EFFICACY OF TWO DIFFERENT RECONSTRUCTION MODALITIES AFTER SURGICAL RESECTION OF MANDIBULAR FIBROUS DYSPLASIA (A CLINICAL STUDY)

Document Type : Original Article

Authors

1 Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry, Suez Canal University

2 Lecturer of Oral and Maxillofacial Surgery, Faculty of Dental Medicine (Assiut) - Al-Azhar University

3 Lecturer of Plastic Surgery, Faculty of Medicine , Suez Canal University

Abstract

Objective: To evaluate efficacy of Nonvascularized bone graft ( NVBG) with bone marrow aspirate concentrate (BMAC) compared with free vascularized fibula graft in reconstruction of mandible after surgical treatment of monostatic mandibular fibrous Dysplasia.
Patients and methods: The present study was carried out of three years on 14 patients (8 males & 6 female) ranging from 9- 18 years who had monostatic fibrous dysplasia and need segmental resection and immediate reconstruction. The patients were divided randomly into two equal groups; group I patients grafted with free vascularized fibula graft after segmental resection and group II patients grafted with iliac crest or rib bone graft and injected with BMAC at surgical site after radical excision of lesion. They were selected from those attending the out patient clinic at Faculty of Dental Medicine, Al Azhar University, Assuit branch and the Faculty of Dentistry,
in coordination with Plastic Surgery at Suez Canal University Hospital over a period of 4 years (July 2013 –July 2017). Postoperative clinical, radiographic evaluation were performed at 6 month and 12 month till two years after that to assess recurrence of lesion and bone graft density.
Results: Both groups was clinically uneventful except two cases in group I and one case in group II .All patients had adequate facial contour, proper facial symmetry and good take post operatively. Radiographic evaluation showed at six month, there was a highly statistically significant difference between two groups. This means that, newly formed bone of group I was significantly denser than group II. At 12 months, the mean of the group I was more than the mean of group II . These showed a difference between means of two groups but this difference was not a statistically significant .
Conclusion: Conventional grafting techniques with NVBGs improved by BMAC injection with satisfactory outcomes . Thereby it can be used as alternative modality for free vascularized bone graft in mandibular reconstruction in cases with massive monostatic fibrous dysplasia depend on the size of the lesion

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