Oral and Maxillofacial Surgery
Bone regeneration after enucleation of mandibular cysts: Comparing autogenous grafts from tissue-engineered bone and iliac bone

https://doi.org/10.1016/j.tripleo.2005.06.001Get rights and content

Objective

The aim of this study was to compare bone regeneration after grafting enucleated mandibular cyst cavities using either autogenous osteoblasts cultured on a biomaterial or autogenous spongiose iliac bone.

Study design

Twenty patients with 22 mandibular cysts were assessed. Eleven cysts were filled in with tissue-engineered bone (autogenous osteblasts cultured on demineralized bone matrix Osteovit) and 11 with spongiose iliac bone as controls. Panoramic radiographs were taken preoperatively, immediately postoperatively, and 3, 6, and 12 months after surgery. Radiolucency was computer analyzed using gray-level histograms.

Results

In both groups bone regeneration took place in a similar fashion. After 3 and 6 months there were few differences in bone density between the groups. However, in radiographic controls after 12 months ossification was considerably stronger in cysts grafted with tissue-engineered bone.

Conclusion

These results advocate for the clinical application of tissue-engineered bone as an alternative viable filling material for cysts.

Section snippets

Patients

The study included 20 patients, 5 females and 15 males, mean age 45.6 years (range 16-72 years), treated from 1998 to 2003 at the Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Germany. All patients underwent enucleation of mandibular cysts. Nine patients (test group) received tissue-engineered bone (autogenous osteoblasts in collagen-based scaffolds) as filler of 11 cavities (in 2 patients, 2 cysts were filled), and for the

Results

In both groups the clinical healing patterns were similar. In 6 patients of the test group 7 wounds healed by secondary intention; in the control group wound dehiscences were observed in 6 patients, too. All these wounds were without any signs of acute infection and healed during follow-up applying local disinfecting rinses with iodine and saline. From the 20 patients a total of 104 panoramic radiographs were evaluated: 22 preoperative, 22 immediately postoperative, 17 after 3 months, 21 after

Discussion

Transplantation of autogenous bone is one of the most frequent operations of reconstructive oral and maxillofacial surgery. The filling of bone defects with autogenous bone accelerates the formation of new bone and maintains the shape of the bone. For a long time there has been a search for alternatives to autogenous bone graft to avoid donor site morbidity. Different biomaterials have been in use to fill mandibular cyst cavities after enucleation. Demineralized allogenic bone matrix has led to

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The study was supported by a grant of the ITI Foundation (197/2000 RCL) and by Sächsiches Ministerium für Wissenschaft und Kultur—Verbundprojekt (7531.50-03-0370-01/9;UT 48). Parts of this study were presented at the 9th Congress of the Austrian Association for Cranio-Maxillofacial Surgery, Bad Hofgastein, Austria, Feb 1-5, 2005.

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