Reconstruction of a post-traumatic maxillary ridge using a radial forearm free flap and immediate tissue engineering (Bone Morphogenetic Protein, Bone Marrow Aspirate concentrate and Cortical-cancellous Bone). Case report

• Published in: Journal of oral and maxillofacial surgery Vol. 75; no. 2; pp. 438.e1 - 438.e6
• Main Authors: Melville, James C., DDS FACS, Tursun, Ramzey, DDS, Green, J. Marshall, DDS, Marx, Robert E., DDS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2017
• Subjects: Bone Marrow Transplantation - methods; Bone Morphogenetic Proteins - therapeutic use; Bone Substitutes - therapeutic use; Bone Transplantation; Cone-Beam Computed Tomography; Dentistry; Female; Forearm - surgery; Free Tissue Flaps - surgery; Humans; Maxilla - growth & development; Maxilla - surgery; Maxillary Fractures - diagnostic imaging; Maxillary Fractures - surgery; Middle Aged; Radiography, Panoramic; Radius - transplantation; Reconstructive Surgical Procedures - methods; Surgery; Surgical Mesh; Tissue Engineering - methods
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2016.11.001

The purpose of this article is to describe reconstruction of the maxillary alveolar ridge by use of a microvascular free flap combined with an immediate tissue-engineered bone graft. This novel surgical technique involved the use of a radial forearm free flap and immediate allogeneic avascular bone graft augmented with bone morphogenetic protein and bone marrow aspirate concentrate. A poly-d,l-lactic acid mesh was used as a containment unit for the bone graft. The patient was successfully treated with a viable radial forearm free flap for soft tissue and regeneration of bone with adequate height and width, which allowed the placement of 3 dental implants with excellent arch coordination. We believe this is the first published case describing such a technique to reconstruct the maxillary alveolus.