Warokar
- Department of PharmacyDadasaheb Balpande College of PharmacyNagpurIndia
| | - Altijana Hromić‐Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural SciencesInternational University of SarajevoSarajevoBosnia and Herzegovina
| | - Hamid Bakshi
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | - Flavia Zacconi
- Departamento de Quimica Orgánica, Facultad de Química y de FarmaciaPontificia Universidad Católica de ChileSantiagoChile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological SciencesPontificia Universidad Católica de ChileSantiagoChile
| | - Vijay Mishra
- School of Pharmaceutical SciencesLovely Professional UniversityPhagwaraIndia
| | - Saurabh Khadse
- Department of Pharmaceutical ChemistryR.C. Patel Institute of Pharmaceutical Education and ResearchDhuleIndia
| | - Alaa A. Aljabali
- Faculty of Pharmacy, Department of Pharmaceutical SciencesYarmouk UniversityIrbidJordan
| | - Mohamed El‐Tanani
- Pharmacological and Diagnostic Research Centre, Faculty of PharmacyAl‐Ahliyya Amman UniversityAmmanJordan
| | - Ãngel Serrano‐Aroca
- Biomaterials and Bioengineering Lab Translational Research Centre San Alberto MagnoCatholic University of Valencia San Vicente MártirValenciaSpain
| | - Srinath Palakurthi
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
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Clinical application of 3D-printed PEEK implants for repairing mandibular defects. J Craniomaxillofac Surg 2022; 50:621-626. [PMID: 35760658 DOI: 10.1016/j.jcms.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 04/16/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to investigate and discuss the efficacy of 3D-printed PEEK implants in personalized reconstruction of mandibular segmental defects. This study was a single-center case series. Six patients who underwent mandibular reconstruction with a custom-made 3D-printed PEEK implant were enrolled. Patient demographics, photographs, computed tomography (CT), and other clinical data were collected and analyzed pre- and postoperatively. The average patient age was 60.0 ± 15.09 years. The mean operative time was 213.33 ± 30.77 min, and the postoperative follow-up time ranged from 10 to 24 months. Mandibular segmental defects ranged from the symphysis to the condyle. Five patients did not have any postoperative complications and were satisfied with the cosmetic and functional results. One patient had to undergo removal of the PEEK implant because of implant exposure at 10 months after surgery. PEEK implants can repair different forms of defect in the mandible, maintaining the original shape of the mandible, whilst not affecting mandible functions, such as mastication and temporomandibular joint movement. However, PEEK implantation requires the strict selection of appropriate indications, especially with regard to the evaluation of soft-tissue conditions in the implanted area.
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