Claudius Steffen, Ana Prates Soares, Thelma Heintzelmann, Heilwig Fischer, Jan Oliver Voss, Susanne Nahles, Jonas Wüster, Steffen Koerdt, Max Heiland, Carsten Rendenbach
{"title":"腓骨游离皮瓣重建下颌骨时邻骨对假关节形成的影响。","authors":"Claudius Steffen, Ana Prates Soares, Thelma Heintzelmann, Heilwig Fischer, Jan Oliver Voss, Susanne Nahles, Jonas Wüster, Steffen Koerdt, Max Heiland, Carsten Rendenbach","doi":"10.1186/s13005-023-00389-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Mechanical and morphological factors have both been described to influence the rate of pseudarthrosis in mandibular reconstruction. By minimizing mechanical confounders, the present study aims to evaluate the impact of bone origin at the intersegmental gap on osseous union.</p><p><strong>Methods: </strong>Patients were screened retrospectively for undergoing multi-segment fibula free flap reconstruction of the mandible including the anterior part of the mandible and osteosynthesis using patient-specific 3D-printed titanium reconstruction plates. Percentage changes in bone volume and width at the bone interface between the fibula/fibula and fibula/mandible at the anterior intersegmental gaps within the same patient were determined using cone-beam computed tomography (CBCT). Additionally, representative samples of the intersegmental zones were assessed histologically and using micro-computed tomography (µCT).</p><p><strong>Results: </strong>The bone interface (p = 0.223) did not significantly impact the change in bone volume at the intersegmental gap. Radiotherapy (p < 0.001), time between CBCT scans (p = 0.006) and wound healing disorders (p = 0.005) were independent risk factors for osseous non-union. Preliminary analysis of the microstructure of the intersegmental bone did not indicate morphological differences between fibula-fibula and fibula-mandible intersegmental bones.</p><p><strong>Conclusions: </strong>The bone interface at the intersegmental gap in mandibular reconstruction did not influence long-term bone healing significantly. Mechanical and clinical properties seem to be more relevant for surgical success.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"19 1","pages":"43"},"PeriodicalIF":2.4000,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546678/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of the adjacent bone on pseudarthrosis in mandibular reconstruction with fibula free flaps.\",\"authors\":\"Claudius Steffen, Ana Prates Soares, Thelma Heintzelmann, Heilwig Fischer, Jan Oliver Voss, Susanne Nahles, Jonas Wüster, Steffen Koerdt, Max Heiland, Carsten Rendenbach\",\"doi\":\"10.1186/s13005-023-00389-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Mechanical and morphological factors have both been described to influence the rate of pseudarthrosis in mandibular reconstruction. By minimizing mechanical confounders, the present study aims to evaluate the impact of bone origin at the intersegmental gap on osseous union.</p><p><strong>Methods: </strong>Patients were screened retrospectively for undergoing multi-segment fibula free flap reconstruction of the mandible including the anterior part of the mandible and osteosynthesis using patient-specific 3D-printed titanium reconstruction plates. Percentage changes in bone volume and width at the bone interface between the fibula/fibula and fibula/mandible at the anterior intersegmental gaps within the same patient were determined using cone-beam computed tomography (CBCT). Additionally, representative samples of the intersegmental zones were assessed histologically and using micro-computed tomography (µCT).</p><p><strong>Results: </strong>The bone interface (p = 0.223) did not significantly impact the change in bone volume at the intersegmental gap. Radiotherapy (p < 0.001), time between CBCT scans (p = 0.006) and wound healing disorders (p = 0.005) were independent risk factors for osseous non-union. Preliminary analysis of the microstructure of the intersegmental bone did not indicate morphological differences between fibula-fibula and fibula-mandible intersegmental bones.</p><p><strong>Conclusions: </strong>The bone interface at the intersegmental gap in mandibular reconstruction did not influence long-term bone healing significantly. Mechanical and clinical properties seem to be more relevant for surgical success.</p>\",\"PeriodicalId\":12994,\"journal\":{\"name\":\"Head & Face Medicine\",\"volume\":\"19 1\",\"pages\":\"43\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2023-10-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546678/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Head & Face Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13005-023-00389-8\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Head & Face Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13005-023-00389-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Impact of the adjacent bone on pseudarthrosis in mandibular reconstruction with fibula free flaps.
Background: Mechanical and morphological factors have both been described to influence the rate of pseudarthrosis in mandibular reconstruction. By minimizing mechanical confounders, the present study aims to evaluate the impact of bone origin at the intersegmental gap on osseous union.
Methods: Patients were screened retrospectively for undergoing multi-segment fibula free flap reconstruction of the mandible including the anterior part of the mandible and osteosynthesis using patient-specific 3D-printed titanium reconstruction plates. Percentage changes in bone volume and width at the bone interface between the fibula/fibula and fibula/mandible at the anterior intersegmental gaps within the same patient were determined using cone-beam computed tomography (CBCT). Additionally, representative samples of the intersegmental zones were assessed histologically and using micro-computed tomography (µCT).
Results: The bone interface (p = 0.223) did not significantly impact the change in bone volume at the intersegmental gap. Radiotherapy (p < 0.001), time between CBCT scans (p = 0.006) and wound healing disorders (p = 0.005) were independent risk factors for osseous non-union. Preliminary analysis of the microstructure of the intersegmental bone did not indicate morphological differences between fibula-fibula and fibula-mandible intersegmental bones.
Conclusions: The bone interface at the intersegmental gap in mandibular reconstruction did not influence long-term bone healing significantly. Mechanical and clinical properties seem to be more relevant for surgical success.
期刊介绍:
Head & Face Medicine is a multidisciplinary open access journal that publishes basic and clinical research concerning all aspects of cranial, facial and oral conditions.
The journal covers all aspects of cranial, facial and oral diseases and their management. It has been designed as a multidisciplinary journal for clinicians and researchers involved in the diagnostic and therapeutic aspects of diseases which affect the human head and face. The journal is wide-ranging, covering the development, aetiology, epidemiology and therapy of head and face diseases to the basic science that underlies these diseases. Management of head and face diseases includes all aspects of surgical and non-surgical treatments including psychopharmacological therapies.