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Enhancing mandibular bone regeneration and perfusion via axial vascularization of scaffolds

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Abstract

Objective

Reconstruction of large and complex bone segments is a challenging problem facing maxillofacial surgery. The majority of current regenerative approaches rely on extrinsic vascularization, which is deficient after cancer ablation and irradiation. The aim of the study was to investigate the efficacy of intrinsic axial vascularization of synthetic bone scaffolds in the management of critical-size mandibular defects.

Materials and methods

Scaffold-guided mandibular regeneration in two groups of adult male goats was compared. Only the scaffolds of the second group were axially vascularized via in situ embedding of an arteriovenous loop through microsurgical anastomosis of facial vessels. After 6 months of follow up, both groups were compared through radiological, biomechanical, histological and histomorphometric analysis.

Results

The axially vascularized constructs have showed significantly more central vascularization (p = 0.021) and markedly enhanced central bone formation (p = 0.08). The biomechanical characteristics were enhanced, but the difference between both groups was not statistically significant (p = 0.98).

Conclusions

Axially vascularized synthetic mandibular grafts show better vascularization at their central regions, permitting more efficient bone regeneration.

Clinical relevance

The encouraging results of the proposed technique could be of benefit in optimizing the reconstruction of large critical-size bone defects.

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Acknowledgments

The authors would like to acknowledge Mrs. Arnold, Mr. Fleischer and Mrs. Weigand for their valuable technical assistance. Some results were presented in the doctoral thesis of Dr. Eweida. The study was funded by a research grant from Alexandria University (AlexREP).

Conflict of interest

The authors declare that there are no conflicts of interest.

Author information

Authors and Affiliations

  1. Head and Neck and Endocrine Surgery, Faculty of Medicine, University of Alexandria, Elkhartoum Square, Alexandria, 21131, Egypt

    Ahmad Mahmoud Eweida, Ayman Sameh Nabawi, Habashi Elhammady, Mohamed Rafik Khalil & Michael Samir Shawky

  2. Tissue Engineering Laboratories, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt

    Ahmad Mahmoud Eweida, Naglaa Nagy & Mona Kamal Marei

  3. Department of Plastic Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Mohamed Abouarab

  4. Department of Radiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Mohamed Kayed & Ashraf Etaby

  5. Department of Plastic Surgery, University of Heidelberg, Seminarstr. 2, 69117, Heidelberg, Germany

    Ulrich Kneser

  6. Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center, Ludwigshafen, Germany

    Ulrich Kneser

  7. Plastic, Reconstructive and Hand Surgery Department, Hospital Erlangen, Friedrich Alexander University of Erlangen–Nuremberg, Erlangen, Germany

    Raymund E. Horch

  8. Tissue Engineering Laboratories, University Hospital Erlangen, Friedrich Alexander University of Erlangen–Nuremberg, Erlangen, Germany

    Raymund E. Horch

  9. Department of Oral Biology, Faculty of Dentistry, Tanta University, Gharbia, Egypt

    Naglaa Nagy

  10. Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

    Mona Kamal Marei

Authors
  1. Ahmad Mahmoud Eweida
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  2. Ayman Sameh Nabawi
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  3. Mohamed Abouarab
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  4. Mohamed Kayed
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  7. Mohamed Rafik Khalil
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  8. Michael Samir Shawky
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  9. Ulrich Kneser
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  10. Raymund E. Horch
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  12. Mona Kamal Marei
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Correspondence to Ahmad Mahmoud Eweida.

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Eweida, A.M., Nabawi, A.S., Abouarab, M. et al. Enhancing mandibular bone regeneration and perfusion via axial vascularization of scaffolds. Clin Oral Invest 18, 1671–1678 (2014). https://doi.org/10.1007/s00784-013-1143-8

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  • DOI: https://doi.org/10.1007/s00784-013-1143-8

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