Osseous Reconstruction Using a Membrane Barrier Following Marginal Mandibulectomy: An Animal Pilot Study

Background: Invasive and malignant tumors of the oral soft tissues adjacent to the mandible are often treated with partial resection of the osseous structure adjacent to the lesion (marginal mandibulectomy). Autogenous bone graft and composite bone grafts are being used to fill the osseous defects w...

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Published in:Journal of periodontology (1970) Vol. 73; no. 12; pp. 1451 - 1456
Main Authors: Peled, M., Machtei, E.E., Rachmiel, A.
Format: Journal Article
Language:English
Published: 737 N. Michigan Avenue, Suite 800, Chicago, IL 60611‐2690, USA American Academy of Periodontology 01.12.2002
Subjects:
animal studies
Animals
Bone Regeneration
Dogs
Guided bone regeneration
Guided Tissue Regeneration - methods
Male
Mandible - surgery
mandibular neoplasms/surgery
Membranes, Artificial
membranes, barrier
Oral Surgical Procedures - methods
Pilot Projects
Polytetrafluoroethylene
polytetrafluoroethylene/therapeutic use
Random Allocation
Surgical Flaps
Titanium
ISSN:0022-3492, 1943-3670
Online Access:Get full text
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Summary:Background: Invasive and malignant tumors of the oral soft tissues adjacent to the mandible are often treated with partial resection of the osseous structure adjacent to the lesion (marginal mandibulectomy). Autogenous bone graft and composite bone grafts are being used to fill the osseous defects with various degrees of success. The aim of the present study was to explore the utilization of membrane barriers and the principle of guided bone regeneration to negotiate these defects. Methods: Following the removal of P1, P2, and P3, experimental bilateral marginal mandibulectomy defects were created in 4 adult dogs. The bone segments (measuring 25 mm × 15 mm) were then removed. Each side was then randomly selected for either experimental (titanium‐reinforced expanded polytetrafluoroethylene membrane, [ePTFE‐TR]) or control (repositioning flaps) treatment. Postoperatively, the animals were put on soft diet, antibiotics, and analgesics. Sutures were removed under light sedation after 4 weeks, and the area was left to heal and mature for 4 to 6 months (mean 5.3 months). The animals were then sacrificed, and block sections of the mandible were obtained for macroscopic and histological evaluation. Results: The size of the residual defect (the vertical distance between the most apical depression in the ridge and the horizontal line connecting the free gingival margins of the proximal teeth) in the experimental sites (6.10 ± 1.00 mm) was much smaller compared to the controls (10.65 ± 0.82 mm), which was statistically significant (P = 0.0127). Histomorphometric measurements of new bone formation (NBF) revealed a similar pattern: for the experimental sites, NBF was 8.08 ± 0.85 mm compared to 4.99 ± 0.61 mm in the controls. These differences were also statistically significant (P = 0.0257). Conclusions: A regenerative approach to large mandibular osseous defects has been described. If this new treatment modality is further substantiated in other independent studies, it might prove a useful tool in restoring the lost osseous structure associated with marginal mandibulectomy procedures. J Periodontol 2002;73:1451‐1456.
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ISSN:0022-3492
1943-3670
DOI:10.1902/jop.2002.73.12.1451