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KMID : 0355619950210040641
Journal of Korean Association of Oral and Maxillofacial Surgeons
1995 Volume.21 No. 4 p.641 ~ p.651
Immediate mandibular reconstruction with autoclaved autogenous reimplant


Abstract
Three cases of mandible reconstruction by immediate reimplanting, either with or without PMCB graft, of autoclaved autogenous bone obtained by partial mandiblectomy were experienced. In one case, reconstruction failed because of oral mucosa
perforation
and exposure of the graft leading to the lysis of the graft. However, in two other cases, we obtained a good functional and esthetic result without foreign body reaction Harding described in 1957. At two years after reimplantation, the graft
incorporation looked good radiographically. During the procedure of metal removal performed 2 years after reimplantation, a clinically good graft incorporation without bony bleeding from the graft were observed. However, microscopically the
grafted
bone
tissue appeared necrotic and osteoporotic without ingrowth of new bone tissue three and a half years after reimplantation, respectively. Based on these results, autoclaved grafts might remodel themselves without foreign body reaction although
remodeling
takes longer than in fresh autogenous grafts. It appears that autogenous reimplantating as used here has the advantage of providing the framework, whose shape could be tailored bo fit the mandibular defecy, for new bone growth to take place in
it.
In
combination with PMCB and rigid fixation, autoclaved autogenous reimplants may be useful in cases where structural mandibular defects need to be corrected minimizing loss of the patient's previous mandibular contour.
KEYWORD
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