Mandibular Defect Reconstruction Using Tissue Engineering: Case Report and Long-Term Follow-Up.

Abstract

Tissue engineering is a new alternative for the treatment of severe mandibular defects, due to its low morbidity and predictability. Specifically, the use of adipose-derived stem cells (ADSc) combined with ceramic substitute like β-TCP. A male patient comes private clinic of Rodrigo Fariña, due to slow-growing and asymptomatic right facial asymmetry. The CT shows a unilocular radiolucent area of 6 cm in its longest axis with defined borders causing rizalysis of adjacent teeth in the right mandibular body. Histopathological examination after incisional biopsy, it´s diagnoses was plexiform unicystic ameloblastoma. Prior to surgical intervention, abdominal adipose tissue was collected for culture with osteoinductive media, in this case ascorbic acid and dexamethasone co-cultivated with blocks of β-TCP. One months later, the mandibular segmental resection with a safety edge is performed where, in the same surgical act, the combination of ADSc and the β-TCP is placed on a titanium mesh at the resection site. Six months later, a biopsy is performed that corroborates the bone neoformation where it is decided to carry out dental rehabilitation on osseointegrated implants. The combination of biomaterials in conjunction with ADSc allows an effective therapy, with a good prognosis for the treatment of severe mandibular defects caused by benign neoplasms.