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J Oral Maxillofac Surg ; 73(1): 195.e1-16, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25511969

RESUMEN

PURPOSE: Many types of soft tissue grafts have been used for grafting or prelaminating bone flaps for intraoral lining reconstruction. The best results are achieved when prelaminating free flaps with mucosal grafts. We suggest a new approach to obtain keratinized mucosa over a fibula flap using full-thickness, engineered, autologous oral mucosa. PATIENTS AND METHODS: We report on a pilot study for grafting fibula flaps for mandibular and maxilla reconstruction with full-thickness tissue-engineered autologous oral mucosa. We describe 2 different techniques: prelaminating the fibula flap and second-stage grafting of the fibula after mandibular reconstruction. Preparation of the full-thickness tissue-engineered oral mucosa is also described. RESULTS: The clinical outcome of the tissue-engineered intraoral lining reconstruction and response after implant placement are reported. A peri-implant granulation tissue response was not observed when prelaminating the fibula, and little response was observed when intraoral grafting was performed. CONCLUSION: Tissue engineering represents an alternative method by which to obtain sufficient autologous tissue for reconstructing mucosal oral defects. The full-thickness engineered autologous oral mucosa offers definite advantages in terms of reconstruction planning, donor site morbidity, and quality of the intraoral soft tissue reconstruction, thereby restoring native tissue and avoiding peri-implant tissue complications.


Asunto(s)
Trasplante Óseo/métodos , Colgajos Tisulares Libres/trasplante , Mandíbula/cirugía , Maxilar/cirugía , Mucosa Bucal/trasplante , Procedimientos de Cirugía Plástica/métodos , Ingeniería de Tejidos/métodos , Aumento de la Cresta Alveolar/métodos , Autoinjertos/trasplante , Carcinoma Mucoepidermoide/cirugía , Técnicas de Cultivo de Célula , Implantación Dental Endoósea/métodos , Femenino , Fibroblastos/fisiología , Peroné/trasplante , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Queratinocitos/fisiología , Masculino , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Mucosa Bucal/citología , Proyectos Piloto , Andamios del Tejido , Resultado del Tratamiento
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