Nonvascularized bone grafts: how successful are they in reconstruction of segmental mandibular defects?

OBJECTIVE: Segmental mandibular defects can occur due to various etiologies, including trauma and tumor resection. Reconstruction should provide adequate support for subsequent dental rehabilitation and allow for proper occlusion. Nonvascularized bone grafts have been used for reconstructing mandibular defects in cases where vascularized grafts were not feasible. The objective of this study was to assess the success rate of these grafts in reconstruction of segmental defects of various sizes in the mandible. STUDY DESIGN: Fifty patients were included in this retrospective chart review. Length of the grafts varied from 3 to 20 cm and patients were followed up from 4 to 80 months. Fifteen grafts were harvested from anterior iliac crest, 23 from posterior iliac crest, 9 grafts were a combination of either with costochondral graft, and 3 were solely allografts. Bone morphogenetic protein was utilized in 41 cases as an adjunct. RESULTS: Success was defined as continuity of bone clinically and radiographically at a 4-month follow-up. Nonvascularized bone grafting was successful in 90% of cases. Complications were observed in 34% of cases, of which the most common were infection followed by wound dehiscence. CONCLUSIONS: Our study demonstrated substantial success rate with nonvascularized bone grafts in reconstruction of segmental mandibular defects.

Multiplex real-time PCR detection and relative quantification of periodontal pathogens.

Periodontitis is a chronic inflammatory disease, which is strongly associated with certain pathogenic bacteria. The aim of this study was to develop a real-time multiplex polymerase chain reaction (PCR) assay to detect and quantify bacterial species associated with periodontitis. We targeted detection and relative quantification of the following five bacterial species relevant to periodontal diseases: Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. The conserved regions of the genome of these species were targeted with oligos and TaqMan probes in real-time PCR assays. The species-specific TaqMan oligos and TaqMan probes showed no cross-amplification, and there was no loss of amplification yield in multiplex real-time PCR assays. All five bacterial targets were amplified analogous to the template concentrations used in these assays. This multiplex real-time PCR strategy could potentially be used to detect the bacterial species in periodontal pockets of patients with periodontal diseases. This assay may also serve as a quick tool for profiling and quantifying bacteria relevant to periodontal diseases and likely be a valuable tool for clinical translational research.